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Insulin sensitivity, and ß-cell function in relation to hemoglobin A1C.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Marini, M. A. Frontoni, S. Succurro, E. Arturi, F. Sciacqua, A. Hribal, M. L. Perticone, F. Sesti, G.
Description	Country affiliation: Italy Author Affiliation: Marini MA ( Department of Systems Medicine, University of Rome-Tor Vergata, Italy.); Frontoni S ( Department of Systems Medicine, University of Rome-Tor Vergata, Italy.); Succurro E ( Department of Medical and Surgical Sciences, University 'Magna Graecia' of Catanzaro, Italy.); Arturi F ( Department of Medical and Surgical Sciences, University 'Magna Graecia' of Catanzaro, Italy.); Sciacqua A ( Department of Medical and Surgical Sciences, University 'Magna Graecia' of Catanzaro, Italy.); Hribal ML ( Department of Medical and Surgical Sciences, University 'Magna Graecia' of Catanzaro, Italy.); Perticone F ( Department of Medical and Surgical Sciences, University 'Magna Graecia' of Catanzaro, Italy.); Sesti G ( Department of Medical and Surgical Sciences, University 'Magna Graecia' of Catanzaro, Italy. Electronic address: sesti@unicz.it.)
Abstract	BACKGROUND AND AIMS: The A1C diagnostic criterion for identifying individuals at increased risk for diabetes, introduced by the American Diabetes Association in 2010, was not defined on the basis of the principal pathophysiological abnormalities responsible for the development and progression of type 2 diabetes; we therefore wished to gain a deeper insight into the metabolic abnormalities characterizing the group of at risk individuals with an A1C value of 5.7-6.4%. METHODS AND RESULTS: As many as 338 non-diabetic offspring of type 2 diabetic patients were consecutively recruited. Insulin secretion was assessed using both indexes derived from oral glucose tolerance test (OGTT), and intravenous glucose tolerance test (IVGTT). Insulin sensitivity was measured by hyperinsulinemic euglycemic clamp. As compared with subjects with A1C <5.7%, individuals with A1C of 5.7-6.4% exhibited lower insulin sensitivity after adjusting for age, gender and body mass index (BMI). Insulin secretion estimated from the OGTT, did not differ between the two groups. By contrast, as compared with subjects with A1C <5.7%, the acute insulin response (AIR) during an IVGTT and both IVGTT-derived and OGTT-derived disposition indexes were reduced in individuals with A1C of 5.7-6.4% after adjusting for age, gender and BMI. As A1C increased to ≥ 5.7%, a sharp decrease in insulin sensitivity and ß-cell function, measured as disposition index, was observed. CONCLUSIONS: Caucasian individuals with A1C ≥ 5.7% exhibit both core pathophysiological defects of type 2 diabetes i.e. insulin resistance and ß-cell dysfunction.
File Format	HTM / HTML
ISSN	09394753
Issue Number	1
Volume Number	24
e-ISSN	15903729
Journal	Nutrition, Metabolism and Cardiovascular Diseases
Language	English
Publisher	Elsevier
Publisher Date	2014-01-01
Publisher Place	Netherlands
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Metabolism Discipline Cardiology Discipline Vascular Diseases Discipline Nutritional Sciences Diabetes Mellitus, Type 2 Diagnosis Hemoglobin A, Glycosylated Metabolism Insulin Resistance Physiology Insulin-secreting Cells Adult Blood Glucose Body Mass Index Physiopathology Female Glucose Clamp Technique Glucose Tolerance Test Humans Insulin Secretion Male Middle Aged Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Nutrition and Dietetics Endocrinology, Diabetes and Metabolism Cardiology and Cardiovascular Medicine

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Determining pancreatic ß-cell compensation for changing insulin sensitivity using an oral glucose tolerance test.

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