Diabetes Metab J.  2015 Oct;39(5):387-394. 10.4093/dmj.2015.39.5.387.

Changing Clinical Characteristics according to Insulin Resistance and Insulin Secretion in Newly Diagnosed Type 2 Diabetic Patients in Korea

• Son JW
• Park CY
• Kim S
• Lee HK
• Lee YS
• Insulin Resistance as Primary Pathogenesis in Newly Diagnosed, Drug Naive Type 2 Diabetes Patients in Korea (SURPRISE) Study Group

• KMID: 2174012
• DOI: http://doi.org/10.4093/dmj.2015.39.5.387

Abstract

BACKGROUND
The role of increased insulin resistance in the pathogenesis of type 2 diabetes has been emphasized in Asian populations. Thus, we evaluated the proportion of insulin resistance and the insulin secretory capacity in patients with early phase type 2 diabetes in Korea.
METHODS
We performed a cross-sectional analysis of 1,314 drug-naive patients with newly diagnosed diabetes from primary care clinics nationwide. The homeostasis model assessment of insulin resistance (HOMA-IR) was used as an index to measure insulin resistance, which was defined as a HOMA-IR > or =2.5. Insulin secretory defects were classified based on fasting plasma C-peptide levels: severe (<1.1 ng/mL), moderate (1.1 to 1.7 ng/mL) and mild to non-insulin secretory defect (> or =1.7 ng/mL).
RESULTS
The mean body mass index (BMI) was 25.2 kg/m2; 77% of patients had BMIs >23.0 kg/m2. Up to 50% of patients had central obesity based on their waist circumference (> or =90 cm in men and 85 cm in women), and 70.6% had metabolic syndrome. Overall, 59.5% of subjects had insulin resistance, and 20.2% demonstrated a moderate to severe insulin secretory defect. Among those with insulin resistance, a high proportion of subjects (79.0%) had a mild or no insulin secretory defect. Only 2.6% of the men and 1.9% of the women had both insulin resistance and a moderate to severe insulin secretory defect.
CONCLUSION
In this study, patients with early phase type 2 diabetes demonstrated increased insulin resistance, but preserved insulin secretion, with a high prevalence of obesity and metabolic syndrome.

Keyword

Diabetes mellitus, type 2; Insulin resistance; Obesity

MeSH Terms

Asian Continental Ancestry Group
Body Mass Index
C-Peptide
Cross-Sectional Studies
Diabetes Mellitus, Type 2
Fasting
Female
Homeostasis
Humans
Insulin Resistance*
Insulin*
Korea*
Male
Obesity
Obesity, Abdominal
Plasma
Prevalence
Primary Health Care
Waist Circumference
C-Peptide
Insulin

Figure

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  Fig. 1 The proportion of study subjects according to body mass index (BMI) and the presence of metabolic syndrome among newly diagnosed patients with type 2 diabetes.

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  Fig. 2 The proportion of study subjects according to insulin resistance and insulin secretion among newly diagnosed patients with type 2 diabetes. HOMA-IR, homeostasis model assessment of insulin resistance.

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