Summary
Insulin responses to intravenous glucose infusion and glucose utilization during hyperinsulinaemic euglycaemic clamp were determined in a large homogeneous group of 65-year-old male subjects. Twenty-eight had untreated Type 2 (non-insulin-dependent) diabetes mellitus and the remaining 44 control subjects had a normal glucose tolerance. Diabetic patients with abdominal obesity displayed peripheral insulin resistance in combination with defective insulin secretion, whereas non-obese diabetic patients showed only a secretory defect. Thus, Type 2 diabetes in obese and non-obese elderly male subjects may take two forms where the cause of hyperglycaemia differs.
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Reaven GM (1988) Role of insulin resistance in human disease. Diabetes 37: 1595–1607
Beck-Nielsen H (1989) Insulin resistance in skeletal muscles of patients with diabetes mellitus. Diab Metab Rev 5: 487–493
Bogardus C (1989) Perspective: does insulin resistance primarily affect skeletal muscle? Diab Metab Rev 5: 527–528
Gerich JE (1988) Role of insulin resistance in the pathogenesis of type 2 (non-insulin-dependent) diabetes mellitus. Baillières Clin Endocrinol Metab 2: 307–326
Taylor R, Agius L (1988) The biochemistry of diabetes. Biochem J 250: 625–640
Pedersen P (1989) The impact of obesity on the pathogenesis of non-insulin-dependent diabetes mellitus: a review of current hypothesis. Diab Metab Rev 5: 505–509
Ginsberg H, Kimmerling G, Olefsky JM, Reaven GM (1975) Demonstration of insulin resistance in untreated adult onset diabetic subjects with fasting hyperglycemia. J Clin Invest 155: 454–461
Kolterman OG, Gray RS, Griffin J, Burstein P, Insel J, Scarlett JA, Olefsky JM (1981) Receptor and post-receptor defects contribute to the insulin resistance in non-insulin-dependent diabetes mellitus. J Clin Invest 68: 957–969
De Fronzo RA, Simonson D, Ferrannini E (1982) Hepatic peripheral insulin resistance: a common feature of Type 2 (non-insulin-dependent) and Type 1 (insulin-dependent) diabetes mellitus. Diabetologia 23: 313–319
De Fronzo RA, Gunnarsson R, Björkman O, Olsson M, Wahren J (1985) Effects of insulin on peripheral and splanchnic glucose metabolism in non-insulin dependent (Type I) diabetes mellitus. J Clin Invest 76: 149–155
Bolinder J, Lithell H, Skarfors E, Arner P (1986) Effects of obesity, hyperinsulinemia and glucose intolerance on insulin action in adipose tissue of sixty-year old men. Diabetes 35: 282–290
Ikkos D, Luft R (1957) On the intravenous glucose tolerance test. Acta Endocrinol (Copenh) 25: 312–334
Pollare T, Lithell H, Selinus I, Berne C (1988) Application of prazosin is associated with an increase of insulin sensitivity in obese patients with hypertension. Diabetologia 31: 415–420
Thorell JI, Nosslin B, Sterky G (1973) Estimation of the early insulin response to intravenous glucose injection. J Lab Clin Med 82: 101–110
Bergman RN, Finegood DT, Ader M (1985) Assessment of insulin sensitivity in vivo. Endocrin Rev 6: 45–86
Livingston J, Pollare T, Lithell H, Arner P (1988) Characterization of insulin-like growth factor I receptor in skeletal muscles of normal and insulin resistant subjects. Diabetologia 31: 871–877
De Fronzo RA (1981) Glucose intolerance and aging. Diabetes Care 4: 493–501
Arner P, Pollare T, Lithell H, Livingston JN (1987) Defective insulin receptor tyrosine kinase in human skeletal muscle in obesity and Type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia 30: 437–440
Porte D Jr., Kahn SE (1989) Hyperproinsulinemia and amyloid in IDDM. Clues to etiology of islet beta-cells dysfunction? Diabetes 38: 1333–1336
Efendic S, Luft R, Wajngot A (1984) Aspects of the pathogenesis of type II diabetes. Endocr Rev 5: 395–410
Zimmet P (1989) Non-insulin-dependent (type 2) diabetes mellitus: does it really exist? Diab Med 6: 728–735
Pershadsingh HH, Christensen RL, McDonald JM (1986) Cellular mechanisms of insulin action: implications for insulin resistance and type II diabetes mellitus. Clin Chem 32: B19-B27
Yoshimasa Y, Seino S, Whittaker J, Kakehi T, Kosaki A, Kuzuya H, Imura H, Bell GI, Steiner DF (1988) Insulin-resistant diabetes due to a point mutation that prevents insulin proreceptor processing. Science 240: 784–787
Kadowaki T, Bevins CL, Cama A, Ojamaa K, Marcus-Sammels B, Kadowaki H, Beitz L, McKeou C, Taylor SI (1988) Two mutant alleles of the insulin receptor gene in a patient with extreme insulin resistance. Science 240: 787–790
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Arner, P., Pollare, T. & Lithell, H. Different aetiologies of Type 2 (non-insulin-dependent) diabetes mellitus in obese and non-obese subjects. Diabetologia 34, 483–487 (1991). https://doi.org/10.1007/BF00403284
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DOI: https://doi.org/10.1007/BF00403284