Acute insulin response is an independent predictor of type 2 diabetes mellitus in individuals with both normal fasting and 2‐h plasma glucose concentrations

Abstract

Background Earlier prospective studies have identified insulin action and secretion as predictors of T2DM in populations with normal glucose tolerance (NGT) and impaired glucose tolerance (IGT) (2‐h OGTT < 7.8 and 7.8–11 mmol/L, respectively). Fasting plasma glucose (FPG), an additional and recently modified (normal p = 0.03), M (HR = 0.51, p = 0.04) and AIR (HR = 0.64, p = 0.003) predicted the development of diabetes after adjustment for age and sex. In regression analysis adjusting for age, sex, %Fat and M at baseline, the non‐diabetic group (NON‐DM) had a higher AIR (p = 0.0002) than the DIAB group; the positive association of AIR with adiposity observed in the NON‐DM group was absent in the DIAB group. Cumulative incidence rates (12y) for diabetes were highest (48%) in subjects with both M and AIR below the population median and lowest (11%) in subjects with both M and AIR above the population median. Conclusion AIR can predict diabetes prior to the current clinical indicators of impaired glucose regulation. Published in 2006 by John Wiley & Sons, Ltd. John Wiley & Sons, Ltd.