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Challenges in Diagnosing Type 1 Diabetes in Different Populations
Marian Rewers
Diabetes Metab J. 2012;36(2):90-97.   Published online April 17, 2012
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  • 48 Download
  • 33 Crossref
AbstractAbstract PDFPubReader   

Diabetes affects today an estimated 366 million people world-wide, including 20 million to 40 million of patients with type 1 diabetes (T1D). While T1D accounts for 5% to 20% of those with diabetes, it is associated with higher morbidity, mortality and health care cost than the more prevalent type 2 diabetes. Patients with T1D require exogenous insulin for survival and should be identified as soon as possible after diagnosis to avoid high morbidity due to a delay in insulin treatment. It is also important to present to the patient correct prognosis that differs by the type of diabetes. From the research point of view, correct classification should help to identify the etiologies and to develop specific prevention for T1D. This review summarizes evidence that may be helpful in diagnosing T1D in various ethnic groups. Challenges in interpretation of results commonly used to determine the type of diabetes are highlighted.


Citations to this article as recorded by  
  • Evaluation of Corneal Endothelium and Central Corneal Thickness in Children and Adolescents with Type 1 Diabetes
    Semra Tiryaki Demir, Ahmet Uçar, Gizem Kara Elitok, Sümeyra Keleş Yeşiltaş, Emine Betül Akbaş Özyürek, Saniye Üke Uzun
    Hamidiye Medical Journal.2023; 4(1): 50.     CrossRef
  • Analysis of Corneal and Lens Densitometry Changes in Patients With Type 1 Diabetes Mellitus
    Yusuf Cem Yilmaz, Serife Ciloglu Hayat, Sefik Can Ipek
    American Journal of Ophthalmology.2023; 254: 23.     CrossRef
  • Altered Prevalence of Pulp Diagnoses in Diabetes Mellitus Patients: A Retrospective Study
    Yandy Gonzalez Marrero, Yoshifumi Kobayashi, Mohammad Saqib Ihsan, Lisa A. Pilch, Liyaa Chen, Shuying Jiang, Yi Ye, Daniel H. Fine, Carla Y. Falcon, Paul A. Falcon, Craig S. Hirschberg, Emi Shimizu
    Journal of Endodontics.2022; 48(2): 208.     CrossRef
  • The relationship between GAD65 autoantibody and the risk of T1DM onset
    Elham Keshavarzi, Behnoud Baradaran Noveiry, Nima Rezaei
    Journal of Diabetes & Metabolic Disorders.2022; 21(2): 1935.     CrossRef
  • Ketosis-Prone Type 2 Diabetes (Flatbush Diabetes) in Remission: A Report of Two Cases
    Beisi Ji, SumathaChannapatna Suresh, Klynt Bally, Kamrun Naher, Mary A Banerji
    Cureus.2022;[Epub]     CrossRef
  • Analysis of immune cell components and immune-related gene expression profiles in peripheral blood of patients with type 1 diabetes mellitus
    Jian Lin, Yuanhua Lu, Bizhou Wang, Ping Jiao, Jie Ma
    Journal of Translational Medicine.2021;[Epub]     CrossRef
  • Identification of a subgroup of black South Africans with type 1 diabetes who are older at diagnosis but have lower levels of glutamic acid decarboxylase and islet antigen 2 autoantibodies
    C. J. Padoa, P. Rheeder, F. J. Pirie, A. A. Motala, J. C. van Dyk, N. J. Crowther
    Diabetic Medicine.2020; 37(12): 2067.     CrossRef
  • Evaluation of retinal neurovascular structures by optical coherence tomography and optical coherence tomography angiography in children and adolescents with type 1 diabetes mellitus without clinical sign of diabetic retinopathy
    Semra Tiryaki Demir, Ahmet Ucar, Gizem Kara Elitok, Mehmet Egemen Karatas, Murat Karapapak, Oguz Kaan Kutucu, Saniye Uke Uzun, Dilek Guven
    Graefe's Archive for Clinical and Experimental Ophthalmology.2020; 258(11): 2363.     CrossRef
  • A Genome-Wide Analysis of Long Noncoding RNAs in Circulating Leukocytes and Their Differential Expression in Type 1 Diabetes Patients
    Yihan Liu, Xiaoming Du, Jia Cui, Changlong Li, Meng Guo, Jianyi Lv, Xin Liu, Jingtao Dou, Xiaoyan Du, Hongjuan Fang, Zhenwen Chen, Bernd Stratmann
    Journal of Diabetes Research.2020; 2020: 1.     CrossRef
  • Uncommon Presentations of Diabetes: Zebras in the Herd
    Karen L. Shidler, Lisa R. Letourneau, Lucia M. Novak
    Clinical Diabetes.2020; 38(1): 78.     CrossRef
  • Changes in Retinal Microcirculation Precede the Clinical Onset of Diabetic Retinopathy in Children With Type 1 Diabetes Mellitus
    Merve Inanc, Kemal Tekin, Hasan Kiziltoprak, Servan Ozalkak, Sibel Doguizi, Zehra Aycan
    American Journal of Ophthalmology.2019; 207: 37.     CrossRef
  • Autoimmune signatures for prediction and diagnosis of autoimmune diabetes in Kuwait
    Mohamed Jahromi, Fahd Al-Mulla, Ebaa Al-Ozairi
    Autoimmunity Reviews.2019; 18(6): 642.     CrossRef
  • Human Leukocyte Antigen (HLA) and Islet Autoantibodies Are Tools to Characterize Type 1 Diabetes in Arab Countries: Emphasis on Kuwait
    Mohamed Jahromi, Ebaa Al-Ozairi
    Disease Markers.2019; 2019: 1.     CrossRef
  • Complete loss of insulin secretion capacity in type 1A diabetes patients during long‐term follow up
    Sae Uno, Akihisa Imagawa, Junji Kozawa, Kenji Fukui, Hiromi Iwahashi, Iichiro Shimomura
    Journal of Diabetes Investigation.2018; 9(4): 806.     CrossRef
  • Incidence of type 1 diabetes has doubled in Kuwaiti children 0-14 years over the last 20 years
    Azza A. Shaltout, Deborah Wake, Thangavel A. Thanaraj, Dina M. Omar, Dalia Al-AbdulRazzaq, Arshad Channanath, Hessa AlKandari, Majedah Abdulrasoul, Sophie Miller, Nicholas Conway, Jaakko Tuomilehto, Lena Davidsson
    Pediatric Diabetes.2017; 18(8): 761.     CrossRef
  • Objective Evaluation of Corneal and Lens Clarity in Children With Type 1 Diabetes Mellitus
    Kemal Tekin, Merve Inanc, Erdal Kurnaz, Elvan Bayramoglu, Emre Aydemir, Mustafa Koc, Zehra Aycan
    American Journal of Ophthalmology.2017; 179: 190.     CrossRef
  • Differential association of body mass index on glycemic control in type 1 diabetes
    Eun Young Lee, Yong‐ho Lee, Sang‐Man Jin, Hae Kyung Yang, Chang Hee Jung, Cheol‐Young Park, Jae Hyoung Cho, Woo Je Lee, Byung‐Wan Lee, Jae Hyeon Kim
    Diabetes/Metabolism Research and Reviews.2017;[Epub]     CrossRef
  • Progress and challenges in macroencapsulation approaches for type 1 diabetes (T1D) treatment: Cells, biomaterials, and devices
    Shang Song, Shuvo Roy
    Biotechnology and Bioengineering.2016; 113(7): 1381.     CrossRef
  • Covariation of the Incidence of Type 1 Diabetes with Country Characteristics Available in Public Databases
    Paula Andrea Diaz-Valencia, Pierre Bougnères, Alain-Jacques Valleron
    PLOS ONE.2015; 10(2): e0118298.     CrossRef
  • Glycated albumin and the risk of micro- and macrovascular complications in subjects with Type 1 Diabetes
    Hye-jin Yoon, Yong-ho Lee, So Ra Kim, Tyler Hyungtaek Rim, Eun Young Lee, Eun Seok Kang, Bong-Soo Cha, Hyun Chul Lee, Byung-Wan Lee
    Cardiovascular Diabetology.2015;[Epub]     CrossRef
  • Lipid peroxidation and antioxidant protection in girls with type 1 diabetes mellitus during reproductive system development
    Lubov I. Kolesnikova, Marina A. Darenskaya, Natalia V. Semenova, Lyudmila A. Grebenkina, Larisa V. Suturina, Marya I. Dolgikh, Svetlana V. Gnusina
    Medicina.2015; 51(2): 107.     CrossRef
  • Diagnostic criteria for acute‐onset type 1 diabetes mellitus (2012): Report of the Committee of Japan Diabetes Society on the Research of Fulminant and Acute‐onset Type 1 Diabetes Mellitus
    Eiji Kawasaki, Taro Maruyama, Akihisa Imagawa, Takuya Awata, Hiroshi Ikegami, Yasuko Uchigata, Haruhiko Osawa, Yumiko Kawabata, Tetsuro Kobayashi, Akira Shimada, Ikki Shimizu, Kazuma Takahashi, Masao Nagata, Hideichi Makino, Toshiaki Hanafusa
    Journal of Diabetes Investigation.2014; 5(1): 115.     CrossRef
  • The Glycated Albumin to Glycated Hemoglobin Ratio Might Not Be Associated with Carotid Atherosclerosis in Patients with Type 1 Diabetes
    Wonjin Kim, Kwang Joon Kim, Byung-Wan Lee, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee
    Diabetes & Metabolism Journal.2014; 38(6): 456.     CrossRef
  • Diabetes mellitus associada à desnutrição proteica: realidade ou ficção?
    Ana Rita Caldas, André Couto Carvalho, Anabela Giestas, Marta Almeida Ferreira, Cláudia Amaral, Cláudia Freitas, Maria Helena Cardoso
    Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo.2014; 9(1): 79.     CrossRef
  • Diagnostic criteria for acute-onset type 1 diabetes mellitus (2012)
    Eiji Kawasaki, Taro Maruyama, Akihisa Imagawa, Takuya Awata, Hiroshi Ikegami, Yasuko Uchigata, Haruhiko Osawa, Yumiko Kawabata, Tetsuro Kobayashi, Akira Shimada, Ikki Shimizu, Kazuma Takahashi, Masao Nagata, Hideichi Makino, Toshiaki Hanafusa
    Diabetology International.2013; 4(4): 221.     CrossRef
  • Phenylmethimazole Suppresses dsRNA-Induced Cytotoxicity and Inflammatory Cytokines in Murine Pancreatic Beta Cells and Blocks Viral Acceleration of Type 1 Diabetes in NOD Mice
    Kelly McCall, Martin Schmerr, Jean Thuma, Calvin James, Maria Courreges, Fabian Benencia, Ramiro Malgor, Frank Schwartz
    Molecules.2013; 18(4): 3841.     CrossRef
  • Variation of C peptide decay rate in diabetic patients with positive glutamic acid decarboxylase antibody: better discrimination with initial fasting C peptide
    Xia Li, Gan Huang, Jian Lin, Lin Yang, Zhiguang Zhou
    BMC Endocrine Disorders.2013;[Epub]     CrossRef
  • The Emerging Global Epidemic of Type 1 Diabetes
    Jaakko Tuomilehto
    Current Diabetes Reports.2013; 13(6): 795.     CrossRef
  • Clinical characteristics and insulin independence of Koreans with new‐onset type 2 diabetes presenting with diabetic ketoacidosis
    H. Seok, C. H. Jung, S. W. Kim, M. J. Lee, W. J. Lee, J. H. Kim, B‐W. Lee
    Diabetes/Metabolism Research and Reviews.2013; 29(6): 507.     CrossRef
  • Diabetes mellitus and inflammatory pulpal and periapical disease: a review
    S. M. F. Lima, D. C. Grisi, E. M. Kogawa, O. L. Franco, V. C. Peixoto, J. F. Gonçalves‐Júnior, M. P. Arruda, T. M. B. Rezende
    International Endodontic Journal.2013; 46(8): 700.     CrossRef
    Infarma - Ciências Farmacêuticas.2013; 25(4): 206.     CrossRef
  • Proteome‐base biomarkers in diabetes mellitus: Progress on biofluids' protein profiling using mass spectrometry
    Ana Isabel Padrão, Rita Ferreira, Rui Vitorino, Francisco Amado
    PROTEOMICS – Clinical Applications.2012; 6(9-10): 447.     CrossRef
  • Diabetes mellitus: formas de presentación clínica y diagnóstico diferencial de la hiperglucemia en la infancia y adolescencia
    Ó. Rubio Cabezas, J. Argente
    Anales de Pediatría.2012; 77(5): 344.e1.     CrossRef
Original Articles
Effects of Resistance Training and Aerobic Exercise on Insulin Sensitivity in Overweight Korean Adolescents: A Controlled Randomized Trial
Sunghwan Suh, In-Kyong Jeong, Mi Yeon Kim, Yeon Soo Kim, Sue Shin, Sun Sin Kim, Jae Hyeon Kim
Diabetes Metab J. 2011;35(4):418-426.   Published online August 31, 2011
  • 21,704 View
  • 48 Download
  • 22 Crossref
AbstractAbstract PDFPubReader   

Data on the impact of resistance training on insulin resistance in overweight or obese children are inconclusive.


