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Cited by 265Diabetes, Cardiovascular Risks, and LipoproteinsPancreatic function and diabetesDiabetes Management and Research

SEQUENTIAL CHANGES IN SERUM INSULIN CONCENTRATION DURING DEVELOPMENT OF NON-INSULIN-DEPENDENT DIABETES

Saad, MohammedF., Pettitt, DavidJ., Mott, DavidM., Knowler, WilliamC., Nelson, RobertG., Bennett, PeterH.·1989·The Lancet
DOI 10.1016/s0140-6736(89)92804-3
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Abstract

Changes in serum insulin concentrations during deterioration of glucose tolerance were studied in 81 Pima Indians who worsened from normal to impaired glucose tolerance (IGT); 44 who changed from IGT to non-insulin-dependent diabetes mellitus (NIDDM); 27 who were seen at diagnosis of NIDDM and 1.4-8.5 years later; and 11 subjects who were seen at each of these stages. When their glucose tolerance was normal, subjects who later developed NIDDM had higher fasting and post-load insulin concentrations than controls of similar age and body mass index who did not become diabetic. Onset of IGT or NIDDM was associated with a further increase in fasting insulin concentrations, although a deterioration from IGT to NIDDM was associated with little change in insulin responses to oral glucose in spite of increased blood glucose. After the onset of NIDDM, both fasting and post-load insulin concentrations diminished. These longitudinal data show that, as glucose tolerance worsens, insulin and glucose concentrations in individuals follow the inverted-U-shaped relation previously reported in cross-sectional population studies.

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Crossref · 10.1016/s0140-6736(89)92804-3

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3 of 3 references verified0 citation errors · 0 not checkable

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  • Natural history studies of cohorts progressing to type 2 diabetes have demonstrated early impairments in insulin sensitivity evident more than 10 years in advance of diabetes development.

    “Natural history studies of cohorts progressing to type 2 diabetes have demonstrated early impairments in insulin sensitivity, which are evident more than 10 years in advance of diabetes development.”

    From 100 years of insulin: celebrating the past, present and future of diabetes therapy (2021) · cites this paper as [74]

  • In progression to type 2 diabetes, beta cell function is initially increased, maintaining glucose levels at higher but still normal levels; around 3 years before onset, decreasing insulin secretion and an accelerated rise in blood glucose levels are observed.

    “Initially, beta cell function is increased, maintaining glucose levels at higher but still normal levels and below the diagnostic threshold for diabetes. However, the ability of the beta cell to maintain this response is finite in some individuals. As the beta cells undergo a process of failure that has been linked with a number of molecular processes, including oxidative and endoplasmic reticulum”

    From 100 years of insulin: celebrating the past, present and future of diabetes therapy (2021) · cites this paper as [74]

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Authors
Saad, M., Pettitt, D., Mott, D., Knowler, W., Nelson, R., & Bennett, P.
Affiliations
National Institutes of Health (US)
Venue
The Lancet
Publisher
Elsevier BV
Published
1989-06
Volume
333
Issue
8651
Pages
1356-1359
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(89)92804-3
OpenAlex
W2033392651
Cited by
265
References
3
Citations by year
2026: 1 · 2025: 1 · 2024: 4 · 2023: 6 · 2022: 3 · 2021: 8 · 2019: 3 · 2018: 5 · 2017: 5 · 2016: 4 · 2015: 3 · 2014: 9 · 2013: 8 · 2012: 4
FWCI
10.46
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
serum insulin, type 2 diabetes, impaired glucose tolerance, glucose tolerance, Pima Indians, fasting insulin, insulin resistance, insulin secretion, type 2 diabetes onset, inverted U-shaped relationship
MeSH terms
Adolescent, Adult, Aged, Arizona, Blood Glucose, Child, Diabetes Mellitus, Type 2, Fasting, Female, Follow-Up Studies, Glucose Tolerance Test, Humans, Indians, North American, Insulin, Insulin Resistance, Male, Middle Aged

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