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Predictors of and longitudinal changes in insulin sensitivity and secretion preceding onset of type 2 diabetes.

Authors
  • Lyssenko, Valeriya
  • Almgren, Peter
  • Anevski, Dragi
  • Perfekt, Roland
  • Lahti, Kaj
  • Nissén, Michael
  • Isomaa, Bo
  • Forsen, Björn
  • Homström, Nils
  • Saloranta, Carola
  • Taskinen, Marja-Riitta
  • Groop, Leif
  • Tuomi, Tiinamaija
Type
Published Article
Journal
Diabetes
Publisher
American Diabetes Association
Publication Date
Jan 01, 2005
Volume
54
Issue
1
Pages
166–174
Identifiers
PMID: 15616025
Source
Medline
License
Unknown

Abstract

Identification of individuals at high risk of developing type 2 diabetes is a prerequisite for prevention of the disease. We therefore studied risk factors predicting type 2 diabetes in the Botnia Study in Western Finland. A total of 2,115 nondiabetic individuals were prospectively followed with repeated oral glucose tolerance tests. After a median follow-up of 6 years, 127 (6%) subjects developed diabetes. A family history of diabetes (hazard ratio [HR] 2.2, P = 0.008), BMI (HR for comparison of values below or above the median 2.1, P < 0.001), waist-to-height index (2.3, P < 0.001), insulin resistance (2.1, P = 0.0004), and beta-cell function adjusted for insulin resistance (2.7, P < 0.0001) predicted diabetes. Marked deterioration in beta-cell function with modest changes in insulin sensitivity was observed during the transition to diabetes. The combination of FPG > or =5.6 mmol/l, BMI > or =30 kg/m(2), and family history of diabetes was a strong predictor of diabetes (3.7, P < 0.0001). Of note, using FPG > or =6.1 mmol/l or 2-h glucose > or =7.8 mmol/l did not significantly improve prediction of type 2 diabetes. In conclusion, a marked deterioration in beta-cell function precedes the onset of type 2 diabetes. These individuals can be identified early by knowledge of FPG, BMI, and family history of diabetes.

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