Thirty overweight South Korean adolescents (mean age of 13.10 years) were divided by sex, and then randomly assigned to one of three treatment groups, which were the diet only (DO), diet with aerobic exercise (AE), or diet with resistance training (RT) group. Physiologic and metabolic parameters were assessed at baseline and after 12 weeks of exercise training and diet modification.


Both exercise groups (aerobic and resistance) showed significant improvements in their insulin area under the curve and insulin sensitivity index values when compared to their baseline values while the DO group showed no significant changes in these variables. Age-, sex-, and body mass index (BMI)-adjusted intergroup comparison analyses showed a marked reduction in BMI and a significant reduction in muscle mass in the AE group when compared to the RT group and the DO group, respectively.


A 12-week exercise training program of either resistance or aerobic activity improved insulin sensitivity in overweight adolescents, although it failed to show superiority over a DO program. Aerobic exercise decreased both body weight and BMI, and it was noted that this group also had a significant reduction in muscle mass when compared to the DO group.


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  • Effect of high-intensity interval training and moderate-intensity continuous training on cardiovascular risk factors in adolescents: Systematic review and meta-analysis of randomized controlled trials
    Ya Wang, Shun Wang, Xiangwu Meng, Husheng Zhou
    Physiology & Behavior.2024; 275: 114459.     CrossRef
  • Exercise and Nutrition Strategies for Combating Sarcopenia and Type 2 Diabetes Mellitus in Older Adults
    Dionysia Argyropoulou, Nikolaos D. Geladas, Tzortzis Nomikos, Vassilis Paschalis
    Journal of Functional Morphology and Kinesiology.2022; 7(2): 48.     CrossRef
  • Effects and dose-response relationships of exercise intervention on weight loss in overweight and obese children: a meta-regression and system review
    Rui Xu, Qiao-Ting Huang, Yu-Ting Chen, Peng-Yin Wang
    Journal of Pediatric Endocrinology and Metabolism.2022; 35(9): 1117.     CrossRef
  • The Benefits of Resistance Training in Obese Adolescents: A Systematic Review and Meta-analysis
    Bruno Ribeiro, Pedro Forte, Raquel Vinhas, Daniel A. Marinho, Luís B. Faíl, Ana Pereira, Fernando Vieira, Henrique P. Neiva
    Sports Medicine - Open.2022;[Epub]     CrossRef
  • Effects of Eight Weeks of Combined Training with Antioxidant Vitamins E and C on Glutathione, Glutathione Peroxidase, and Superoxide Dismutase in the Heart Tissue of Streptozotocin-induced Diabetic Rats
    Elaheh Heydarnia, Farzaneh Taghian, Khosro Jalali Dehkodi, Mehrzad Moghadasi
    Gene, Cell and Tissue.2021;[Epub]     CrossRef
  • Effect of resistance training with and without caloric restriction on visceral fat: A systemic review and meta‐analysis
    Mousa Khalafi, Abbas Malandish, Sara K. Rosenkranz, Ali A. Ravasi
    Obesity Reviews.2021;[Epub]     CrossRef
    Samiya Noreen, Muhammad Shafique, Tayyaba Mustafa Mian, Hafiz Abdul Rehman, Abdul Rehman, Muhammad Saad Shafiq, Ibraheem Zafar, Ramsha Masood
    Pakistan BioMedical Journal.2021;[Epub]     CrossRef
  • Role of exercise on insulin sensitivity and beta-cell function: is exercise sufficient for the prevention of youth-onset type 2 diabetes?
    Joon Young Kim, Justin Y. Jeon
    Annals of Pediatric Endocrinology & Metabolism.2020; 25(4): 208.     CrossRef
  • Effects of HIIT and MICT on cardiovascular risk factors in adults with overweight and/or obesity: A meta-analysis
    LiQiang Su, JinMei Fu, ShunLi Sun, GuangGao Zhao, Wei Cheng, ChuanChuan Dou, MingHui Quan, Belinda Parmenter
    PLOS ONE.2019; 14(1): e0210644.     CrossRef
  • What Is the Role of Resistance Exercise in Improving the Cardiometabolic Health of Adolescents with Obesity?
    SoJung Lee, YoonMyung Kim, Jennifer L. Kuk
    Journal of Obesity & Metabolic Syndrome.2019; 28(2): 76.     CrossRef
  • Does exercise training affect resting metabolic rate in adolescents with obesity?
    Angela S. Alberga, Denis Prud’homme, Ronald J. Sigal, Gary S. Goldfield, Stasia Hadjiyannakis, Réjeanne Gougeon, Penny Phillips, Janine Malcolm, George A. Wells, Steve Doucette, Jinhui Ma, Glen P. Kenny
    Applied Physiology, Nutrition, and Metabolism.2017; 42(1): 15.     CrossRef
  • Iniciación al entrenamiento de fuerza en edades tempranas: revisión
    G. Peña, J.R. Heredia, C. Lloret, M. Martín, M.E. Da Silva-Grigoletto
    Revista Andaluza de Medicina del Deporte.2016; 9(1): 41.     CrossRef
  • Effects of aerobic training, resistance training, or both on cardiorespiratory and musculoskeletal fitness in adolescents with obesity: the HEARTY trial
    Angela S. Alberga, Denis Prud’homme, Ronald J. Sigal, Gary S. Goldfield, Stasia Hadjiyannakis, Penny Phillips, Janine Malcolm, Jinhui Ma, Steve Doucette, Rejeanne Gougeon, George A. Wells, Glen P. Kenny
    Applied Physiology, Nutrition, and Metabolism.2016; 41(3): 255.     CrossRef
  • The response of circulating omentin-1 concentration to 16-week exercise training in male children with obesity
    Farzad Zehsaz, Negin Farhangi, Mehri Ghahramani
    The Physician and Sportsmedicine.2016; 44(4): 355.     CrossRef
  • Epidemiology of Childhood Obesity in Korea
    Kyoung Hwa Ha, Dae Jung Kim
    Endocrinology and Metabolism.2016; 31(4): 510.     CrossRef
  • Muscle strength in youth and cardiovascular risk in young adulthood (the European Youth Heart Study)
    Anders Grøntved, Mathias Ried-Larsen, Niels Christian Møller, Peter Lund Kristensen, Karsten Froberg, Søren Brage, Lars Bo Andersen
    British Journal of Sports Medicine.2015; 49(2): 90.     CrossRef
  • Position statement on youth resistance training: the 2014 International Consensus
    Rhodri S Lloyd, Avery D Faigenbaum, Michael H Stone, Jon L Oliver, Ian Jeffreys, Jeremy A Moody, Clive Brewer, Kyle C Pierce, Teri M McCambridge, Rick Howard, Lee Herrington, Brian Hainline, Lyle J Micheli, Rod Jaques, William J Kraemer, Michael G McBride
    British Journal of Sports Medicine.2014; 48(7): 498.     CrossRef
  • Abdominal obesity and low physical activity are associated with insulin resistance in overweight adolescents: a cross-sectional study
    Claudia-María Velásquez-Rodríguez, Marcela Velásquez-Villa, Leidy Gómez-Ocampo, Juliana Bermúdez-Cardona
    BMC Pediatrics.2014;[Epub]     CrossRef
  • Exercise and Insulin Resistance in Youth: A Meta-Analysis
    Michael V. Fedewa, Nicholas H. Gist, Ellen M. Evans, Rod K. Dishman
    Pediatrics.2014; 133(1): e163.     CrossRef
  • What is the Effect of Resistance Training on the Strength, Body Composition and Psychosocial Status of Overweight and Obese Children and Adolescents? A Systematic Review and Meta-Analysis
    Natasha Schranz, Grant Tomkinson, Tim Olds
    Sports Medicine.2013; 43(9): 893.     CrossRef
  • A Review of Randomized Controlled Trials of Aerobic Exercise Training on Fitness and Cardiometabolic Risk Factors in Obese Adolescents
    A. S. Alberga, A. Frappier, R. J. Sigal, D. Prud'homme, G. P. Kenny
    The Physician and Sportsmedicine.2013; 41(2): 44.     CrossRef
  • Effects of Aerobic Versus Resistance Exercise Without Caloric Restriction on Abdominal Fat, Intrahepatic Lipid, and Insulin Sensitivity in Obese Adolescent Boys
    SoJung Lee, Fida Bacha, Tamara Hannon, Jennifer L. Kuk, Chris Boesch, Silva Arslanian
    Diabetes.2012; 61(11): 2787.     CrossRef
The Effect of Rosiglitazone on Gluose Metabolism and Insulin Sensitivity in Non Obese Type 2 Diabetic Rat Models.
Mi Jin Kim, Eui Jong Chung, Byung Wook Ha, Ji Hoon Kim, Su Min Nam, Mi Young Lee, Jang Hyun Kho, Young Goo Shin, Choon Hee Chung
Korean Diabetes J. 2007;31(4):319-325.   Published online July 1, 2007
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  • 21 Download
AbstractAbstract PDF
In Korea, most of type 2 diabetic patients are non obese. We made non obese type 2 diabetic rat models, which were characterized by insulin resistance and insulin secretion defect. Our study aimed to investigate the effect of rosiglitazone on glucose metabolism and insulin sensitivity in non obese type 2 diabetic rat models. Furthermore, we may estimate the effect of rosiglitazone treatment in non obese type 2 diabetic patients in Korea. METHODS: 20 male newborn (12 hours old) Sprague-Dawley rats were made diabetes by streptozotocin (75 mg/kg, intraperitoneal injection). At 16 weeks old, diabetes were confirmed by intraperitoneal glucose tolerance test (IPGTT, 30% D/W, 2 kg/kg). After that, diabetic groups were divided into two groups. One group was fed on normal chow and rosiglitazone (3 mg/kg/day) and the other group was fed on normal chow for eight weeks. At the age of 24 weeks, we measured body weight (BW), plasma glucose, insulin, C-peptide levels. And we performed IPGTT and insulin tolerance test (ITT) in two groups. Thereafter, we determined the insulin content of pancreas and epididymal fat weight. RESULTS: Body weight was significantly higher in rosiglitazone group than control group. On IPGTT, plasma glucose, insulin and C-peptide levels were not significantly different between two groups. But, on insulin tolerance test, Kitt (%/min) values of rosiglitazone group were significantly higher than control group (2.7 vs. 1.8). The insulin content of pancreas and epididymal fat weight was not different between two groups. CONCLUSION: These results suggested that rosiglitazone improved insulin sensitivity in non obese type 2 diabetes rat models independent of glucose level.
Usefulness of Insulin Sensitivity Indexes derived from Oral Glucose Tolerance Test in Women with Polycystic Ovary Syndrome.
Hyo Jeong Kim, Eun Kyung Byun, Jee Young Oh, Yeon Ah Sung, Hye Won Chung
Korean Diabetes J. 2006;30(4):277-284.   Published online July 1, 2006
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  • 22 Download
  • 1 Crossref
AbstractAbstract PDF
Insulin resistance is prevalent in women with polycystic ovary syndrome (PCOS), and it makes them to have high risk for development of type 2 diabetes. Evaluation of insulin sensitivity would be important to predict their risks. Although the euglycemic-hyperinsulinemic clamp technique is the gold standard for measuring insulin sensitivity, it is too hard to practice in large epidemiologic studies. The aim of this study is to verify the validity of various insulin sensitivity indexes from oral glucose tolerance test (OGTT) in women with PCOS. METHODS: We performed euglycemic-hyperinsulinemic clamp (target glucose; 90 mg/dL, insulin ;~1 mU/kg.min) to obtain insulin-mediated glucose disposal rate (M-value) in 62 non-diabetic women with PCOS (BMI < 23 kg/m2; n = 37, BMI > or = 23 kg/m2; n = 25). Homeostasis model assessment [HOMA(IR)], quantitative insulin sensitivity check index (QUICKI), glucose to insulin ratio (G/I ratio), whole body insulin sensitivity index [ISI(COMP)], metabolic clearance rate of glucose [MCR(est)-OGTT(1,2)], and insulin sensitivity indexes [ISI(est)-OGTT(1,2)] were calculated from plasma glucose and insulin levels from standard 75-g OGTT. The correlations of various insulin sensitivity indexes from OGTT with M-value were evaluated. RESULTS: In lean women with PCOS (BMI < 23 kg/m2, n = 37), ISI(COMP) (r = 0.36, P < 0.05), MCRest-OGTT1 (r = 0.49, P < 0.01), ISI(est)-OGTT(1) (r = 0.50, P < 0.01), MCR(est)-OGTT(2) (r = 0.45, P < 0.01) and ISI(est)-OGTT(2) (r = 0.40, P < 0.05) were significantly correlated with M-value. In overweight and obese women with PCOS (BMI > or = 23 kg/m2, n = 25), HOMA(IR) (r = -0.40, P < 0.05), QUICKI (r = 0.40, P < 0.05), MCR(est)-OGTT(1) (r = 0.76, P < 0.001), ISI(est)-OGTT(1) (r = 0.63, P < 0.001), MCR(est)-OGTT(2) (r = 0.58, P < 0.01) and ISI(est)-OGTT(2) (r = 0.42, P < 0.05) showed significant correlations with M-value. CONCLUSION: MCR(est)-OGTT(1) and ISI(est)-OGTT(1) were the most reliable and easily accessible insulin sensitivity indexes obtained from OGTT for measuring of insulin sensitivity in women with PCOS regardless of obesity.


Citations to this article as recorded by  
  • Insulin resistance in a large cohort of women with polycystic ovary syndrome: a comparison between euglycaemic-hyperinsulinaemic clamp and surrogate indexes
    Flavia Tosi, Enzo Bonora, Paolo Moghetti
    Human Reproduction.2017; 32(12): 2515.     CrossRef
Effects of Aging and Obesity on Insulin Secretion and Sensitivity.
J Y Kim, J H Jee, H J Kim, B W Lee, Y J Chung, J H Chung, Y K Min, M S Lee, M K Lee, K W Kim
Korean Diabetes J. 2005;29(1):39-47.   Published online January 1, 2005
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AbstractAbstract PDF
Type 2 diabetes is occurring in epidemic proportions worldwide and aging has been defined as one of the risk factors for the progression to diabetes. The mechanism responsible for deterioration of glucose tolerance with aging is still unclear. It has been debated whether this deterioration results from an abnormal beta cell secretory function or/and decreased insulin sensitivity, from the aging process per se, or some other factors, such as an increase in BMI and abdominal fat. The changes in the insulin secretion and sensitivity were assessed in relation to aging and obesity, and the association between obesity and factors influencing glucose homeostasis in obese subjects evaluated. METHODS: 530 individuals, aged 24 to 75 years, having undergone a 75 g OGTT were enrolled, and the insulinogenic index and HOMA-IR calculated for each subject. 212 individuals were obese, i.e. a BMI above 25, which was evaluated from the body composition by CT at the umbilicus and thigh levels. RESULTS: There was negative correlation between the insulinogenic index and age, but not between HOMA-IR and age. In relation to increasing age, the body composition changed toward a metabolically obese state, with increasing WHR, visceral fat area, VSR and VWR. Both the insulinogenic index and HOMA-IR were positively correlated with the anthropometric parameters. CONCLUSION: The age-associated deterioration in glucose tolerance may be due to decreases in both insulin secretion and insulin sensitivity from changes in body composition
Effect of Captopril on Insulin Sensitivity for Subjects with Insulin Resistance.
Hye Jung Lee, Hyuk Sang Kwon, Jin Hee Lee, Sung Koo Kang, Yoon Hee Choi, Sung Ha Hwang, Seung Hyun Ko, Jung Min Lee, Kun Ho Yoon, Bong Yun Cha, Won Chul Lee, Kwang Woo Lee, Ho Young Son
Korean Diabetes J. 2004;28(5):416-424.   Published online October 1, 2004
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AbstractAbstract PDF
Angiotensin converting enzyme (ACE) inhibitors are becoming increasingly popular as the first-choice antihypertensive agents for diabetic patients. This could be partly related to their suggested beneficial effects on insulin sensitivity. This study was designed to compare the effect of captopril with that of control (nitrendipine) on insulin sensitivity for subjects with insulin resistance. METHODS: 24 subjects, aged less than 60 years, with their insulin resistance being defined as the area under the curve (AUCi) of insulin that was 2 standard deviations (SD) more than that of the control subjects during oral glucose tolerance test were recruited. A randomized, double-blind, crossover trial was conducted for an 8 weeks treatment period with captopril and the control (nitrendipine) that was given after an initial 6 weeks run-in period. Anthropometric measurement including weight, height, waist and hip circumference, blood pressure (systolic & diastolic), lipid profile blood chemistry, electrolytes levels & renal function testing, and frequently sampled intravenous glucose tolerance tests (FSIGT) for the insulin sensitivity index (SI) & acute insulin response to glucose (AIRg) were also done before and after treatment, respectively. RESULTS: 18 subjects (6 males, 12 females) completed the study. The mean age of the study subjects was 47.9+/-2.9 years (mean+/-SEM), and their BMI was 28.0+/-0.7 kg/m2 (mean+/-SEM).There was a significant decrease in weight (baseline; 71.5+/-9.2 kg vs. captopril; 70.7+/-9.0 kg and nitrendipine; 709+/-9.2 kg, p<0.05, respectively) and BMI (baseline; 28.0+/-3.0 kg/m2 vs. captopril; 27.7+/-2.8 kg/m2 and nitrendipine; 27.8+/-2.9 kg/m2, p<0.05, respectively) for both groups compared with the baseline, but there are no significant differences between the two groups. Triglyceride was significantly decreased after treatment with captopril compared to the baseline and nitrendipine (187.0+/-99.5 mg/dL vs. 224.5+/-134.2 mg/dL, respectively, p<0.05). The SI was significantly increased after captopril treatment compared with the baseline (1.4+/-1.0 vs. 2.5+/-0.8 min-1 per mU/ml, respectively, p<0.05), and the captopril group was significantly higher than that of nitrendipine (1.5+/-1.0 min-1 per mU/ml, p <0.05). Acute insulin response to glucose in both groups was also increased after treatment, but there was no statistically significance. CONCLUSION: Captopril therapy improved insulin sensitivity, and it decreased the concentration of fasting insulin in subjects with insulin resistance.
Insulin Secretory Dysfunction in the Pathogenesis of Type 2 Diabetes in Koreans: A Minimal Model Analysis.
