title: Insulin secretion and sensitivity in Bangladeshi prediabetic subjects.
abstract: OBJECTIVE
  There are still considerable controversies regarding the basic pathophysiological mechanisms of impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT). The present study was undertaken to explore the beta-cell function and insulin sensitivity in a Bangladeshi prediabetic population.
  
  
  METHODS
  Twenty-four IFG and 112 IGT subjects, along with 40 healthy controls, were selected purposively following 2003 ADA cut-off values and 2006 WHO/IDF grouping. IGT subjects were subcategorized into 53 isolated IGT (I-IGT) and 59 combined IFG-IGT subjects. Plasma glucose and insulin (by chemiluminescent immunoassay) were measured at fasting and 2 h after 75 g of oral glucose load. Insulin sensitivity was assessed by homeostasis model assessment (HOMA-S%) and insulin sensitivity index for glycemia (ISI(gly)) and insulin secretion by HOMA-B%.
  
  
  RESULTS
  Compared to control, fasting and 2-h plasma insulin were higher in I-IGT and IFG-IGT subjects; similarly, HOMA-S% [median (range)] was lower in I-IGT and IFG-IGT subjects [116 (54-227) vs. 93 (23-187) and 79 (32-197)%, P<.05 and P<.001]; ISI(gly) was also lower in I-IGT and IFG-IGT subjects [0.95 (0.54-1.64) vs. 0.64 (0.26-1.24) and 0.65 (0.29-1.20), P<.001]. But HOMA-B% was compromised in IFG and IFG-IGT groups [88 (59-182) vs. 68 (37-107) and 74 (36-141)%, P<.001 and P<.05]. The IGT group (combination of I-IGT and IFG-IGT) showed higher fasting and 2-h insulin, and lower HOMA-S% as well as ISI(gly), but compromised HOMA-B% was not evident.
  
  
  CONCLUSIONS
  The pathophysiological mechanisms differ in IFG (having B-cell dysfunction) and I-IGT (an insulin-resistant condition). The pathophysiology of IFG-IGT (having both B-cell dysfunction and insulin resistance) indicates that it may be a different entity and not be included in IGT.
authors.affiliation: Department of Pharmacology, Faridpur Medical College, Faridpur, Bangladesh. hafizdrendo@yahoo.com
authors.forename: Muhammad Hafizur
authors.initials: MH
authors.lastname: Rahman
authors.forename: Rahman Muhammad
authors.initials: RM
authors.lastname: Hafizur
authors.forename: Qamrun
authors.initials: Q
authors.lastname: Nahar
authors.forename: Abdur Rahman
authors.initials: AR
authors.lastname: Khan
authors.forename: Liaquat
authors.initials: L
authors.lastname: Ali
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001459:Bangladesh; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D018149:Glucose Intolerance / Q000175:diagnosis* / Q000503:physiopathology; D005951:Glucose Tolerance Test / Q000706:statistics & numerical data; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000145:classification / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin