Abstract | OBJECTIVE: RESEARCH DESIGN AND METHODS: Sixteen Ab- and 26 Ab+ clinically diagnosed type 2 diabetic patients and 39 obese control youth underwent evaluation of insulin sensitivity (3-h hyperinsulinemic-euglycemic clamp), substrate oxidation (indirect calorimetry), first- and second-phase insulin secretion (2-h hyperglycemic clamp), body composition and abdominal adiposity (dual energy X-ray absorptiometry and computed tomography scan, respectively), and glucose disposition index (first-phase insulin secretion x insulin sensitivity). RESULTS:
Insulin-stimulated total, oxidative, and nonoxidative glucose disposal, and suppression of fat oxidation during hyperinsulinemia were significantly lower in Ab- compared with Ab+ clinically diagnosed type 2 diabetic and control subjects with no difference between the latter two. First- and second-phase insulin secretion and C-peptide were lower in Ab+ compared with Ab- type 2 diabetes. Glucose disposition index was not different between the Ab- and Ab+ clinically diagnosed type 2 diabetic patients, but both were significantly lower than that in control subjects. Systolic blood pressure and alanine aminotransferase were higher in Ab- versus Ab+ clinically diagnosed type 2 diabetic patients, whereas the frequency of ketonuria at diagnosis was higher in Ab+ versus Ab- patients. CONCLUSIONS: Islet-cell Ab- clinically diagnosed type 2 diabetic youth are characterized by severe insulin resistance and relative insulin deficiency, whereas Ab+ youth have severe insulin deficiency and beta-cell failure. The former group has additional features of insulin resistance. These important metabolic differences could influence the natural history of hyperglycemia, insulin dependence, and clinical outcomes in these youth.
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Authors | Hala Tfayli, Fida Bacha, Neslihan Gungor, Silva Arslanian |
Journal | Diabetes
(Diabetes)
Vol. 58
Issue 3
Pg. 738-44
(Mar 2009)
ISSN: 1939-327X [Electronic] United States |
PMID | 19073767
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Autoantibodies
- Blood Glucose
- Insulin
- islet cell antibody
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Topics |
- Autoantibodies
(analysis)
- Black People
- Blood Glucose
(drug effects, metabolism)
- Blood Pressure
- Body Composition
- Child
- Chromatography, High Pressure Liquid
- Diabetes Mellitus, Type 2
(genetics, immunology)
- Female
- Glucose Clamp Technique
- Humans
- Insulin
(metabolism, pharmacology)
- Insulin Secretion
- Obesity
(immunology)
- White People
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