Cited by 1,508Diabetes, Cardiovascular Risks, and LipoproteinsPancreatic function and diabetesDiabetes Management and Research

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.

Insulin resistance and insulin secretory dysfunction as precursors of non-insulin-dependent diabetes mellitus. Prospective studies of pima indians

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Abstract

BACKGROUND: The relative roles of obesity, insulin resistance, insulin secretory dysfunction, and excess hepatic glucose production in the development of non-insulin-dependent diabetes mellitus (NIDDM) are controversial. We conducted a prospective study to determine which of these factors predicted the development of the disease in a group of Pima Indians. METHODS: A body-composition assessment, oral and intravenous glucose-tolerance tests, and a hyperinsulinemic--euglycemic clamp study were performed in 200 non-diabetic Pima Indians (87 women and 113 men; mean [+/- SD] age, 26 +/- 6 years). The subjects were followed yearly thereafter for an average of 5.3 years. RESULTS: Diabetes developed in 38 subjects during follow-up. Obesity, insulin resistance (independent of obesity), and low acute plasma insulin response to intravenous glucose (with the degree of obesity and insulin resistance taken into account) were predictors of NIDDM: The six-year cumulative incidence of NIDDM was 39 percent in persons with values below the median for both insulin action and acute insulin response, 27 percent in those with values below the median for insulin action but above that for acute insulin response, 13 percent in those with values above the median for insulin action and below that for acute insulin response, and 0 in those with values originally above the median for both characteristics. CONCLUSIONS: Insulin resistance is a major risk factor for the development of NIDDM: A low acute insulin response to glucose is an additional but weaker risk factor.

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Crossref · 10.1056/nejm199312303292703

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Research works printed but not linked: 2

  1. 1985, World Health Organ Tech Rep Ser, 727, 9
  2. Gottesman I, 1983, Am J Physiol, 244, E632

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Metadata

Authors
Lillioja, S., Mott, D. M., Spraul, M., Ferraro, R., Foley, J. E., Ravussin, E., Knowler, W. C., Bennett, P. H., & Bogardus, C.
Affiliations
National Institutes of Health (US)
Venue
New England Journal of Medicine
Published
1993-12-30
Volume
329
Issue
27
Pages
1988-1992
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2334309509
Cited by
1,508
References
27
Citations by year
2026: 13 · 2025: 16 · 2024: 30 · 2023: 22 · 2022: 34 · 2021: 38 · 2020: 39 · 2019: 37 · 2018: 40 · 2017: 30 · 2016: 40 · 2015: 52 · 2014: 44 · 2013: 45 · 2012: 44
FWCI
30.07
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Research Online (University of Wollongong) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
insulin resistance, type 2 diabetes, Pima Indians, obesity, acute insulin response, hepatic glucose production, insulin action, diabetes risk factors, hyperinsulinemic-euglycemic clamp, glucose tolerance
MeSH terms
Insulin Secretion, Adult, Arizona, Body Composition, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Glucose, Glucose Tolerance Test, Humans, Indians, North American, Insulin, Insulin Resistance, Liver, Male, Obesity, Prospective Studies, Risk Factors, Proportional Hazards Models

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