Sung Hoon Kim, Dong Jun Kim, Byung Wan Lee, In Ah Seo, Jae Hoon Chung, Young Ki Min, Myung Shik Lee, Kwang Won Kim, Moon Kyu Lee
Korean Diabetes J. 2003;27(5):414-419.   Published online October 1, 2003
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AbstractAbstract PDF
Type 2 diabetes is a complex, heterogeneous disorder, characterized by impairments in both insulin secretion and insulin action. This study was done to examine the significance of alterations in insulin sensitivity and beta-cell function in the pathogenesis of type 2 diabetes in Korean subjects with varying degrees of glucose intolerance. METHODS: Forty Korean subjects were studied, 12 with normal glucose tolerance (NGT), 14 with impaired glucose tolerance (IGT) and 14 with type 2 diabetes. An oral glucose tolerance test (OGTT) was performed on each subject. Insulin sensitivity (SI), glucose effectiveness (Sg), acute insulin response after intravenous glucose (AIRg) and the disposition index (DI= SI x AIRg) were measured by the insulin-modified, frequently sampled intravenous glucose tolerance test (FSIGT). RESULTS: Neither fasting serum insulin level nor SI was significantly different among the NGT, lGT and diabetes groups. Sg was significantly lower in the type 2 diabetes group than in the NGT group. The mean AIRg was blunted in the IGT and diabetes groups when compared with the NGT group. DI was more powerful in differentiating between NGT and IGT, compared to AIRg alone. CONCLUSION: These findings suggest that a defect in the compensatory insulin secretion might be more important than insulin resistance in the development of type 2 diabetes in Korean subjects.
The Role of Chromium as an Insulin Sensitizer in Rats Receivieng Corticosteroid.
Dong Sun Kim, Chang Beom Lee, Yong Soo Park, You Hern Ahn, Tae Wha Kim, Ho Soon Choi, Il Kyu Park, Hyun Jin Shin, Ju Seop Kang
Korean Diabetes J. 2001;25(3):211-217.   Published online June 1, 2001
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Chromium (Cr) has been known to be essential for the regulation of insulin action. Recently it has been reported that corticosteroid increases urinary loss of Cr, and that Cr supplementation recovers steroid induced diabetes mellitus. METHODS: Rats were daily treated with dexamethasone (0.2 mg/kg, ip) for first 7 days and were further treated daily with dexamethasone plus either chromium picolinate (30 mg/kg) or a placebo for a period of 14 days. RESULTS: At the end of experiment (Day 21), the control rats treated only with dexamethasone weighed 320 gram (80% of initial weight) in average, but the Cr treated rats weighed 364 gram (91% of initial weight. p<0.05). An insulin sensitivity test [subcutaneous injection of insulin (5 U/kg) plus intraperitoneal injection of glucose (30 minutes after insulin injection)] were conducted. During the insulin sensitivity tests, the area under curves (AUC(0->120 min)) of the time-glucose concentrations curves in the Cr-treated group were decreased compared to those in the control group (5250 vs 15883 mg-min/dL, p<0.01). Fasting serum insulin levels in the Cr-treated rats were clearly decreased by 46.9% compared to those in the control group (2.98 vs 5.60 ng/mL, p<0.05). CONCLUSIONS: We conclude that chromium supplementation reverse a catabolic state, and increase insulin sensitivity in dexamethasone treated rats.
The Combined Effects of Protein Malnutrition and Chronic Alcohol lntake on lnsulin Secretion and Sensitivity in Growing Rats.
Bong Soo Cha, Chul Woo Ahn, Hae II Lee, Yong Seok Yoon, Jae Kyeung Sung, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 2000;24(1):19-36.   Published online January 1, 2001
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This investigation was performed to examine the combined effects of protein malnutrition and chronic moderate amount of alcohol intake on insulin secretory capacity and sensitivity in growing rats. METHODS: Weanling 4-week-old male Sprague-Dawley rats were fed low protein [5%, (wt/wt)] or control (C, 20%) diet from 4 to 12 weeks and alcohol (5g/kg/d) or saline gavage from 8 to 12 weeks. All rats were divided into the 4 groups according to different diet protocols: group 1 (protein-deficient alcohol rats), group II (protein-deficient saline rats), group III (protein-sufficient alcohol rats), and group IV (protein-sufficient saline or control rats), At the age of 12 weeks, we determined the insulin secretory capacity and sensitivity in the 4 different diet groups. RESULTS: The results are summarized as following: 1. Normal weight gain was nearly completely arrested in protein-deficient rats compared to control rats. In protein-sufficient rats, chronic alcohol intake decreased body weight gain. Pancreatic weight adjusted with body weight was not different among the 4 groups, but epididymal fat weight adjusted with body weight was decreased in group II compared to group IV. 2. Intraperitoneal glucose tolerance was improved in group I compared to the other groups. Insulin responses to glucose challenge were markedly decreased in group II compared to group IV, but not in group l. 3. Glucose disposal rate during euglycemic clamp test was diminished in group II compared to qroup IV, but there were no differences between group I and group I 3. Glycogen synthase activities of skeletal muscle after 2 hour hyperinsulinemic state were not different among the 4 groups. 4. There were no differences of reserved insulin content of whole pancreas adjusted with pancreas weight among the 4 groups. 5. In light microscopic findings of pancreatic islets, sizes of islets, islet cells and nuclei were decreased in protein-deficlent rats compared to control rats. However, the sizes of islet cells and nuclei were further decreased in group II compared to group l. CONCLUSION: These results suggest that impaired insulin secretion and decreased insulin sensitivity due to protein malnutrition can be restored by chronic, moderate amount of alcohol intake, but these beneficial effects may not be appeared in protein-sufficient state. Therefore, the chronic alcohol intake differently influences glucose metabolism according to individual nutritional status, and further studies for the effects of alcohol intake in lean diabetic patients are required to extrapolate these resuits in human.
Relation of Angiotensin Converting Enzyme (ACE) Gene Polymorphism to Insulin Sensitivity and Carotid Atherosclerosis in Female Nondiabetic Offspring of NIDDM Patients.
