PMID- 17032347
OWN - NLM
STAT- MEDLINE
DCOM- 20070529
LR  - 20061011
IS  - 0014-2972 (Print)
IS  - 0014-2972 (Linking)
VI  - 36
IP  - 11
DP  - 2006 Nov
TI  - Assessing progression to impaired glucose tolerance and type 2 diabetes mellitus.
PG  - 796-802
AB  - BACKGROUND: A prospective evaluation of the relationship between insulin 
      secretion and insulin sensitivity, derived from the fasting state, is needed in 
      clinical practice in order to identify the worsening of glucose metabolism. In 
      this study the authors examine whether the product of insulin sensitivity and 
      insulin secretion, assessed from the fasting state, predicts progression from 
      normal glucose tolerance (NGT) to impaired fasting glucose (IFG) and from 
      impaired glucose tolerance (IGT) to type 2 diabetes mellitus (T2DM). MATERIALS 
      AND METHODS: A cohort of 300 subjects with NGT and 75 subjects with IGT were 
      followed up over a 5-year period. Insulin sensitivity was calculated using the 
      Belfiore index (B) and insulin secretion by the homeostasis model analysis 
      beta-cell (HOMA-beta cell) index: the product of B-beta is expressed as: (40 x 
      Ins(0) pmol L(-1))/Glu(0) mmol L(-1)[(Glu(0) mmol L(-1)x Ins(0) pmol L(-1)) + 1] 
      - 3.5[(Glu(0) mmol L(-1) x Ins(0) pmol L(-1)) - 1], where Glu(0) is fasting 
      glucose and Ins(0) is fasting insulin. RESULTS: From baseline at the end of the 
      follow-up period, the product B-beta decreased 10.7% and 52.2% in progressors to 
      IGT and T2DM, respectively. The product B-beta predicts the progression from NGT 
      to IGT [relative risk (RR) 2.7, CI(95%) 1.2-9.1] and from IGT to T2DM (RR 5.3, 
      CI(95%) 1.3-8.55). The cut-off point for the product B-beta that better predicts 
      progression from NGT to IGT is 0.25 (sensitivity 88%, specificity 92%) and from 
      IGT to T2DM 0.15 (sensitivity 92%, specificity 95%). CONCLUSIONS: Adaptation of 
      insulin secretion to compensate for decreased insulin sensitivity during 
      transition to IGT and T2DM can be successfully assessed with simple measures 
      derived from the fasting state. The product B-beta predicts the development to 
      IGT and T2DM.
FAU - Guerrero-Romero, F
AU  - Guerrero-Romero F
AD  - Medical Research Unit in Clinical Epidemiology, Mexican Social Security Institute 
      and Research Group on Diabetes and Chronic Illnesses, Durango, Mexico. 
      guerrero_romero@hotmail.com
FAU - Rodriguez-Moran, M
AU  - Rodriguez-Moran M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur J Clin Invest
JT  - European journal of clinical investigation
JID - 0245331
SB  - IM
MH  - Adult
MH  - Cohort Studies
MH  - Diabetes Mellitus, Type 2/*physiopathology
MH  - Disease Progression
MH  - Female
MH  - Glucose Intolerance/physiopathology
MH  - Glucose Tolerance Test
MH  - Humans
MH  - *Insulin Resistance
MH  - Insulin-Secreting Cells/*physiology
MH  - Male
MH  - Middle Aged
MH  - Prediabetic State/physiopathology
EDAT- 2006/10/13 09:00
MHDA- 2007/05/30 09:00
CRDT- 2006/10/13 09:00
PHST- 2006/10/13 09:00 [pubmed]
PHST- 2007/05/30 09:00 [medline]
PHST- 2006/10/13 09:00 [entrez]
AID - ECI1728 [pii]
AID - 10.1111/j.1365-2362.2006.01728.x [doi]
PST - ppublish
SO  - Eur J Clin Invest. 2006 Nov;36(11):796-802. doi: 
      10.1111/j.1365-2362.2006.01728.x.