Pathogenic factors of glucose intolerance in obese Japanese adolescents with type 2 diabetes.

Abstract

We attempted to identify the pathogenic factors involved in the progression to type 2 diabetes in obese Japanese adolescents. Subjects included 18 nondiabetic obese adolescents, 12 obese adolescents with type 2 diabetes on diet therapy, 10 obese adolescents with type 2 diabetes manifesting ketosis at onset or with a history of treatment with hypoglycemic agents, and 26 non-obese adolescent control subjects. The first-phase insulin response (FPIR), glucose disappearance constant (Kg), glucose effectiveness (Sg), and insulin sensitivity (S(I)) were obtained using an insulin-modified frequently sampled intravenous glucose tolerance test (FSIGT) and a minimal model analysis. The disposition index (DI, by FPIR x S(I)) was determined to assess any endogenous insulin effect. The results showed that Kg was decreased significantly (P = .0006) with the progression to severe diabetes in the obese groups. Although S(I) and Sg did not differ significantly among the 3 obese groups, both parameters were significantly lower in each obese group versus the non-obese controls. As a result of the significant decrease in FPIR (P < .0001), the DI decreased (P = .0006) with the progression to severe diabetes in the obese groups. In conclusion, an early manifestation of type 2 diabetes with occasional ketosis at onset may result from beta-cell dysfunction to glucose stimulation. This finding is demonstrated by the relatively low FPIR to decreased S(I) in obese Japanese adolescents, as well as the low Sg as a synergic role in glucose intolerance. The present findings from a Japanese population for pathogenic factors aside from obesity may help us to gain a better understanding of the progression to adolescent, early-onset, obese type 2 diabetes and its severity.

• Authors: K Kobayashi, S Amemiya, K Higashida, T Ishihara, E Sawanobori, K Kobayashi, M Mochizuki, N Kikuchi, K Tokuyama, S Nakazawa
• Journal: Metabolism: clinical and experimental (Metabolism) Vol. 49 Issue 2 Pg. 186-91 (Feb 2000) ISSN: 0026-0495 [Print] United States
• PMID: 10690942 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Hypoglycemic Agents
• Insulin

Topics

• Adolescent
• Blood Glucose (metabolism)
• Diabetes Mellitus (drug therapy, metabolism)
• Diabetes Mellitus, Type 2 (metabolism)
• Disease Progression
• Female
• Glucose Intolerance (metabolism)
• Glucose Tolerance Test
• Homeostasis (physiology)
• Humans
• Hypoglycemic Agents (therapeutic use)
• Immunoenzyme Techniques
• Insulin (therapeutic use)
• Male
• Models, Biological
• Obesity