Does the presence of diabetic nephropathy in parents influence the metabolic response in the offspring?
Non-insulin dependent (Type 2) diabetes mellitus (NIDDM) and long-term complications such as nephropathy have a strong genetic predisposition. Insulin resistance is thought to be a pathogenetic factor, predisposing genetically prone individuals to develop the microvascular complications of diabetes. To test these hypotheses, two groups of young individuals were studied: 28 offspring of parents having NIDDM and diabetic nephropathy (group 1) aged 29.5 +/- 6.1 years, BMI 25.2 +/- 4.7 kg m(-2) and 31 offspring of diabetic parents with no history of nephropathy, aged 31.6 +/- 4.1 years and BMI 26.3 +/- 4.9 kg m(-2) (group 2). All underwent a standard oral glucose tolerance test with measurement of serum insulin levels and serum lipid profile. Urine albumin:creatinine ratio (A/C ratio) and blood pressure were also recorded. Diabetes was detected in 2/28 (7.1%) and 3/31 (9.7%) and IGT was detected in 5/28 (25%) and 8/31 (25%) of groups 1 and 2, respectively. These differences were not statistically significant, but were higher than in a group of non-diabetic controls with healthy parents. Comparison of the normoglycaemic subjects (19 and 20 in group 1 and 2, respectively) showed no significant differences between blood pressure readings, fasting and 2 h plasma glucose, and lipid profiles. Plasma insulin values, fasting and 2 h, and the area under the graph were also similar in both groups, indicating an absence of higher insulin response in group 1 in comparison with group 2. These values were also not different from those in the non-diabetic controls. A delay in insulin response to glucose was noted in many of the offspring as indicated by a low deltaI/deltaG at 30'. We conclude that offspring of diabetic parents with nephropathy do not show higher risk of glucose intolerance or insulin resistance compared to those with diabetic parents without nephropathy. The relatively high plasma glucose values in the presence of normal insulin secretion in both groups of offspring of diabetic parents suggest the presence of insulin resistance.
Vijay
V
V
Diabetes Research Centre, Royapuram, Madras, India.
Snehalatha
C
C
Terin
M
M
Ramachandran
A
A
D000328:Adult; D000419:Albuminuria; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003404:Creatinine / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000235:genetics*; D003925:Diabetic Angiopathies / Q000235:genetics*; D003928:Diabetic Nephropathies / Q000235:genetics*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D008074:Lipoproteins / Q000097:blood; D009679:Nuclear Family; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D008074:Lipoproteins; D014280:Triglycerides; D002784:Cholesterol; D003404:Creatinine