Impaired beta-cell sensitivity to glucose and maximal insulin secretory capacity in adolescents with type 2 diabetes.
Pediatr Diabetes
; 11(5): 314-21, 2010 Aug.
Article
in En
| MEDLINE
| ID: mdl-19961550
ABSTRACT
BACKGROUND:
Adults with type 2 diabetes mellitus (T2DM) have broad impairments in beta-cell function, including severe attenuation of the first-phase insulin response to glucose, and reduced beta-cell mass. In adolescents with T2DM, there is some evidence that beta-cell dysfunction may be less severe. Our objective was to determine beta-cell sensitivity to glucose and maximal insulin secretory capacity (AIR(max)) in teenagers with T2DM.METHODS:
Fifteen adolescents with T2DM [11 F/4 M, age 18.4 +/- 0.3 yr, body mass index (BMI) 39.8 +/- 2.2 kg/m(2)] and 10 non-diabetic control subjects (7 F/3 M, age 17.4 +/- 0.5 yr, BMI 41.5 +/- 2.2 kg/m(2)) were studied. T2DM subjects had a mean duration of diabetes of 48.8 +/- 6.4 months, were treated with conventional therapies, and had good metabolic control [hemoglobin A1c (HbA1c) 6.7 +/- 1.2%]. Insulin and C-peptide were determined before and after a graded glucose infusion and after intravenous arginine at a whole blood glucose level of >or=22 mM.RESULTS:
The insulin response to increasing plasma glucose concentrations was blunted in the diabetic compared with control subjects (34.8 +/- 11.9 vs. 280.5 +/- 57.8 pmol/mmol; p < 0.0001), and AIR(max) was also significantly reduced in the diabetic group (1868 +/- 330 vs. 4445 +/- 606; p = 0.0005).CONCLUSION:
Even adolescents with well-controlled T2DM have severe impairments of insulin secretion. These data support beta-cell dysfunction as central in the pathogenesis of T2DM in young people, and indicate that these abnormalities can develop over a period of just several years.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Blood Glucose
/
Diabetes Mellitus, Type 2
/
Insulin-Secreting Cells
/
Insulin
Type of study:
Diagnostic_studies
Limits:
Adolescent
/
Female
/
Humans
/
Male
Language:
En
Journal:
Pediatr Diabetes
Journal subject:
ENDOCRINOLOGIA
Year:
2010
Type:
Article
Affiliation country:
United States