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The Insulin Resistance but Not the Insulin Secretion Parameters Have Changed in the Korean Population during the Last Decade
Hae Kyung Yang, Jin Hee Lee, In-Young Choi, Hyuk Sang Kwon, Jeong Ah Shin, Seung Hee Jeong, Seung-Hwan Lee, Jae Hyoung Cho, Ho Young Son, Kun Ho Yoon
Diabetes Metab J. 2015;39(2):117-125.   Published online April 20, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.2.117
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AbstractAbstract PDFPubReader   
Background

This study aimed to compare the patterns of insulin secretion and resistance between Korean subjects in the 1990s and 2000s.

Methods

Insulin secretion and resistance indices were calculated from subjects who underwent 75-g oral glucose tolerance tests in the year 1997 to 1999 and 2007 to 2011 at the Seoul St. Mary's Hospital, Korea.

Results

A total of 578 subjects from the 1990s (mean age, 48.5 years) and 504 subjects from the 2000s (mean age, 50.2 years) were enrolled. Compared with the subjects from the 1990s, those from the 2000s exhibited increased insulin resistance (increased homeostatic model assessment for insulin resistance), and reduced insulin sensitivity (reduced Matsuda index and quantitative insulin sensitivity check index), regardless of their glucose tolerance status. However, insulinogenic index did not reveal significant differences between the 2 decades in subjects with or without diabetes. A distinct relationship was confirmed between Matsuda index and total area under the curve (insulin/glucose) in each glucose tolerance group. The mean product of the Matsuda index and the total area under the curve (insulin/glucose) as well as the oral disposition index, was lower in subjects with normal glucose tolerance from the 2000s than in those from the 1990s.

Conclusion

After rapid economic growth and changes in lifestyle patterns, insulin resistance has worsened across the glucose tolerance status; however, the insulin secretory function remained unchanged, which resulted in an increase in the susceptibility to the development of type 2 diabetes mellitus among Korean subjects without diabetes. We could not rule out the potential selection bias and therefore, further studies in general Korean population are needed.

Citations

Citations to this article as recorded by  
  • Insulin Resistance, Non-Alcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus: Clinical and Experimental Perspective
    Inha Jung, Dae-Jeong Koo, Won-Young Lee
    Diabetes & Metabolism Journal.2024; 48(3): 327.     CrossRef
  • Longitudinal Changes in Insulin Resistance, Beta-Cell Function and Glucose Regulation Status in Prediabetes
    Chul-Hee Kim, Hong-Kyu Kim, Eun-Hee Kim, Sung-Jin Bae, Jaewon Choe, Joong-Yeol Park
    The American Journal of the Medical Sciences.2018; 355(1): 54.     CrossRef
  • Association of serum 25-hydroxyvitamin D and diabetes-related factors in Korean adults without diabetes: The Fifth Korea National Health and Nutrition Examination Survey 2010–2012
    Hyunah Kim, Hyunyong Lee, Hyeon Woo Yim, Hun-Sung Kim
    Primary Care Diabetes.2018; 12(1): 59.     CrossRef
  • Long‐term effects on glycaemic control and β‐cell preservation of early intensive treatment in patients with newly diagnosed type 2 diabetes: A multicentre randomized trial
    Suk Chon, Sang Youl Rhee, Kyu Jeung Ahn, Sei Hyun Baik, Yongsoo Park, Moon Suk Nam, Kwan Woo Lee, Soon Jib Yoo, Gwanpyo Koh, Dae Ho Lee, Young Seol Kim, Jeong‐Taek Woo
    Diabetes, Obesity and Metabolism.2018; 20(5): 1121.     CrossRef
  • Four Plasma Glucose and Insulin Responses to a 75 g OGTT in Healthy Young Japanese Women
    Kei Takahashi, Hidetaka Nakamura, Hiroshi Sato, Hideto Matsuda, Kazuo Takada, Tomiko Tsuji
    Journal of Diabetes Research.2018; 2018: 1.     CrossRef
  • Comparison of insulin intensification strategies with insulin lispro low mixture twice daily versus basal insulin glargine and prandial insulin lispro once daily in East Asian and Caucasian patients with type 2 diabetes mellitus
    In‐Kyung Jeong, Choon Hee Chung, Zhiguang Zhou, Jeong Hee Han, Ran Duan, Diana M. Edralin, Angel Rodriguez
    Journal of Diabetes.2017; 9(4): 396.     CrossRef
  • Insulin Secretory Capacity and Insulin Resistance in Korean Type 2 Diabetes Mellitus Patients
    Jong-Dai Kim, Won-Young Lee
    Endocrinology and Metabolism.2016; 31(3): 354.     CrossRef
  • Antisenescence activity of G9a inhibitor BIX01294 on human bone marrow mesenchymal stromal cells
    Min-Ji AHN, Sin-Gu JEONG, Goang-Won CHO
    TURKISH JOURNAL OF BIOLOGY.2016; 40: 443.     CrossRef
  • Urinary N-acetyl-β-D-glucosaminidase, an early marker of diabetic kidney disease, might reflect glucose excursion in patients with type 2 diabetes
    So Ra Kim, Yong-ho Lee, Sang-Guk Lee, Eun Seok Kang, Bong-Soo Cha, Jeong-Ho Kim, Byung-Wan Lee
    Medicine.2016; 95(27): e4114.     CrossRef
Normal Glucose Tolerance with a High 1-Hour Postload Plasma Glucose Level Exhibits Decreased β-Cell Function Similar to Impaired Glucose Tolerance
Tae Jung Oh, Se Hee Min, Chang Ho Ahn, Eun Ky Kim, Soo Heon Kwak, Hye Seung Jung, Kyong Soo Park, Young Min Cho
Diabetes Metab J. 2015;39(2):147-153.   Published online March 9, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.2.147
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  • 15 Web of Science
  • 13 Crossref
AbstractAbstract PDFPubReader   
Background

Subjects with normal glucose tolerance (NGT) who have a high 1-hour postload plasma glucose level (≥155 mg/dL; NGT 1 hour-high) have been shown to be at higher risk for type 2 diabetes than subjects with NGT 1 hour-low postload plasma glucose level (<155 mg/dL). We compared β-cell function in subjects with NGT 1 hour-high, NGT 1 hour-low, and impaired glucose tolerance (IGT).

Methods

We classified subjects into NGT 1 hour-low (n=149), NGT 1 hour-high (n=43), and IGT (n=52). The β-cell function was assessed based on insulinogenic index (IGI), oral disposition index (DI), and insulin secretion-sensitivity index-2 (ISSI-2).

Results

Insulin sensitivity was comparable between the subjects with NGT 1 hour-high and NGT 1 hour-low. The β-cell function with/without adjusting insulin sensitivity was significantly different among the three groups. The IGI (pmol/mmol) was 116.8±107.3 vs. 64.8±47.8 vs. 65.8±80.6 (P=0.141), oral DI was 3.5±4.2 vs. 1.8±1.4 vs. 1.8±3.1 (P<0.001), and ISSI-2 was 301.2±113.7 vs. 213.2±67.3 vs. 172.5±87.5 (P<0.001) in NGT 1 hour-low, NGT 1 hour-high, and IGT, respectively. Post hoc analyses revealed that oral DI and ISSI-2 were significantly different between NGT 1 hour-low and NGT 1 hour-high but comparable between NGT 1 hour-high and IGT.

Conclusion

Among Korean subjects with NGT, those who have a higher 1-hour postload glucose level have a compromised insulin-sensitivity adjusted β-cell function to a similar degree as IGT subjects.

