Metabolic characteristics of individuals with impaired fasting glucose and/or impaired glucose tolerance

• Published in: Diabetes (New York, N.Y.) Vol. 48; no. 11; pp. 2197 - 2203
• Main Authors: WEYER, C, BOGARDUS, C, PRATLEY, R. E
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.11.1999
• Subjects: Adult; Arizona; Biological and medical sciences; Blood Glucose - metabolism; Body Constitution; Body Weight; Diabetes Mellitus - classification; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fasting; Female; Glucose - metabolism; Glucose Clamp Technique; Glucose Intolerance - metabolism; Glucose Tolerance Test; Glucose tolerance tests; Humans; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - blood; Indians, North American; Infusions, Intravenous; Insulin - administration & dosage; Insulin - blood; Male; Medical sciences; Physiological aspects; Regression Analysis; Societies, Medical; United States; United States; Arizona; Endocrinopathy; Human; Pancreatic hormone; Senescence; Fasting; Diabetes mellitus; Hormonal investigation; Metabolism; Impaired glucose tolerance; Insulin; Glycemia
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/diabetes.48.11.2197

Metabolic characteristics of individuals with impaired fasting glucose and/or impaired glucose tolerance. C Weyer , C Bogardus and R E Pratley Clinical Diabetes and Nutrition Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona 85016, USA. cweyer@phx.niddk.nih.gov Abstract With the release of the new 1997 American Diabetes Association diagnostic criteria, a new category was introduced, termed "impaired fasting glucose" (IFG). The metabolic abnormalities of individuals with IFG, compared with those with impaired glucose tolerance (IGT) (World Health Organization criteria), remain to be elucidated. We assessed insulin action (hyperinsulinemic clamp), insulin secretion (25-g intravenous glucose tolerance test), and endogenous glucose output (EGO) (3-(3)H-glucose) in 434 nondiabetic Pima Indians with either normal (NFG; <6.1 mmol/l) or impaired (IFG; 6.1-7.0 mmol/l) fasting glucose and with either normal (NGT; 2-h glucose <7.8 mmol/l) or impaired (IGT; 2-h glucose 7.8-11.1 mmol/l) glucose tolerance: NFG/NGT (n = 307), IFG/NGT (n = 11), NFG/IGT (n = 98), and IFG/IGT (n = 18). Compared with the NFG/NGT group, individuals with IFG/NGT had lower maximal insulin-stimulated glucose disposal (M; -20%, P < 0.01), a lower acute insulin response (AIR) to intravenous glucose (-33%, P < 0.05), and higher EGO (8%, P = 0.055). Individuals with NFG/IGT also had lower M (-21%, P < 0.001) and lower AIR (-8%, P < 0.05), but normal EGO (-1%, NS). Individuals with IFG/IGT showed the most severe abnormalities in M (-27%), AIR (-51%), and EGO (+13%) (all P < 0.001 compared with NFG/NGT). These group differences could be explained by the observation that AIR and EGO, but not M, were more strongly related to the fasting than to the 2-h glucose concentration. Thus, Pima Indians with isolated IFG and isolated IGT show similar impairments in insulin action, but those with isolated IFG have a more pronounced defect in early insulin secretion and, in addition, increased EGO. More severe metabolic abnormalities are present in Pima Indians with combined IFG and IGT.