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

Metabolism. 2000 Feb;49(2):186-91. doi: 10.1016/s0026-0495(00)91221-6.

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.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Blood Glucose / metabolism
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / 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*

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin