Progressive deterioration of β-cell function in obese youth with type 2 diabetes
Article first published online: 23 AUG 2012
© 2012 John Wiley & Sons A/S
Volume 14, Issue 2, pages 106–111, March 2013
How to Cite
Progressive deterioration of β-cell function in obese youth with type 2 diabetes., , , .
- Issue published online: 25 FEB 2013
- Article first published online: 23 AUG 2012
- Manuscript Accepted: 5 JUL 2012
- Manuscript Revised: 5 JUN 2012
- Manuscript Received: 12 MAR 2012
- United States Public Health Service. Grant Number: K24 HD01357
- Richard L. Day Endowed Chair
- Department of Defense
- Thrasher Research Fund
- National Institutes of Health. Grant Number: MO1 RR00084, UL1 RR024153, UL1TR000005
- β-cell function;
- insulin secretion;
- youth type 2 diabetes
In adults, type 2 diabetes (T2DM) is characterized with progressive deterioration in insulin secretion. Data are scanty in youth. We investigated prospectively the change in β-cell function and in insulin sensitivity in youth with T2DM.
Research Design and Methods
Six adolescents with T2DM [hemoglobin A1c (HbA1c) 6.6 ± 1.0%] underwent evaluation of hepatic glucose production (HGP; [6,6-2H2] glucose), insulin-stimulated glucose disposal (Rd; hyperinsulinemic-euglycemic clamp), first- and second-phase insulin/C-peptide secretion (hyperglycemic clamp), body composition dual energy X-ray absorptiometry (DEXA), and abdominal adiposity (computed tomography) within 3 yr of the diagnosis of diabetes and after 12–16 months of follow-up.
Weight, body mass index (37.1 ± 6.9), HbA1c (6.3 ± 0.7%), HGP (2.8 ± 1.2 mg/kg/min), and Rd (4.9 ± 3.4 mg/kg/min) did not change significantly from baseline. However, first-phase insulin and C-peptide declined (152.6 ± 261.2 vs. 75.9 ± 108.5 μU/mL, p = 0.028; 8.0 ± 6.3 vs. 5.9 ± 4.4 ng/mL, p = 0.048, respectively) with no significant change in second-phase insulin/C-peptide. The rate of decline in β-cell function was ∼20% per year.
After a median duration of 20 months of diabetes, youth with T2DM manifest a rapid decline in β-cell function with no significant changes in peripheral or hepatic insulin sensitivity. Interventions to retard this deterioration in β-cell function should be investigated.