Citations

Citations to this article as recorded by  
  • Triglyceride-glucose index predicts type 2 diabetes mellitus more effectively than oral glucose tolerance test-derived insulin sensitivity and secretion markers
    Min Jin Lee, Ji Hyun Bae, Ah Reum Khang, Dongwon Yi, Mi Sook Yun, Yang Ho Kang
    Diabetes Research and Clinical Practice.2024; 210: 111640.     CrossRef
  • Pancreatic fat accumulation is associated with decreased β‐cell function and deterioration in glucose tolerance in Korean adults
    Sang Ouk Chin, You‐Cheol Hwang, In‐Jin Cho, In‐Kyung Jeong, Kyu Jeung Ahn, Ho Yeon Chung
    Diabetes/Metabolism Research and Reviews.2021;[Epub]     CrossRef
  • Indirect insulin resistance detection: Current clinical trends and laboratory limitations
    Sylwia Placzkowska, Lilla Pawlik-Sobecka, Izabela Kokot, Agnieszka Piwowar
    Biomedical Papers.2019; 163(3): 187.     CrossRef
  • Clinical Implications of Using Post-Challenge Plasma Glucose Levels for Early Diagnosis of Type 2 Diabetes Mellitus in Older Individuals
    Kyong Hye Joung, Sang Hyun Ju, Ji Min Kim, Sorim Choung, Jae Min Lee, Kang Seo Park, Hyun Jin Kim, Bon Jeong Ku
    Diabetes & Metabolism Journal.2018; 42(2): 147.     CrossRef
  • The 1-h post-load plasma glucose as a novel biomarker for diagnosing dysglycemia
    Ram Jagannathan, Martin Buysschaert, José Luis Medina, Karin Katz, Sarah Musleh, Brenda Dorcely, Michael Bergman
    Acta Diabetologica.2018; 55(6): 519.     CrossRef
  • Elevated 1‐hour post‐load plasma glucose identifies obese youth with abnormal glucose metabolism and an unfavourable inflammatory profile
    Anastasios Serbis, Vasileios Giapros, Anna Challa, Nikolaos Chaliasos, Ekaterini Siomou
    Clinical Endocrinology.2018; 89(6): 757.     CrossRef
  • One‐hour postload plasma glucose concentration in people with normal glucose homeostasis predicts future diabetes mellitus: a 12‐year community‐based cohort study
    Tae Jung Oh, Soo Lim, Kyoung Min Kim, Jae Hoon Moon, Sung Hee Choi, Young Min Cho, Kyong Soo Park, HakChul Jang, Nam H. Cho
    Clinical Endocrinology.2017; 86(4): 513.     CrossRef
  • An elevated 1-h post- load glucose level during the oral glucose tolerance test detects prediabetes
    Martin Buysschaert, Michael Bergman, Donald Yanogo, Ram Jagannathan, Benoit Buysschaert, Vanessa Preumont
    Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2017; 11(2): 137.     CrossRef
  • Delayed insulin secretion response during an OGTT is associated with an increased risk for incidence of diabetes in NGT subjects
    Yun Sun, Junfeng Han, Ziwei Lin, Lige Song, Chen Wang, Weiping Jia
    Journal of Diabetes and its Complications.2016; 30(8): 1537.     CrossRef
  • Postprandial Hyperglycemia
    Tae Jung Oh
    The Journal of Korean Diabetes.2016; 17(4): 233.     CrossRef
  • β-Cell Function and Insulin Sensitivity in Normal Glucose-Tolerant Subjects Stratified by 1-Hour Plasma Glucose Values
    Miranda M. Priya, Anandakumar Amutha, T.A. Pramodkumar, Harish Ranjani, Saravanan Jebarani, Kuppan Gokulakrishnan, Rajendra Pradeepa, Ranjit Unnikrishnan, Ranjit Mohan Anjana, Viswanathan Mohan
    Diabetes Technology & Therapeutics.2016; 18(1): 29.     CrossRef
  • Response: Normal Glucose Tolerance with a High 1-Hour Postload Plasma Glucose Level Exhibits Decreased β-Cell Function Similar to Impaired Glucose Tolerance (Diabetes Metab J2015;39:147-53)
    Tae Jung Oh, Se Hee Min, Chang Ho Ahn, Eun Ky Kim, Soo Heon Kwak, Hye Seung Jung, Kyong Soo Park, Young Min Cho
    Diabetes & Metabolism Journal.2015; 39(3): 270.     CrossRef
  • Letter: Normal Glucose Tolerance with a High 1-Hour Postload Plasma Glucose Level Exhibits Decreased β-Cell Function Similar to Impaired Glucose Tolerance (Diabetes Metab J2015;39:147-53)
    Hee Kyung Kim
    Diabetes & Metabolism Journal.2015; 39(3): 268.     CrossRef
The Association of Brachial-Ankle Pulse Wave Velocity with 30-Minute Post-Challenge Plasma Glucose Levels in Korean Adults with No History of Type 2 Diabetes
Eun-Suk Choi, Eun-Jung Rhee, Ji-Hoon Choi, Ji-Cheol Bae, Seung-Hyun Yoo, Won-Jun Kim, Se-Eun Park, Cheol-Young Park, Won-Young Lee, Yong-Kyun Cho, Ki-Won Oh, Sung-Woo Park, Sun-Woo Kim
Korean Diabetes J. 2010;34(5):287-293.   Published online October 31, 2010
DOI: https://doi.org/10.4093/kdj.2010.34.5.287
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AbstractAbstract PDFPubReader   
Background

Acute postprandial hyperglycemia is an important affector for atherosclerosis in subjects with glucose intolerance. We analyzed the relationship of brachial-ankle pulse wave velocity (baPWV) with fasting and post-challenge plasma glucose levels according to different time points during oral glucose tolerance test (OGTT).

