Fasting insulin levels and metabolic risk factors in type 2 diabetic patients at the first visit in Japan: a 10-year, nationwide, observational study (JDDM 28).
OBJECTIVE
To investigate the relationship between fasting insulin levels and metabolic risk factors (MRFs) in type 2 diabetic patients at the first clinic/hospital visit in Japan over the years 2000 to 2009.


METHODS
In total, 4,798 drug-naive Japanese patients with type 2 diabetes were registered on their first clinic/hospital visits. Conventional clinical factors and fasting insulin levels were observed at baseline within the Japan Diabetes Clinical Data Management (JDDM) study between consecutive 2-year groups. Multiple linear regression analysis was performed using a model in which the dependent variable was fasting insulin values using various clinical explanatory variables.


RESULTS
Fasting insulin levels were found to be decreasing from 2000 to 2009. Multiple linear regression analysis with the fasting insulin levels as the dependent variable showed that waist circumference (WC), BMI, mean blood pressure, triglycerides, and HDL cholesterol were significant, with WC and BMI as the main factors. ANCOVA after adjustment for age and fasting plasma glucose clearly shows the decreasing trend in fasting insulin levels and the increasing trend in BMI.


CONCLUSIONS
During the 10-year observation period, the decreasing trend in fasting insulin was related to the slight increase in WC/BMI in type 2 diabetes. Low pancreatic β-cell reserve on top of a lifestyle background might be dependent on an increase in MRFs.
Matsuba Medical Clinic, Kawasaki, Kanagawa, Japan. ikuro@matsuba-web.com
Ikuro
I
Matsuba
Kazumi
K
Saito
Masahiko
M
Takai
Koichi
K
Hirao
Hirohito
H
Sone
D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000378:metabolism; D005215:Fasting / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood*; D050417:Insulin-Secreting Cells / Q000378:metabolism; D007564:Japan; D016014:Linear Models; D008875:Middle Aged; D012307:Risk Factors
D007328:Insulin