An assessment of the new NIH diagnostic criteria for diabetes mellitus according to insulin response in a 75 g oral glucose tolerance test and levels of hemoglobin AIC.
This study reviews the new diagnostic criteria for diabetes mellitus proposed by NIH. We measured insulin levels during 75 g oral glucose tolerance test (75 g OGTT) and hemoglobin AIC levels in patients diagnosed as having impaired glucose tolerance (IGT) or non-insulin dependent diabetes (NIDDM) according to the NIH criteria. In a 75 g oral glucose tolerance test, there was no significant difference in insulin-glucose ratio between nonobese IGT and nonobese NIDDM who had fasting blood glucose levels of less than 120 mg/dl (NIDDM-A group). However, in nonobese NIDDM with fasting blood glucose higher than 120 mg/dl (NIDDM-B group), the insulin-glucose ratio was significantly lower than in the IGT or NIDDM-A group. The NIDDM-B group had a higher hemoglobin AIC levels than the IGT and NIDDM-A groups, with no significant difference between the levels of the two latter groups. These observations suggest that the impairment in the function of pancreatic B cells and the state of chronic hyperglycemia are the same in IGT & NIDDM-A groups. Therefore, the NIH standards do not appear refined enough to truly differentiate between IGT and nonobese NIDDM with fasting blood glucose of less than 120 mg/dl.
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000175:diagnosis*; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007328:Insulin / Q000097:blood*; D008297:Male; D009316:National Institutes of Health (U.S.); D014481:United States
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin