Changing Clinical Characteristics according to Insulin Resistance and Insulin Secretion in Newly Diagnosed Type 2 Diabetic Patients in Korea.
10.4093/dmj.2015.39.5.387
- Author:
Jang Won SON
1
;
Cheol Young PARK
;
Sungrae KIM
;
Han Kyu LEE
;
Yil Seob LEE
Author Information
1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea. kimsungrae@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Diabetes mellitus, type 2;
Insulin resistance;
Obesity
- MeSH:
Asian Continental Ancestry Group;
Body Mass Index;
C-Peptide;
Cross-Sectional Studies;
Diabetes Mellitus, Type 2;
Fasting;
Female;
Homeostasis;
Humans;
Insulin Resistance*;
Insulin*;
Korea*;
Male;
Obesity;
Obesity, Abdominal;
Plasma;
Prevalence;
Primary Health Care;
Waist Circumference
- From:Diabetes & Metabolism Journal
2015;39(5):387-394
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The role of increased insulin resistance in the pathogenesis of type 2 diabetes has been emphasized in Asian populations. Thus, we evaluated the proportion of insulin resistance and the insulin secretory capacity in patients with early phase type 2 diabetes in Korea. METHODS: We performed a cross-sectional analysis of 1,314 drug-naive patients with newly diagnosed diabetes from primary care clinics nationwide. The homeostasis model assessment of insulin resistance (HOMA-IR) was used as an index to measure insulin resistance, which was defined as a HOMA-IR > or =2.5. Insulin secretory defects were classified based on fasting plasma C-peptide levels: severe (<1.1 ng/mL), moderate (1.1 to 1.7 ng/mL) and mild to non-insulin secretory defect (> or =1.7 ng/mL). RESULTS: The mean body mass index (BMI) was 25.2 kg/m2; 77% of patients had BMIs >23.0 kg/m2. Up to 50% of patients had central obesity based on their waist circumference (> or =90 cm in men and 85 cm in women), and 70.6% had metabolic syndrome. Overall, 59.5% of subjects had insulin resistance, and 20.2% demonstrated a moderate to severe insulin secretory defect. Among those with insulin resistance, a high proportion of subjects (79.0%) had a mild or no insulin secretory defect. Only 2.6% of the men and 1.9% of the women had both insulin resistance and a moderate to severe insulin secretory defect. CONCLUSION: In this study, patients with early phase type 2 diabetes demonstrated increased insulin resistance, but preserved insulin secretion, with a high prevalence of obesity and metabolic syndrome.
