scholarly journals Insulin Secretory Defect and Insulin Resistance in Isolated Impaired Fasting Glucose and Isolated Impaired Glucose Tolerance

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Sae Aoyama-Sasabe ◽  
Mitsuo Fukushima ◽  
Xin Xin ◽  
Ataru Taniguchi ◽  
Yoshikatsu Nakai ◽  
...  

Objective.To investigate the characteristics of isolated impaired glucose tolerance (IGT) and isolated impaired fasting glucose (IFG), we analyzed the factors responsible for elevation of 2-hour postchallenge plasma glucose (2 h PG) and fasting plasma glucose (FPG) levels.Methods.We investigated the relationship between 2 h PG and FPG levels who underwent 75 g OGTT in 5620 Japanese subjects at initial examination for medical check-up. We compared clinical characteristics between isolated IGT and isolated IFG and analyzed the relationships of 2 h PG and FPG with clinical characteristics, the indices of insulin secretory capacity, and insulin sensitivity.Results.In a comparison between isolated IGT and isolated IFG, insulinogenic index was lower in isolated IGT than that of isolated IFG (0.43 ± 0.34 versus 0.50 ± 0.47, resp.;p<0.01). ISI composite was lower in isolated IFG than that of isolated IGT (6.87 ± 3.38 versus 7.98 ± 4.03, resp.;p<0.0001). In isolated IGT group, insulinogenic index showed a significant correlation with 2 h PG (r=-0.245,p<0.0001) and had the strongest correlation with 2 h PG (β=-0.290). In isolated IFG group, ISI composite showed a significant correlation with FPG (r=-0.162,p<0.0001) and had the strongest correlation with FPG (β=-0.214).Conclusions.We have elucidated that decreased early-phase insulin secretion is the most important factor responsible for elevation of 2 h PG levels in isolated IGT subjects, and decreased insulin sensitivity is the most important factor responsible for elevation of FPG levels in isolated IFG subjects.

2014 ◽  
Vol 34 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Vera Zdravković ◽  
Silvija Sajić ◽  
Jadranka Mitrović ◽  
Igor Stefanović ◽  
Polina Pavićević ◽  
...  

Summary Background: Prediabetes is characterized by isolated impaired fasting glucose (IFG), isolated impaired glucose tolerance (IGT), and combined IFG/IGT. This study aimed to establish the prevalence of prediabetes and examine possible contributory factors in a cohort of obese adolescents. Methods: In this prospective study, we recruited 85 obese patients from the Obesity Clinic at the University Children’s Hospital and 17 normal weight controls. All patients were of Caucasian origin, 60 males/42 females, aged 7.4-18.3 years, with at least Tanner 2 stage of puberty. Results: Depending on criteria we used, insulin resistance was confirmed in 62-100% of obese patients, predominantly in the group with BMI SDS > 3. oGTT revealed isolated impaired fasting glucose (IFG) in 13.9%, impaired glucose tolerance (IGT) in 20.8% and combined IFG and IGT only in 2.8% of the obese patients. Patients in the prediabetes group were older (14±2.4 vs 12.8±2.5 p=0.04) and had higher glucose levels (p<0.001) during the whole oGTT compared to normal glucose tolerance (NGT) group. There was no difference between groups in respect to family history, BMI, lipids and fasting insulin. Insulinogenic index, WBISI and HOMA%B were significantly lower in the prediabetes group compared to the NGT group (p=0.07, 0.01 and 0.04 respectively). HbA1c level was measured in 58% of patients and was significantly higher in the prediabetes group (5.4±0.3 vs 5.7±0.4, p=0.002). Conclusion: Prediabetes occurrence was fairly high in our obese adolescents. Further studies should establish what would be the most appropriate screening test to diagnose these patients at risk for type 2 diabetes and initiate treatment without delay.


2019 ◽  
Vol 16 (4) ◽  
pp. 337-343
Author(s):  
Fahim Abbasi ◽  
Paul JW Tern ◽  
Gerald M Reaven

Aim: The aim of this study was to gain insight into the pathophysiological significance of elevated plasma glucose concentrations (mmol/L) 60 min post oral glucose load in apparently healthy individuals. Methods: Comparison of resistance to insulin action and associated cardio-metabolic risk factors in 490 apparently healthy persons, subdivided into those with a plasma glucose concentration 60 min following a 75-g oral glucose challenge of <8.6 versus ⩾8.6. Results: Insulin resistance was significantly greater in persons with normal glucose tolerance whose 60-min glucose concentration was ⩾8.6, associated with higher blood pressure, plasma concentrations of glucose, insulin, triglyceride and lower high-density lipoprotein cholesterol concentrations. Similar differences were seen in persons with impaired fasting glucose, but not in those with impaired glucose tolerance or both impaired fasting glucose and impaired glucose tolerance. The group whose 60-min glucose was <8.6 ( n = 318) contained primarily persons with normal glucose tolerance (88%), whereas the majority of those whose 60-min value was ⩾8.6 ( n = 172) had prediabetes (59%) and in particular combined impaired fasting glucose and impaired glucose tolerance. Conclusion: Plasma glucose concentration of ⩾8.6 mmol/L 60 min post oral glucose identifies higher proportions of combined impaired fasting glucose and impaired glucose tolerance individuals as well as normal glucose tolerance and impaired fasting glucose individuals with a more adverse cardio-metabolic profile, contributing to observed increased overall risk of type 2 diabetes and other metabolic diseases.


2020 ◽  
Vol 103 (8) ◽  
pp. 829-836

It is well established that individuals who have prediabetes either impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) have high risk to develop diabetes. However, it is unclear whether the rate of progression to diabetes is different between these two categories. Lifestyle modification has been recommended for diabetes prevention in these high-risk groups. However, given the differences in their pathophysiology, it is possible that these subtypes of prediabetes condition may have different responses to lifestyle modification. The present review was to summarize the risk of progression to diabetes and the effectiveness of lifestyle intervention for diabetes prevention in individuals who have isolated IGT or isolated IFG or combined. The risk of progression to diabetes is highest in combined IFG and IGT subtype. Individuals who have isolated IFG by the American Diabetes Association criteria (100 to 125 mg/dl) has lower risk of progression to diabetes than those with World Health Organization criteria (110 to 125 mg/dl) and the latter has similar or higher risk of incident diabetes than those with isolated IGT. Lifestyle modification is most effective in individuals with IGT (with or without IFG) but is less effective in those with isolated IFG. In conclusion, The risk of progression to diabetes and the effectiveness of lifestyle intervention for diabetes prevention are disparate between prediabetes subtypes. Given the paucity of diabetes prevention data in individuals with isolated IFG, more studies dedicated to this subtype is required. Keywords: Impaired fasting glucose, Impaired glucose tolerance, Prediabetes, Type 2 diabetes, Lifestyle intervention, Diabetes prevention


2008 ◽  
Vol 25 (8) ◽  
pp. 1008-1010 ◽  
Author(s):  
R. Oka ◽  
K. Yagi ◽  
S. Hifumi ◽  
S. Miyamoto ◽  
H. Mabuchi ◽  
...  

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