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Diabetes Res Clin Pract. 2016 Aug;118:50-7. doi: 10.1016/j.diabres.2016.06.007. Epub 2016 Jun 17.

Identifying hyperinsulinaemia in the absence of impaired glucose tolerance: An examination of the Kraft database.

Author information

1
Human Potential Centre, AUT University, Auckland, New Zealand. Electronic address: ccrofts@aut.ac.nz.
2
Human Potential Centre, AUT University, Auckland, New Zealand.
3
Department of Biostatistics and Epidemiology, AUT University, Auckland, New Zealand.
4
Department of Clinical Pathology and Nuclear Medicine, St Joseph Hospital, Chicago, IL, USA.

Abstract

OBJECTIVE:

Hyperinsulinaemia is associated with development of chronic metabolic disease and is emerging as a health risk independent to that of insulin resistance. However, little is known to what extent hyperinsulinaemia occurs with normal glucose tolerance in lean subjects.

METHOD:

Oral glucose tolerance tests with concurrent insulin assay were conducted during the 1970s-1990s. Participants were classified according to glucose tolerance and insulin response pattern. Analysis of variance compared differences in plasma glucose, plasma insulin, and demographic and metabolic risk factors between groups.

RESULTS:

Participants with normal glucose tolerance comprised 54% (n=4185) of the total cohort. Of these, just over half (n=2079) showed hyperinsulinaemia despite normal glucose clearance. Obesity had a modest association with hyperinsulinaemia in people with normal glucose tolerance. Fasting insulin had limited value in diagnosing hyperinsulinaemia. The majority of participants (93%) with impaired glucose tolerance or diabetes had concurrent hyperinsulinaemia.

CONCLUSION:

Hyperinsulinaemia in the absence of impaired glucose tolerance may provide the earliest detection for metabolic disease risk and likely occurs in a substantial proportion of an otherwise healthy population. Dynamic insulin patterning may produce more meaningful and potentially helpful diagnoses. Further research is needed to investigate clinically useful hyperinsulinaemia screening tools.

KEYWORDS:

Diabetes; Hyperinsulinaemia; Insulin; Oral glucose tolerance test

PMID:
27344544
DOI:
10.1016/j.diabres.2016.06.007
[Indexed for MEDLINE]

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