[Features of insulin secretion and insulin resistance in newly diagnosed type 2 diabetes of different body mass indices].
OBJECTIVE
To investigate insulin secretion function and insulin resistance in Chinese newly diagnosed type 2 diabetes (obese and non-obese patients) in order to provide evidence for clinical treatment.


METHODS
408 newly diagnosed type 2 diabetes and 40 normal controls were recruited. Height, weight were measured, insulin and glucose of 0 min, 30 min, 60 min, 120 min during oral glucose tolerance test were examined. The patients with fasting glucose level greater than 8.3mmol/L were treatment with Gliclazide for 1 - 3 months. After normalization of the plasma glucose levels for more than 2 weeks, and withdraw this medication for 48 hours, then OGTT were repeated to assess IR and IS.


RESULTS
The patients were divided into four groups based on fasting plasma glucose (DM1: FPG < 6.9mmol/L; DM2: 6.9 mmol/L < or = FPG < 8.3 mmol/L; DM3: 8.3 mmol/L < or = FPG < 9.7 mmol/L; DM4: FPG > or = 9.7 mmol/L). Every groups were further stratified to subgroups by cut point of BMI = 24 kg/m(2). Their insulin sensitivity and insulin secretion function compared between subgroups. (1) True insulin level in BMI > or = 24 (FPG < 6.9 mmol/L) subgroups were higher than control's (3.5 +/- 0.5 vs 3.2 +/- 0.6 natural logarithm) (P < 0.05). (2) In BMI > or = 24 subgroups, their insulin sensitivity were even worse than BMI < 24 groups', but their insulin secretion function were better at the same FPG level. (3) After intervention, the change of insulin sensitivity in BMI < 24 group was better than BMI > or = 24 group's (-4.7 +/- 0.9 vs -5.5 +/- 1.4 natural logarithm) (P < 0.05); but the change of insulin secretion function in BMI < 24 group was worse.


CONCLUSIONS
(1) In newly diagnostic type 2 diabetes, insulin sensitivity and insulin secretion function were decreased with the increase of FPG, but they were different between obese and non-obese group. (2) Insulin secretion function was recovered better in obese group when eliminated glucose toxicity.
An
Ya-Li
YL
Center for Endocrine and Metabolic Diseases, China-Japan friendship hospital, Peking Union Medical College, Beijing 100029, China.
Gao
Yan
Y
Zhu
Qian
Q
Ning
Guang
G
Jia
Wei-Ping
WP
Huang
Qin
Q
Xu
Wen
W
Li
Cheng-Jiang
CJ
Zhou
Zhi-Guang
ZG
Shi
Bing-Yin
BY
Shan
Zhong-Yan
ZY
Chen
Lu-Lu
LL
Xu
Zhang-Rong
ZR
Wang
Heng
H
Yan
Li
L
Zhong
Hui-Ju
HJ
Ji
Qiu-He
QH
Li
Hong
H
Xue
Yuan-Ming
YM
Zhing
Mu-Xun
MX
Gu
Wei
W
Guo
Xiao-Hui
XH
Gao
Lei-Li
LL
Hong
Jie
J
Liu
Fang
F
Zou
Da-Jin
DJ
Li
Yan-Bing
YB
Zhang
Xiao-Ying
XY
Li
Zhen
Z
Guo
Gui
G
Zhao
Xiao-Juan
XJ
Wu
Han-Ni
HN
Wang
Yu-Zhen
YZ
Zhao
Wei-Gang
WG
Zhang
Shao-Lin
SL
Wu
Jing
J
Zhang
Nan-Yan
NY
Yang
Feng-Ying
FY
Zhang
Yun
Y
Zhou
Xin-Rong
XR
Ren
Yue-Zhong
YZ
Li
Guang-Wei
GW
D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D008297:Male; D008875:Middle Aged; D055815:Young Adult
D007328:Insulin