Changes in insulin secretion and insulin sensitivity in relation to the glycemic outcomes in subjects with impaired glucose tolerance in the Indian Diabetes Prevention Programme-1 (IDPP-1)
Open accessAbstract
OBJECTIVE: The Indian Diabetes Prevention Programme-1 (IDPP-1) showed that lifestyle modification (LSM) and metformin were effective for primary prevention of diabetes in subjects with impaired glucose tolerance (IGT). Among subjects followed up for 3 years (n = 502), risk reductions versus those for the control group were 28.5, 26.4, and 28.2% in LSM, metformin (MET), and LSM plus MET groups, respectively. In this analysis, the roles of changes in secretion and action of insulin in improving the outcome were studied. RESEARCH DESIGN AND METHODS: For this analysis, 437 subjects (93 subjects with normoglycemia [NGT], 150 subjects with IGT, and 194 subjects with diabetes) were included. Measurements of anthropometry, plasma glucose, and plasma insulin at baseline and at follow-up were available for all of them. Indexes of insulin resistance (homeostasis model assessment of insulin resistance) and β-cell function (insulinogenic index [ΔI/G]: 30-min fasting insulin divided by 30-min glucose) were also analyzed in relation to the outcome. RESULTS: Subjects with IGT showed a deterioration in β-cell function with time. Individuals with higher insulin resistance and/or low β-cell function at baseline had poor outcome on follow-up. In relation to no abnormalities, the highest incidence of diabetes occurred when both abnormalities coexisted (54.9 vs. 33.7%, χ2 = 7.53, P = 0.006). Individuals having abnormal insulin resistance (41.1%) or abnormal ΔI/G (51.2%, χ2 = 4.87, P = 0.027 vs. no abnormalities) had lower incidence. Normal β-cell function with improved insulin sensitivity facilitated reversal to NGT, whereas deterioration in both resulted in diabetes. The beneficial changes were better with intervention than in the control group. Intervention groups had higher rates of NGT and lower rates of diabetes. CONCLUSIONS: In the IDPP-1 subjects, beneficial outcomes occurred because of improved insulin action and sensitivity caused by the intervention strategies.
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Successful lifestyle interventions seem to improve insulin sensitivity and β-cell function.
“Successful lifestyle interventions seem to improve insulin sensitivity and β-cell function.92,93”
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- Authors
- Snehalatha, C., Mary, S., Selvam, S., Sathish Kumar, C. K., Shetty, S. B. A., Nanditha, A., & Ramachandran, A.
- Affiliations
- India Diabetes Research Foundation (IN)
- From the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India.
- Corresponding author
- Ramachandran, Ambady
- ORCID
- Ramachandran, Ambady
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2009-07-08
- Volume
- 32
- Issue
- 10
- Pages
- 1796-1801
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2752907
- OpenAlex
- W2138167262
- Cited by
- 64
- References
- 26
- Citations by year
- 2026: 1 · 2024: 6 · 2023: 6 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 5 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 6 · 2014: 6 · 2013: 4 · 2012: 5
- FWCI
- 4.11
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- 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 Treatment and Management
- Keywords
- impaired glucose tolerance, insulin secretion, insulin sensitivity, insulin resistance, beta-cell function, insulinogenic index, lifestyle modification, metformin, diabetes prevention, glycemic outcomes
- MeSH terms
- Insulin Secretion, Adult, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemic Agents, Insulin, Insulin Resistance, Male, Metformin, Middle Aged, Treatment Outcome, Glucose Intolerance
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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