Jee Young Oh, Yeon Ah Sung, Nan Ho Kyung, Yeon Jin Jang
Korean Diabetes J. 1999;23(6):831-842.   Published online January 1, 2001
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Angiotensin converting enzyme (ACE) gene polymorphism has been known to related to atherosclerotic heart disease such as acute myocardial infarction or left ventricular hypertrophy, diabetic nephropathy or retinopathy, as well as, insulin sensitivity. However, an exact relationship between ACE gene polymorphism and aforementioned diseases have not been fully established. It has been suggested that NIDDM and atherosclerosis may have common pathogenesis since some of NIDDM patients already have atherosclerotic changes at the time of the initial diagnosis. Futhermore, offspring of NIDDM patients are considered as a high risk group for both NIDDM and atherosclerosis, and these two disorders are known to be affected by some common genetic factors. Therefore, in the present study, we planned to investigate, by analyzing female offspring of NIDDM patients (offspring), the relationship of ACE gene polymorphism to insulin resistance and atherosclerosis. METHODS: Fifty-three female offspring of patients with NIDDM were participated in this study, and twenty age-BMI matched normal glucose tolerant subjects without a family history of diabetes were selected as the controls. Based on 75-g oral glucose tolerance test, subjects were divided into normal glucose tolerance (n=42) or impaired glucose tolerance (n=ll). We assessed the patterns of body fat distribution by anthropometric measurement, bioelectric impedence analysis and computed tomogram; insulin sensitivity by minimal model analysis using insulin modified frequently sampled intravenous glucose tolerance test; carotid intima-medial thickness by ultrasonography. We investigated the alleles of the ACE gene by PCR. RESULT: 1. ACE genotypes in offspring were distributed as follows; 39.6% for II, 32.0% for ID, 28.4% for DD 55.7% for I al#lele, 44.3% for D allele. This distribution was not significantly different from those in controls (35.0% for II, 55.0% for ID, 10.0% for DD, 62.5% for I allele, and 37.5% for D allele). 2. There was no significant difference in body mass index (BMI), systolic and diastolic blood pressure, and serum lipid concentrations among three genotypes. However, in the subjects with ID genotype, VSR was significantly increased compared to the subjects with DD genotype (p<0.05). In the subjects with ID genotype, percent body fat, visceral fat area, CIMT were increased, and SI and SG were decreased in comparison to II and DD subjects, although the differences between the two groups did not reached the statistical significance. 3. When the subjects were divided into quartiles of CIMT, the frequency of ID genotype of ACE showed the tendency of increment from the lowest to the highest quartile of CIMT. 4. Multiple regression analysis showed that ACE genotypes was significantly associated with visceral obesity, carotid intima-medial thickening and insulin sensitivity. CONCLUSION: ACE genotypes was not significantly associated with visceral obesity, carotid intima- medial thickening and insulin sensitivity. However, to explore the true associations of ACE gene polymorphism with insulin resistance and ather-osclerosis, we further suggest and recommend prospective studies.
Insulin Secretion, Insulin Sensitivity and Body Fat Distribution Patterns in Patients with Impaired Glucose Tolerance.
Jin Hwa Lee, Yeon Ah Sung, Nan Ho Kyung, Yeon Jin Jang
Korean Diabetes J. 1999;23(5):647-660.   Published online January 1, 2001
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Type 2 diabetes mellitus(DM) is characterized by impaired insulin secretion and decreased insulin sensitivity, and often preceded by impaired glucose tolerance (IGT). To determine the relative importance of impaired insulin secretion and insulin resistance in development of type 2 DM, we evaluated body fat distribution patterns, insulin secretion and sensitivity in patients with IGT. METHODS: Thirty-six patients with IGT and age and weight matched twenty-four control subjects, were recruited from urban diabetes incidence cohort. Fasting serum glucose and insulin were measured. Body fat distribution pattern was assessed by waist to hip ratio (WHR), percent body fat and fat mass measured by bioelectrical impedence analyzer, and visceral to subcutaneous fat ratio (VSR) at the level of umbilicus using the computed tomography. Using insulin modified intravenous glucose tolerance test, insulin sensitivity was measured as minimal model derived sensitivity index (S(I)), and insulin secretion was measured as acute insulin response to glucose (AIR(g)) and beta-cell disposition index (AlR(g) X Sr). RESULT: l) In the patients with IGT, AIR(g)X S(I)(p<0.01) and area under the curve of insulin (AUC(I))(p<0.01) were significantly decreased compared with control subjects and age was greater than control subjects without statistical significance (p=0.17). 2) In the patients with IGT, body fat distribution patterns, indices of insulin secretion and sensitivity were not different according to the presence of family history of DM. AIR, and S(I) were negatively correlated in control subjects (r=-0.38, p=0.08) and the patients with IGT without family history of DM (r=-0.37, p=0.10), but not in the patients with IGT with family history of DM. 3) In the patients with IGT, indices of insulin secretion and sensitivity were not different according to body mass index (BMI). In both obese (BMI>=25 kg/m ) and non-obese (BMI<25 kg/m) patients with IGT, AIR(g)(p<0.05) and AIR(g) X S(I) were significantly decreased compared with control subjects (p<0.01). 4) In control subjects, age (p<0.05) and body fat mass (p<0.05) were significantly associated with AIR(g) X S(I) by multiple regression analysis. In the patients with IGT, body fat mass was significantly associated with AIR(g)(p<0.01) and AUC(I)(p<0.01), and BMI(p<0.01) was significantly associated with S(I). CONCLUSION: In patients with IGT, impaired insulin secretion was more prominent than decreased insulin sensitivity as compared with control subjects regardless of obesity and the presence of family history.
The Effect of Cyclosporine on Insulin Sensitivity in Streptozotocin Induced Diabetic Rats.
Ju Seop Kang, Dong Sun Kim, Chang Beom Lee, Yong Soo Park, Woong Hwan Choi, Tae Wha Kim, Mok Hyun Kim
Korean Diabetes J. 1999;23(2):142-146.   Published online January 1, 2001
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Cyclosporine (CsA), being used as a immunosuppressant is known to have deleterious effects on the liver and kidney, but the harmful effect on glucose tolerance has not been clearly elucidated. This study was undertaken to determine whether the CsA affected peripheral insulin sensitivity in streptozotocin (STZ)-induced diabetic Sprague-Dawley rats. METHODS: After the daily treatment of CsA (10mg/kg, i.p.) for 2 weeks, glucose tolerance tests were carried out by the intraperitoneal administration of glucose alone or in conjunction with insulin (5 U/kg, s.c.). The glucose tolerance and peripheral insulin sensitivity were determined by measuring the deremental area under the time-lasma glucose concentration curve (AUC; mg-min/mL) according to the trapezoidal rule. The plasma glucose levels (mg/dL) were measured by a glucose analyzer at 0, 10, 30, 60, 90 and 120min after glucose load (2 g/kg). The STZ-diabetic rats were divided into thre groups (GLU- as control, INS+GLU- and CsA+INS+GLU-treated group, n 7 in each groups). RESULTS: In STZ-diabetic rats, the AUC 0-120 of the CsA+INS+GLU-treated group was significantly (p<0.01) lower than those of the control group (48.6% of control), but significantly (p<0.03) higher thain those of the INS+GLUtreated group (28.1% of control). CONCLUSIONS: These results suggest that intraperitoneal injection of CsA gives rise to a deterioration of glucose etabolism which is probably due to a decrease of insulin sensitivity of peripheral tissue in STZ-diabetic rats.
Insulin Resistance and Related Factors in the Healthy Young Men.
