Insulin Problems Come First in Obese Youth
Evidence for Early Defects in Insulin Sensitivity and Secretion Before the Onset of Glucose Dysregulation in Obese Youths: A Longitudinal Study, by Cosimo Giannini and colleagues. Diabetes 61:606–614, 2012
What is the problem and what is known about it so far?
Type 2 diabetes was once known as adult-onset diabetes, but today more and more young people are developing the disease. The rise is thought to be due, in part, to the expanding waistlines of U.S. children. The growing presence of type 2 diabetes in youth is still a fairly new phenomenon, so scientists still haven’t worked out the details for how the disease develops in young people.
Why did the researchers do this particular study?
Researchers wanted to determine whether obese youths with normal blood glucose levels have underlying metabolic problems that make them more susceptible to developing diabetes.
Who was studied?
A multi-ethnic group of 1,601 obese young people between the ages of 8 and 22 with normal blood glucose levels were studied.
How was the study done?
The researchers tested the participants’ insulin sensitivity — a measure of how well the body uses insulin — and their ability to produce insulin. They also gave the participants an oral glucose tolerance test, which challenges the body to process a large dose of glucose and is one way to diagnose diabetes and prediabetes. Two years later, the researchers tested the participants a second time.
What did the researchers find?
Even though the young people had normal glucose tolerance, the insulin tests revealed impairment. Participants with defective insulin sensitivity and production at the start of the study were the most likely to have impaired glucose tolerance when tested two years later.
What were the limitations of the study?
The participants were recruited for the study at a clinic, and so they may not be representative of young people in general.
What are the implications of the study?
These findings suggest that obese young people may be at heightened risk for diabetes even before their blood glucose levels reveal a problem. The researchers say that it may be important to test insulin sensitivity and insulin production in obese young people, in addition to their blood glucose levels, to get a true picture of their risk for developing type 2 diabetes.
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