Methods

In 663 subjects with fasting hyperglycemia, 75 g OGTT were performed to confirm the glucose tolerant status, and fasting, post-challenge 30-minute and 120-minute glucose levels were measured. Anthropometric measurements were done, and fasting lipid profiles were measured. baPWV were measured in all subjects and the relationship between fasting, 30- and 120-minute post-challenge glucose levels and baPWV were analyzed.

Results

Among the participants, 62.9% were prediabetes and 31.7% were diabetes. Mean baPWV value was significantly higher in subjects with diabetes compared with prediabetes group. In bivariate correlation analyses, age, blood pressure, total cholesterol, low density lipoprotein cholesterol, 30-minute and 120-minute post-challenge glucose levels showed significant positive correlation with baPWV value. In multiple regression analysis, 30-minute post-challenge glucose level was a weak but significant determinant for mean baPWV value even after adjustment for other confounding variables.

Conclusions

Postprandial hyperglycemia, especially 30-minute glucose levels showed significant correlation with baPWV in subjects with fasting hyperglycemia. These results can imply the deleterious effect of acute hyperglycemic excursion on arterial stiffness in subjects with glucose intolerance.

Citations

Citations to this article as recorded by  
  • One-Hour Post-Load Plasma Glucose Levels are Associated with Early Arterial Stiffness in Subjects with Different Glucose Tolerance
    Rui Wang, Xiao-li Liu, Xiao-jiao Jia, Yan Liu, Qiang Lu
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2022; Volume 15: 1537.     CrossRef
  • The Temporal Pattern of Arterial Stiffness during Aging: A Large-Scale Cross-Sectional Study
    Zhengli Tang, Yuanyuan Lu, Yiming Hao, Robert Morris, Di Kang, Fang Wang, Lin Fan, Weijian Wang, Yiqin Wang, Feng Cheng, Gaetano Santulli
    Journal of Diabetes Research.2021; 2021: 1.     CrossRef
  • Newly diagnosed abnormal glucose tolerance determines post-MI prognosis in patients with hospital related hyperglycaemia but without known diabetes
    Sudipta Chattopadhyay, Anish George, Joseph John, Thozhukat Sathyapalan
    Journal of Diabetes and its Complications.2020; 34(4): 107518.     CrossRef
  • The effect of oral glucose tolerance testing on changes in arterial stiffness and blood pressure in elderly women with hypertension and relationships between the stage of diabetes and physical fitness levels
    Jaesong Lee, Wonil Park, Eunsook Sung, Bokbeom Kim, Nahyun Kim, Saejong Park, Chulho Shin, Jonghoon Park
    Physical Activity and Nutrition.2020; 24(4): 34.     CrossRef
  • Two-hour post-challenge glucose is a better predictor of adverse outcome after myocardial infarction than fasting or admission glucose in patients without diabetes
    Sudipta Chattopadhyay, Anish George, Joseph John, Thozhukat Sathyapalan
    Acta Diabetologica.2018; 55(5): 449.     CrossRef
  • Adjustment of the GRACE score by 2-hour post-load glucose improves prediction of long-term major adverse cardiac events in acute coronary syndrome in patients without known diabetes
    Sudipta Chattopadhyay, Anish George, Joseph John, Thozhukat Sathyapalan
    European Heart Journal.2018; 39(29): 2740.     CrossRef
  • Investigating the Effect of Glucose on Aortic Pulse Wave Velocity Using Pancreatic Clamping Methodology
    Houry Puzantian, Karen Teff, Raymond R. Townsend
    Biological Research For Nursing.2015; 17(3): 270.     CrossRef
