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The Metabolic Associations of Intravenous Glucose Tolerance in the 10 Years from Diagnosis of Type 2 Diabetes
Author(s) -
Coppack S.W.,
Yajnik C.S.,
Doll H.A.,
Thursfield V.,
Hockaday T.D.R.
Publication year - 1990
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 - 10.1111/j.1464-5491.1990.tb01476.x
Subject(s) - medicine , endocrinology , insulin , type 2 diabetes , diabetes mellitus , ketone bodies , homeostasis , glucose homeostasis , impaired glucose tolerance , glucose tolerance test , insulin resistance , metabolism
Intravenous glucose tolerance was measured at diagnosis and during the subsequent 10 years in 103 Type 2 diabetic patients not treated with insulin. K G (the rate constant for clearance of intravenous glucose) was inversely related to fasting plasma glucose at all review times (at diagnosis being R s = −0.77, p < 0.001), and at times to the circulating concentrations of ketone bodies (at diagnosis being R s = −0.52, p < 0.001) and glycerol ( R s = −0.29, p < 0.01). In the first year of treatment, most metabolic abnormalities improved. One to 10 years after diagnosis, fasting glucose concentration and intravenous glucose tolerance deteriorated (median glucose from 6.4 to 7.4 mmol I −1 , p < 0.001; median K G from 0.81 to 0.69 % min −1 , p < 0.01). Likewise, the ‘homeostatic model assessment’ of insulin insensitivity deteriorated (median from 2.3 to 3.7 arbitrary units, p < 0.001) over the same period but first‐phase insulin secretion remained steady or improved. This suggests that increases in insulin insensitivity have a predominant effect on slowly deteriorating glucose tolerance from 1 to 10 years after diagnosis in Type 2 diabetes.