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Fasting hyperglycemia blunts the regression of impaired glucose tolerance in older adults after lifestyle modification
Author(s) -
Malin Steven K.,
Kirwan John P.
Publication year - 2012
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.26.1_supplement.869.4
Subject(s) - prediabetes , medicine , impaired fasting glucose , impaired glucose tolerance , endocrinology , type 2 diabetes , diabetes mellitus , insulin resistance , insulin , glucose tolerance test , carbohydrate metabolism
Lifestyle modification (LM) delays the progression from prediabetes to type 2 diabetes (T2D), but no study has determined the efficacy of LM on glucose metabolism in different prediabetes subtypes. Methods Older (65.1 ± 0.6yr) obese adults with impaired fasting glucose (IFG; n=12), impaired glucose tolerance (IGT; n=9), and combined glucose intolerance (IFG+IGT = CGI; n=22) were compared to normal glucose tolerant (NGT; n=15) and T2D (n=18) groups after 12 weeks of LM (60 min/d for 5d/wk at ~85% HRmax). An oral glucose tolerance test was used to assess glucose levels. Insulin sensitivity (euglycemic hyperinsulinemic: 40 mU/m 2 ·min −1 ) and β‐cell function (glucose induced insulin secretion corrected for insulin sensitivity) were also assessed. Results LM reduced weight and improved aerobic fitness and β‐cell function similarly across groups (p < 0.05). LM lowered fasting glucose levels in IFG, CGI and T2D (p < 0.05) and 2‐hour glucose levels in IGT, CGI and T2D (p < 0.05). However, 2‐hour glucose levels were not normalized in adults with CGI compared to IGT (p < 0.05). Insulin sensitivity was improved approximately 40% in IFG and IGT, but only 17% in CGI. Conclusion After 12‐ weeks, lifestyle modification may not be sufficient to normalize 2‐ hour glucose levels in adults with CGI. Given the high risk of progressing to T2D, adults with CGI may require more aggressive therapies to prevent diabetes. Support: RO1 AG12834 (J.P.K).