  • Association between the Postprandial Glucose Levels and Arterial Stiffness Measured According to the Cardio-ankle Vascular Index in Non-diabetic Subjects
    Atsuko Tsuboi, Chikako Ito, Rumi Fujikawa, Hideya Yamamoto, Yasuki Kihara
    Internal Medicine.2015; 54(16): 1961.     CrossRef
  • Insulin Sensitivity and Beta-Cell Function Are Associated with Arterial Stiffness in Individuals without Hypertension
    Chuchen Meng, Min Sun, Zhixiao Wang, Qi Fu, Mengdie Cao, Zhenxin Zhu, Jia Mao, Yun Shi, Wei Tang, Xiaoping Huang, Yu Duan, Tao Yang
    Journal of Diabetes Research.2013; 2013: 1.     CrossRef
  • Urinary adiponectin concentration is positively associated with micro- and macro-vascular complications
    Won Seon Jeon, Ji Woo Park, Namseok Lee, Se Eun Park, Eun Jung Rhee, Won Young Lee, Ki Won Oh, Sung Woo Park, Cheol-Young Park, Byung-Soo Youn
    Cardiovascular Diabetology.2013;[Epub]     CrossRef
Usefulness of Insulin Sensitivity Indexes derived from Oral Glucose Tolerance Test in Women with Polycystic Ovary Syndrome.
Hyo Jeong Kim, Eun Kyung Byun, Jee Young Oh, Yeon Ah Sung, Hye Won Chung
Korean Diabetes J. 2006;30(4):277-284.   Published online July 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.4.277
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AbstractAbstract PDF
BACKGROUND
Insulin resistance is prevalent in women with polycystic ovary syndrome (PCOS), and it makes them to have high risk for development of type 2 diabetes. Evaluation of insulin sensitivity would be important to predict their risks. Although the euglycemic-hyperinsulinemic clamp technique is the gold standard for measuring insulin sensitivity, it is too hard to practice in large epidemiologic studies. The aim of this study is to verify the validity of various insulin sensitivity indexes from oral glucose tolerance test (OGTT) in women with PCOS. METHODS: We performed euglycemic-hyperinsulinemic clamp (target glucose; 90 mg/dL, insulin ;~1 mU/kg.min) to obtain insulin-mediated glucose disposal rate (M-value) in 62 non-diabetic women with PCOS (BMI < 23 kg/m2; n = 37, BMI > or = 23 kg/m2; n = 25). Homeostasis model assessment [HOMA(IR)], quantitative insulin sensitivity check index (QUICKI), glucose to insulin ratio (G/I ratio), whole body insulin sensitivity index [ISI(COMP)], metabolic clearance rate of glucose [MCR(est)-OGTT(1,2)], and insulin sensitivity indexes [ISI(est)-OGTT(1,2)] were calculated from plasma glucose and insulin levels from standard 75-g OGTT. The correlations of various insulin sensitivity indexes from OGTT with M-value were evaluated. RESULTS: In lean women with PCOS (BMI < 23 kg/m2, n = 37), ISI(COMP) (r = 0.36, P < 0.05), MCRest-OGTT1 (r = 0.49, P < 0.01), ISI(est)-OGTT(1) (r = 0.50, P < 0.01), MCR(est)-OGTT(2) (r = 0.45, P < 0.01) and ISI(est)-OGTT(2) (r = 0.40, P < 0.05) were significantly correlated with M-value. In overweight and obese women with PCOS (BMI > or = 23 kg/m2, n = 25), HOMA(IR) (r = -0.40, P < 0.05), QUICKI (r = 0.40, P < 0.05), MCR(est)-OGTT(1) (r = 0.76, P < 0.001), ISI(est)-OGTT(1) (r = 0.63, P < 0.001), MCR(est)-OGTT(2) (r = 0.58, P < 0.01) and ISI(est)-OGTT(2) (r = 0.42, P < 0.05) showed significant correlations with M-value. CONCLUSION: MCR(est)-OGTT(1) and ISI(est)-OGTT(1) were the most reliable and easily accessible insulin sensitivity indexes obtained from OGTT for measuring of insulin sensitivity in women with PCOS regardless of obesity.

