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Cited by 153Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and ResearchPancreatic function and diabetes

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Mode of Onset of Type 2 Diabetes from Normal or Impaired Glucose Tolerance

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Ferrannini, Ele, Nannipieri, Monica, Williams, Ken, Gonzales, Clicerio, Haffner, Steve M., Stern, Michael P.·2004·Diabetes
DOI 10.2337/diabetes.53.1.160
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Abstract

Fasting plasma glucose concentrations (FPG) predict development of type 2 diabetes. Whether hyperglycemia evolves from normoglycemia gradually over time or as a step increase is not known. We measured plasma glucose and insulin levels during oral glucose testing in 35- to 64-year-old men and nonpregnant women from a population-based survey (Mexico City Diabetes Study) at baseline (n = 2,279) and after 3.25 (n = 1,740) and 7 years (n = 1,711) of follow-up. In subjects with normal glucose tolerance (NGT) on all three occasions (nonconverters; n = 911), FPG increased only slightly (0.23 ± 0.79 mmol/l, mean ± SD; P < 0.0001) over 7 years. In contrast, conversion to diabetes among NGT subjects (n = 98) was marked by a large step-up in FPG regardless of time of conversion (3.06 ± 2.57 and 2.94 ± 3.11 mmol/l, respectively, at 3.25 and 7 years; P < 0.0001 vs. nonconverters). Likewise, in subjects who converted to diabetes from impaired glucose tolerance (n = 75), FPG rose by 3.14 ± 3.83 and 3.12 ± 3.61 mmol/l (P < 0.0001 vs. nonconverters). Three-quarters of converters had increments in FPG above the 90th percentile of the corresponding increments in nonconverters. Converters had higher baseline BMI (30.4 ± 4.9 vs. 27.3 ± 4.0 kg/m2; P < 0.001) and fasting plasma insulin values (120 ± 78 vs. 84 ± 84 pmol/l; P < 0.02) than nonconverters; however, no consistent change in either parameter had occurred before conversion. In contrast, changes in 2-h postglucose insulin levels between time of conversion and preceding measurement were significantly (P < 0.0001) related to the corresponding changes in FPG in an inverse manner. We conclude that, within a 3-year time frame, the onset of diabetes is very often rapid rather than gradual and is in part explained by a fall in glucose-stimulated insulin response.

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Research works printed but not linked: 1

  1. Bennett PH, Knowler WC, Pettitt DJ, Carraher MJ, Vasquez B: Longitudinal studies in the development of diabetes in Pima Indians. In Advances in Diabetes Epidemiology. Eschwege E, Ed. Amsterdam, Netherlands, Elsevier,1982, p. 65–74

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Metadata

Authors
Ferrannini, E., Nannipieri, M., Williams, K., Gonzales, C., Haffner, S. M., & Stern, M. P.
Affiliations
  • University of Pisa (IT)
  • The University of Texas at San Antonio Health Science Center (US)
  • Mexican Social Security Institute (MX)
  • Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio, Texas
ORCID
Venue
Diabetes
Publisher
American Diabetes Association
Published
2004-01-01
Volume
53
Issue
1
Pages
160-165
ISSN
  • 0012-1797 (ISSN-L)
  • 1939-327X
DOI
10.2337/diabetes.53.1.160
OpenAlex
W2111493733
Cited by
153
References
17
Citations by year
2026: 3 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 9 · 2021: 7 · 2020: 8 · 2019: 6 · 2018: 4 · 2017: 12 · 2016: 8 · 2015: 8 · 2014: 7 · 2013: 11 · 2012: 10
FWCI
5.79
Type
journal article
Language
en
Open access
Locations
  • Diabetes (publishedVersion)
  • PubMed (publishedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
Funders
  • National Institutes of Health (5r37hl036820-10)
  • National Heart, Lung, and Blood Institute (R37HL36820, HL24799)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
Keywords
type 2 diabetes, diabetes onset, impaired glucose tolerance, normal glucose tolerance, fasting blood glucose, hyperglycemia, insulin, body mass index, oral glucose tolerance test, prediabetes, insulin resistance, beta-cell dysfunction, insulin sensitivity, HOMA-IR, insulin sensitivity index
MeSH terms
Blood Glucose, Body Constitution, Body Weight, Diabetes Mellitus, Type 2, Female, Glucose Tolerance Test, Humans, Male, Middle Aged, Risk Factors, Glucose Intolerance, Disease Progression

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