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Metabolic impact of a family history of Type 2 diabetes. Results from a European multicentre study (EGIR)
Author(s) -
Vaag A.,
Lehtovirta M.,
ThyeRönn P.,
Groop L.
Publication year - 2001
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2001.00496.x
Subject(s) - medicine , insulin , insulin resistance , family history , diabetes mellitus , endocrinology , type 2 diabetes , body mass index , glucose clamp technique , type 1 diabetes , pancreatic hormone
Abstract Background Insulin resistance was found in some but not in all previous studies of non‐diabetic first degree relatives of Type 2 diabetic patients. Small study groups, ethnic differences and/or non‐optimal techniques may explain the conflicting results. Aim To study the impact of a family history of Type 2 diabetes on insulin action in a large group of non‐diabetic Europeans using the ‘gold standard’ euglycaemic hyperinsulinaemic clamp technique. Methods Non‐diabetic subjects ( n = 235) with a positive family history of Type 2 diabetes (FH+) and 564 subjects with no family history of diabetes (FH−) were recruited from The European Group of Insulin Resistance (EGIR) database. This database includes measurements of insulin action using the insulin clamp technique (1 mU/kg per min) in normal glucose‐tolerant individuals from 20 different European centres. In a subset of subjects the measurements were performed in combination with indirect calorimetry ( n = 80 vs. 213 with and without family history of Type 2 diabetes). Results The body mass index (BMI) was slightly higher in FH+ compared with FH− (26.7 ± 4.6 vs. 25.1 ± 4.7 kg/m 2 ; P < 0.02). After correction for covariates according to differences between investigators and subject characteristics including BMI (multiple regression analysis), insulin‐stimulated glucose disposal was lower in FH+ compared with FH− ( P < 0.00001). Insulin‐stimulated glucose oxidation was slightly increased in FH+ compared with FH−, and insulin‐stimulated non‐oxidative glucose metabolism was consequently markedly reduced in FH+ compared with FH− ( P < 0.0005). Conclusion Insulin resistance is present in European non‐diabetic relatives of Type 2 diabetic patients. The insulin resistance is independent of degree of obesity and is restricted solely to the pathway of non‐oxidative glucose metabolism. Diabet. Med. 18, 533–540 (2001)