Exaggerated insulin secretion in Pima Indians and African-Americans but higher insulin resistance in Pima Indians compared to African-Americans and Caucasians
Abstract
AIMS: African-Americans have a higher prevalence of Type 2 diabetes than Caucasians, but a lower prevalence than Pima Indians. Studies suggest that both African-Americans and Pima Indians are more insulin resistant and have higher acute insulin secretory responses to glucose than Caucasians; however, a direct comparison between these three populations is lacking. METHODS: We measured insulin secretory responses to intravenous glucose (acute insulin response, AIR, 25 g ivGTT); insulin action at physiological (M-low) and supra-physiological (M-high) levels of hyperinsulinaemia (2-step hyperinsulinaemic clamp); basal and insulin-suppressed endogenous glucose production in 30 African-Americans, 30 Pima Indians and 30 Caucasians with normal glucose tolerance who were carefully matched for age, sex, and body fat (hydrodensitometry or DEXA). A subgroup of 24 subjects from each group additionally underwent a standardized mixed meal test. RESULTS: M-low was lower in Pima Indians (0.50 +/- 0.03) compared to Caucasians (0.59 +/- 0.02, P = 0.02) and African-Americans [0.58 +/- 0.03 mg/kgEMBS/min, log10 (means +/- SE), P = 0.03] but was not different between African-Americans and Caucasians. Basal endogenous glucose production was lower in Pima Indians (2.43 +/- 0.06) compared to African-Americans (2.70 +/- 0.06, P = 0.02) and was not different between Pima Indians and Caucasians (2.59 +/- 0.09 mg/kgEMBS/min) or African-Americans and Caucasians (all P > 0.18). Insulin-suppressed endogenous glucose production during the clamp was not different among the groups (all P > 0.40). AIR was higher in both African-Americans (13.51 +/- 0.26) and Pima Indians (13.72 +/- 0.27) compared to Caucasians (12.33 +/- 0.25 pM, log10, both P < 0.01). The areas under the curve for glucose in response to the oral glucose tolerance test and mixed meal test were higher in Pima Indians compared to African-Americans (P = 0.03 and P = 0.03, respectively) and Caucasians (P = 0.01, mixed meal test), but not different between African-Americans and Caucasians. CONCLUSIONS: Exaggerated glucose-stimulated insulin secretion, manifested initially as an increased response to an intravenous glucose challenge, appears to be a characteristic in people with normal glucose tolerance at higher risk for diabetes. Lower whole-body insulin sensitivity in Pima Indians compared to African-Americans, however, may contribute to the higher risk for Type 2 diabetes in Pima Indians compared to African-Americans.
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African Americans, Mexican Americans, and Native Americans secrete a greater amount of insulin than European Americans for a given amount of exposure to oral or intravenous glucose.
“African Americans (AAs), Mexican Americans, and Native Americans secrete a greater amount of insulin than do European Americans (EAs) for a given amount of exposure to oral or intravenous glucose (19)(20)(21).”
From A Lower-Carbohydrate, Higher-Fat Diet Reduces Abdominal and Intermuscular Fat and Increases Insulin Sensitivity in Adults at Risk of Type 2 Diabetes (2015) · cites this paper as [21]
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- Authors
- Stefan, N., Stumvoll, M., Weyer, C., Bogardus, C., Tataranni, P. A., & Pratley, R. E.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Stefan, N.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2004-09-22
- Volume
- 21
- Issue
- 10
- Pages
- 1090-1095
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W1997079833
- Cited by
- 44
- References
- 26
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2022: 1 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 4 · 2015: 2 · 2014: 3 · 2013: 1
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- insulin secretion, insulin resistance, Pima Indians, African Americans, Caucasians, acute insulin response, endogenous glucose production, hyperinsulinemic-euglycemic clamp, mixed meal tolerance test, oral glucose tolerance test, type 2 diabetes risk, ethnic differences, glucose tolerance, insulin action, hydrodensitometry, dual-energy X-ray absorptiometry, body composition
- MeSH terms
- Insulin Secretion, Adolescent, Adult, Black or African American, Female, Glucose, Glucose Tolerance Test, Humans, Hyperinsulinism, Indians, North American, Insulin, Longitudinal Studies, Male, Middle Aged, Area Under Curve, White People
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