OBJECTIVE: To compare oral glucose tolerance test (OGTT) glucose, C-peptide, and insulin responses and insulin sensitivity in youth and adults with impaired glucose tolerance (IGT) or recently diagnosed type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 66 youth (80.3% with IGT) and 355 adults (70.7% with IGT) underwent a 3-h OGTT to assess 1) insulin sensitivity (1/fasting insulin), 2) C-peptide index (CPI) and insulinogenic index (IGI) over the first 30 min, and 3) glucose, C-peptide, and insulin incremental areas above fasting over the 3-h post-ingestion (incremental glucose [G-iAUC], incremental C-peptide [CP-iAUC], and incremental insulin area under the curve [I-iAUC] responses, respectively). RESULTS:Fasting, 2-h glucose, and G-iAUC were similar in both age-groups, but youth had ∼50% lower 1/fasting insulin (P < 0.001), 75% higher CPI (mean [95% CI] 0.703 [0.226, 2.183] vs. 0.401 [0.136, 1.183] nmol/mmol; P < 0.001), and more than twofold higher IGI (257.3 [54.5, 1,215.8] vs. 114.8 [28.0, 470.8] pmol/mmol; P < 0.001). Two-hour C-peptide and insulin concentrations, CP-iAUC, and I-iAUC were all higher in youth (all P < 0.001). C-peptide and insulin responses remained significantly greater in youth after adjustment for insulin sensitivity. Within each age-group, individuals with type 2 diabetes versus IGT had significantly lower CPI and IGI with no difference in insulin sensitivity. CONCLUSIONS: The balance between insulin sensitivity and β-cell responses differs between youth and adults with IGT or recently diagnosed type 2 diabetes. Despite similar postload glucose levels, youth demonstrate greater C-peptide and insulin responses that exceed what is needed to compensate for their lower insulin sensitivity. Longitudinal studies are required to determine whether this feature contributes to a more rapid decline in β-cell function in youth with dysglycemia.
RCT Entities:
OBJECTIVE: To compare oral glucose tolerance test (OGTT) glucose, C-peptide, and insulin responses and insulin sensitivity in youth and adults with impaired glucose tolerance (IGT) or recently diagnosed type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 66 youth (80.3% with IGT) and 355 adults (70.7% with IGT) underwent a 3-h OGTT to assess 1) insulin sensitivity (1/fasting insulin), 2) C-peptide index (CPI) and insulinogenic index (IGI) over the first 30 min, and 3) glucose, C-peptide, and insulin incremental areas above fasting over the 3-h post-ingestion (incremental glucose [G-iAUC], incremental C-peptide [CP-iAUC], and incremental insulin area under the curve [I-iAUC] responses, respectively). RESULTS: Fasting, 2-h glucose, and G-iAUC were similar in both age-groups, but youth had ∼50% lower 1/fasting insulin (P < 0.001), 75% higher CPI (mean [95% CI] 0.703 [0.226, 2.183] vs. 0.401 [0.136, 1.183] nmol/mmol; P < 0.001), and more than twofold higher IGI (257.3 [54.5, 1,215.8] vs. 114.8 [28.0, 470.8] pmol/mmol; P < 0.001). Two-hour C-peptide and insulin concentrations, CP-iAUC, and I-iAUC were all higher in youth (all P < 0.001). C-peptide and insulin responses remained significantly greater in youth after adjustment for insulin sensitivity. Within each age-group, individuals with type 2 diabetes versus IGT had significantly lower CPI and IGI with no difference in insulin sensitivity. CONCLUSIONS: The balance between insulin sensitivity and β-cell responses differs between youth and adults with IGT or recently diagnosed type 2 diabetes. Despite similar postload glucose levels, youth demonstrate greater C-peptide and insulin responses that exceed what is needed to compensate for their lower insulin sensitivity. Longitudinal studies are required to determine whether this feature contributes to a more rapid decline in β-cell function in youth with dysglycemia.
Authors: Elizabeth J Mayer-Davis; Jean M Lawrence; Dana Dabelea; Jasmin Divers; Scott Isom; Lawrence Dolan; Giuseppina Imperatore; Barbara Linder; Santica Marcovina; David J Pettitt; Catherine Pihoker; Sharon Saydah; Lynne Wagenknecht Journal: N Engl J Med Date: 2017-04-13 Impact factor: 91.245
Authors: Courtney M Peterson; Haiyan Su; Diana M Thomas; Moonseong Heo; Amir H Golnabi; Angelo Pietrobelli; Steven B Heymsfield Journal: JAMA Pediatr Date: 2017-07-01 Impact factor: 16.193
Authors: Abbas E Kitabchi; Marinella Temprosa; William C Knowler; Steven E Kahn; Sarah E Fowler; Steven M Haffner; Reuben Andres; Christopher Saudek; Sharon L Edelstein; Richard Arakaki; Mary Beth Murphy; Harry Shamoon Journal: Diabetes Date: 2005-08 Impact factor: 9.461
Authors: Miriam Cnop; Melinda J Landchild; Josep Vidal; Peter J Havel; Negar G Knowles; Darcy R Carr; Feng Wang; Rebecca L Hull; Edward J Boyko; Barbara M Retzlaff; Carolyn E Walden; Robert H Knopp; Steven E Kahn Journal: Diabetes Date: 2002-04 Impact factor: 9.461
Authors: Melinda E Chen; Aaditya G Chandramouli; Robert V Considine; Tamara S Hannon; Kieren J Mather Journal: Diabetes Care Date: 2017-11-28 Impact factor: 19.112
Authors: Karla A Temple; Ashley H Tjaden; Karen M Atkinson; Elena Barengolts; Tamara S Hannon; Kieren J Mather; Kristina M Utzschneider; Sharon L Edelstein; David A Ehrmann; Babak Mokhlesi Journal: Diabetes Care Date: 2019-06-08 Impact factor: 19.112
Authors: Thomas H Inge; Anita P Courcoulas; Todd M Jenkins; Marc P Michalsky; Mary L Brandt; Stavra A Xanthakos; John B Dixon; Carroll M Harmon; Mike K Chen; Changchun Xie; Mary E Evans; Michael A Helmrath Journal: N Engl J Med Date: 2019-05-16 Impact factor: 91.245
Authors: Kristina M Utzschneider; Mark T Tripputi; Alexandra Kozedub; Kieren J Mather; Kristen J Nadeau; Sharon L Edelstein; Tamara S Hannon; Silva A Arslanian; Melanie Cree-Green; Thomas A Buchanan; Sonia Caprio; Andrea Mari Journal: Pediatr Diabetes Date: 2020-10-14 Impact factor: 4.866
Authors: Amy G Huebschmann; Rachel R Huxley; Wendy M Kohrt; Philip Zeitler; Judith G Regensteiner; Jane E B Reusch Journal: Diabetologia Date: 2019-08-27 Impact factor: 10.122
Authors: Joon Young Kim; Fida Bacha; Hala Tfayli; Sara F Michaliszyn; Shahwar Yousuf; Silva Arslanian Journal: Diabetes Care Date: 2018-11-19 Impact factor: 19.112
Authors: Anny H Xiang; Enrique Trigo; Mayra Martinez; Namir Katkhouda; Elizabeth Beale; Xinhui Wang; Jun Wu; Ting Chow; Cortney Montgomery; Krishna S Nayak; Fadi Hendee; Thomas A Buchanan Journal: Diabetes Care Date: 2018-10-03 Impact factor: 19.112