Seok Won Park, Yoon Sok Chung, Yong Seok Yun, Bong Soo Cha, Young Duk Song, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1998;22(4):504-512.   Published online January 1, 2001
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Resistance to insulin-stimulated glucose uptake is present in the majority of patients with obesity, glucose intolerance, hypertension, dyslipidemia, and coronary artery disease. It is known that values for insulin-stimulated glucose uptake(insulin sensitivity) vary widely within individuals with normal glucose tolerance. We investigated the variations in insulin sensitivity and related factors in the nonobese healthy young men. METHODS: Insulin sensitivity was considered as whole body insulin-stimulated glucose uptake rate(M), determined by euglycemic hyperinsulinemic clamp technique in 44 non-obese healthy young men with normal glucose tolerance. Plasma glucose, insulin, and C-peptide concentrations after a standard oral glucose tolerance test and total cholesterol, triglyceride, and HDL-cholesterol levels were measured after 12-hours fasting. The subjects were divided into four quartiles based on the insulin sensitivity (M) and their clinical and biochemical characteristics were compared. RESULTS: Glucose disposal rates (M-values) were ranged from 4.14 to 11.06 mg/kg/min and distributed normally. The plasma glucose levels were not different between quartiles but plasma insulin levels of quartile 1 were significantly higher than the other three quartiles during oral glucose tolerance test. There was a curvilinear relationship between insulin sensitivity and acute insulin response (Ins[o-30]) to oral glucose challenge. There were negative cnrrelations between insulin sensitivity and BMI, percent ideal body weight, WHR, body fat content, fasting insulin level, insulin response area during OGTT, and fasting serum triglyceride level. HDL-cholesterol concentration was positively correlated with insulin sensitivity. In multiple linear regression analysis, body fat content, fasting insulin, and HDL-cholesterol were independent variables, which were related to the insulin sensitivity. CONCLUSION: There were considerable variations in insulin sensitivity in the nonobese healthy young men with normal glucose tolerance and the related independent factors were body fat content, fasting insulin, and HDL-cholesterol cancentrations.
Dehydroepiandrosterone-Sulfate, Sex Hormone Binding Globulin, Body Fat Distribution Pattern and Insulin Resistance in Women.
Young Sun Hong, Jee Young Oh, Yeon Ah Sung, Nan Ho Kyung, Yeon Jin Jang
Korean Diabetes J. 1998;22(3):328-337.   Published online January 1, 2001
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Sex hormone-binding globulin (SHBG) has been known to be associated with obesity, central fat accumulation and insulin resistance and thought to be a indirect marker for androgenicity in women. The relationships between circulating dehydroepiandrosterone(DHEA). dehydroepiandrosterone sulfate(DHEA-S) levels and body fat accumulation are still controversial. We conducted a cross-sectional study to eva]uate the relationships between serum levels of SHBG, DHEA-S, body fat distribution pattern and insulin sensitivity in women. METHODS: We tested 57 women(age 30~65yr; BMI 18.5~32.8kg/m, 45 premenopausal on the 5~10 day of the menstrual cycle, 12 postmenopausal who were not using hormone replacement therapy) with varying degree of glucose tolerance(32 normal glucose tolerance(NGT), 17 impaired glucose tolerance(IGT) and 8 newly diagnosed diabetes). lnsulin sensitivity was measured as minimal model derived sensitivity index(S) using insulin modified IV glucose tolerance test and fasting serum levels of SHBG and DHEA-S were measured by RIA. Body fat distribution pattern was assessed by waist to hip ratio(WHR),% body fat measured by bioelectrical impedance analyzer, subcutaneous fat area(SFA), visceral fat area(VFA) and VFA to SFA ratio(VSR) at the level of umbilicus using the computed tomography. RESULTS: 1) Measured SHBG and DHEA-S levels were not significantly different among subjects with NGT, IGT and diabetes. 2) SHBG was inversely associated with age, BMI, WHR, diastolic blood pressure, VFA, SFA, VSR,% body fat, fasting insulin and positively associated with S, whereas DHEA-S did not show any significant correlation with above variables except diastolic blood pressure. 3) SHBG level was significantly lower(p<0.05) and DHEA-S level was insignificantly lower (p=0.05) in postmenopausal women than in premenopausal women but the significance disappeared after adjustment for age, BMI, WHR and% body fat. 4) BMI was independently and negatively related to S, WHR and fasting insulin to SHBG by multiple regression analysis. CONCLUSION: We confirmed that SHBG was independently associated with central obesity and fasting hyperinsulinemia. However, S was independently associated with BMI only. It suggested that hyperinsulinemia in insulin resistance might cause the decreased level of SHBG even thaugh the directionality of the association was uncertain because of a cross-sectional nature of this study.
Short Insulin Tolerance Test(SITT) for the Determination of in vivo Insulin Sensitivity-A Comparison with Euglycemic Clamp Test.
Seok Won Park, Yong Seok Yun, Churl Woo Ahn, Jae Hyun Nam, Suk Ho Kwon, Min Kyung Song, Seol Hye Han, Bong Soo Cha, Young Duk Son, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1998;22(2):199-208.   Published online January 1, 2001
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The euglycemic hyperinsulinemic clamp technique is currently regarded as gold standard for measuring insulin sensitivity, but it requires sophisticated equipment and highly trained personnel. We investigated the reliability of short insulin tolerance test as a simple tesl to measure in vivo insulin sensitivity. METHODS: Short insulin tolerance test(SITT) and euglyeemic hyperinsulinemic clamp test were performed at random order in 14 healthy subjects and 10 abnormal glucose tolerant subjects. The plasma glucose disappearance rate(kitt: %/min) after iv injection of regular insulin(0.1U/kg) was determinecl and compared to insulin sensitivitv indices(M, M/I) of euglycemic hyperinsulinemic clamp test. RESULTS: The mean Kitt value of healthy subjects was 3.50+0.75%/min and that of subjects with abnormal glucose tolerance was 2.56+0.56%/min. Changing sampling time from 15 min to 18~21 min and sampling interval from 3 min to 1.5 min had no influence on Kitt value. Kitt values were reproducible in six subjects, with a CV of 8.8+2.0%. There was a highly significant correlations between the Kitt value derived from SITT and M or M/I derived from euglycemic hyperinsulinemic clamp test. There were no significant adverse effects including hypoglycemic symptom while performing SITT. CONCLUSION: SITT is simple, safe, rapid to perform, and provides reliable index of in vivo insulin sensitivity. It seems particularly suitable for studies involving large series of subjects or including repeated evaluation of insulin sensitivity.

Diabetes Metab J : Diabetes & Metabolism Journal
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