Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp.
A novel estimate of insulin sensitivity that is simple to calculate and provides a reasonable approximation of whole-body insulin sensitivity from the oral glucose tolerance test (OGTT).
Glucose clamp technique: a method for quantifying insulin secretion and resistance.
Methods for the quantification of beta-cell sensitivity to glucose (hyperglycemic clamp technique) and of tissue sensitivity to insulin (euglycemic insulin clamp technique) are described.…
Follow-up report on the diagnosis of diabetes mellitus.
The International Expert Committee was convened to reexamine the classification and diagnostic criteria of diabetes, which were based on the 1979 publication of the National Diabetes Data Group and subsequent WHO study group and adopted several changes to the diagnostic criteria for diabetes and for lesser degrees of impaired glucose regulation (IFG/IGT).
Insulin Resistance: A Multifaceted Syndrome Responsible for NIDDM, Obesity, Hypertension, Dyslipidemia, and Atherosclerotic Cardiovascular Disease
In summary, insulin resistance appears to be a syndrome that is associated with a clustering of metabolic disorders, including non-insulin-dependent diabetes mellitus, obesity, hypertension, lipid abnormalities, and atherosclerotic cardiovascular disease.
Coordinated reduction of genes of oxidative metabolism in humans with insulin resistance and diabetes: Potential role of PGC1 and NRF1
- M. Patti, A. Butte, L. Mandarino
- Biology, MedicineProceedings of the National Academy of Sciences…
- 27 June 2003
It is demonstrated that insulin resistance and DM associate with reduced expression of multiple nuclear respiratory factor-1 (NRF-1)-dependent genes encoding key enzymes in oxidative metabolism and mitochondrial function.
From the Triumvirate to the Ominous Octet: A New Paradigm for the Treatment of Type 2 Diabetes Mellitus
- R. DeFronzo
- Medicine, BiologyDiabetes
- 1 April 2009
Eight players comprise the ominous octet and dictate that treatment should be based upon reversal of known pathogenic abnormalities and not simply on reducing the A1C, and therapy must be started early to prevent/slow the progressive β-cell failure that already is well established in IGT subjects.
Skeletal Muscle Insulin Resistance Is the Primary Defect in Type 2 Diabetes
This work focuses on recent advances about the time of onset, as well as the mechanism, of the skeletal muscle insulin resistance and the euglycemic insulin clamp technique.
Pathogenesis of NIDDM: A Balanced Overview
Information concerning the loss of first-phase insulin secretion, altered pulsatility of insulin release, and enhanced proinsulin-insulin secretory ratio is discussed as it pertains to altered β-cell function in NIDDM.
Effects of exenatide (exendin-4) on glycemic control and weight over 30 weeks in metformin-treated patients with type 2 diabetes.
- R. DeFronzo, R. Ratner, Jenny Han, Dennis D. Kim, M. Fineman, A. Baron
- MedicineDiabetes Care
- 1 May 2005
Exenatide was generally well tolerated and reduced HbA(1c) with no weight gain and no increased incidence of hypoglycemia in patients with type 2 diabetes failing to achieve glycemic control with metformin.
Type 2 diabetes mellitus
The greatest need is for agents that enhance insulin sensitivity, halt the progressive pancreatic β-cell failure that is characteristic of T2DM and prevent or reverse the microvascular complications.