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Impaired Pulsatile Secretion of Insulin in Relatives of Patients with Non-Insulin-Dependent Diabetes
Abstract
In fasting nondiabetic subjects, insulin is secreted in regular pulses every 12 to 15 minutes, but patients with non-insulin-dependent diabetes lack regular oscillatory insulin secretion. To investigate whether abnormal insulin oscillations are an early feature of diabetes, we studied 10 minimally glucose-intolerant first-degree relatives of patients with non-insulin-dependent diabetes and 10 controls matched for age and obesity. We performed a time-series analysis of fasting plasma insulin levels in blood samples obtained at 1-minute intervals for 150 minutes. Fasting plasma glucose levels were higher in the relatives than in the controls (mean +/- SD, 5.4 +/- 0.7 vs. 4.4 +/- 0.3 mmol per liter). Autocorrelation of pooled data showed no regular oscillatory activity in the relatives but a 13-minute cycle in the controls (r = 0.23, P less than 0.001). Similarly, Fourier transform analysis showed no significant peak in the relatives but the expected significant peak at 13 to 14 minutes in the controls (P less than 0.05). First-phase (0 to 10 minutes) insulin secretory responses to glucose administered intravenously were not significantly impaired in the relatives (geometric mean, 188 pmol per liter [26.2 mU per liter]; range of SD, +103 to -67 pmol per liter [+14.4 to -9.3 mU per liter]), as compared with the controls (geometric mean, 231 pmol per liter [32.2 mU per liter]; range of SD, +131 to -83 pmol per liter [+18.2 to -11.6 mU per liter]). We conclude that abnormal oscillatory insulin secretion may be an early phenomenon in the development of non-insulin-dependent diabetes.
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Plasma insulin oscillations are less apparent in patients with T2DM.
“These oscillations are less apparent in patients with T2DM (285, 483).”
From Pancreatic β-Cell Electrical Activity and Insulin Secretion: Of Mice and Men (2018) · cites this paper as [483]
In established Type 2 diabetes, there are alterations in pulsatile insulin release and ultradian oscillatory insulin secretion, and the beta cell is unable to oscillate in concert with fluctuations in plasma glucose induced by an oscillating glucose infusion.
“In addition, alterations in pulsatile insulin release [74, 75] and ultradian oscillatory insulin secretion [76] can be observed. The beta cell is also unable to oscillate in concert with the fluctuations in plasma glucose induced by an oscillating glucose infusion [76].”
From The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes (2003) · cites this paper as [74]
Studies in high-risk subjects have shown reductions in the later second-phase insulin response to intravenous glucose, glucose potentiation of insulin release, pulsatile insulin secretion, oscillatory insulin release, and the ability of an oscillating glucose infusion to induce oscillations in insulin secretion.
“Studies in subjects at high risk including first degree relatives of subjects with Type 2 diabetes [121, 122], women with a history of gestational diabetes [100] or polycystic ovarian disease [96] and subjects with IGT [123, 124] have shown reductions in the later (second-phase) insulin response to intravenous glucose [121], in glucose potentiation of insulin release [123], in pulsatile insulin”
From The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes (2003) · cites this paper as [74]
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Metadata
- Authors
- O'Rahilly, S., Turner, R. C., & Matthews, D. R.
- ORCID
- Matthews, David R.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1988-05-12
- Volume
- 318
- Issue
- 19
- Pages
- 1225-1230
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2336304679
- Cited by
- 540
- References
- 22
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 6 · 2023: 6 · 2022: 11 · 2021: 18 · 2020: 8 · 2019: 13 · 2018: 9 · 2017: 13 · 2016: 15 · 2015: 13 · 2014: 20 · 2013: 10 · 2012: 18
- FWCI
- 20.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- insulin secretion, pulsatile insulin secretion, insulin oscillations, type 2 diabetes, first-degree relatives, impaired glucose tolerance, early diabetes, fasting insulin, first-phase insulin response, time series analysis, Fourier transform analysis
- MeSH terms
- Insulin Secretion, Adult, Blood Glucose, Diabetes Mellitus, Type 2, Female, Fourier Analysis, Glucose Tolerance Test, Humans, Insulin, Male, Middle Aged, Pulsatile Flow
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