Citations

Citations to this article as recorded by  
  • Insulin resistance in a large cohort of women with polycystic ovary syndrome: a comparison between euglycaemic-hyperinsulinaemic clamp and surrogate indexes
    Flavia Tosi, Enzo Bonora, Paolo Moghetti
    Human Reproduction.2017; 32(12): 2515.     CrossRef
Can the Oral Glucose Tolerance Test (OGTT) done at Postpartum (PPT) 1 Wddk Substitute OGTT at PPT 6 Week OGTT at PPT 6 Week in Diagnosing Rersistent PPT Glucose Intolerance in the Patients with Gastrational Diagetes Melltus (GDM)?.
Yoo Lee Kim, Yong Wook Cho, Seok Won Park, Yun Kyung Cho, Hwa Young Lee, In Hyun Kim, Jong Gun Won, Hye Sun Jun, Ho Taek Lee, Seog Ki Lee, Sang Jong Lee
Korean Diabetes J. 2000;24(2):267-280.   Published online January 1, 2001
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AbstractAbstract PDF
BACKGROUND
Although 75 g-OGTT at PPT 6 week is necessary to diagnose persistent PPT glucose intolerance (PPGI) in GDM patients, it 1s difficult to perform this test because many patients drop-out during the follow-up period. Thus we tested whether OGTT done at PPT 1 week can substitute OGTT at PPT 6 week in diagnosing PPGI in GDM patients. METHOD: In 370 GDM patients, 75 g-OGTT was performed at PPT 1 week and repeat OGTT was done in 196 patients at PPT 6 week. Results of OGTT were classified as normal glucose tolerance(NGT), impaired glucose tolerance(IGT), and diabetes mellitus (DM) according to National Diabetes Data Group(NDDG) criteria. Changes in glucose tolerance state between PPT 1 and 6 week were assessed, and the predictability of clinical characteristics for these changes were investigated by logistic regression analysis. RESULTS: Among 370 GDM patients who performed OGTT at PPT 1 week, 79.4% had NGT, 12.2% had IGT, and 8.4% had DM. 53% (196/370) of subjects repeated OGTT at PPT 6 week. In OGTT at PPT 6 week, 77.6% (152/196, 140/149 in NGT, 4/26 in IGT and 8/21 in DM) were in the same glucose tolerance state as at PPT 1 week. The glucose tolerance improved in 14.8% (29/196, 16/26 in IGT and 13/21 in DM) and deteriorated in 7,6% (15/196, 9/149 in NGT and 6/26 in IGT). 94%(140/149) of patients who had NGT at PPT 1 week had NGT at PPT b week and 48.9/o (23/47) of patients who had abnormal glucose tolerance at PPT 1 week had abnormal glucose tolerance at PPT 6 week. Mean fasting plasma glucose level on OGTT became lower at PPT 1 week than during pregnancy (4.6+/-0,8 vs 5.1+/-1.2mmol/L, p<0.05) and became higher at PPT 6 week than at PPT 1 week (5.4+/-1.1 vs 4.6+/-0.8 mmol/L, p<0.05). Mean plasma glucose level at 2 hour after glucose load was significantly lower at PPT 6 week than at PPT 1 week (7.2+/-2.7 vs 8.3+/-2.5 mmol/L). When the subjects were grouped into NGT, IGT, and DM according to glucose tolerance state at PPT 6 week, the NGT group already showed normal glucose tolerance at PPT 1 week. The IGT and DM group showed slightly lower glucose levels at PPT 1 week than during pregnancy but became high to the level during pregnancy at PPT 6 week. In the patients group showing deterioration in glucose tolerance state between PPT 1 and 6 week, prevalence of insulin treatment was higher (63.4% vs 9.4, 20.7%), the gestational age at diagnosis of GDM were lower (25.0+/-6.2 week vs 29.8+/-3.3, 29.9+/-4,8 waek), and prepregnant weight was higher (113.4+/-21.2% vs 102.5+/-12.4, 102.4+/-14.6%) than those in the patients groups showing no change and improvement in glucose tolerance state, Weight gain until diagnosis of GDM during pregnancy(5.7+/-4.4kg vs 9.4+/-3.4kg) and weight change between prepregnancy and PPT 5 week(-1,3+/-3.5kg vs 1.5+/-29kg) was smaller in the deterioration group than those in the no change group. Logistic regression analysis performed using improvement and deterioration of glucose tolerance state between PPT 1 and 6 week as an outcome of interest revealed that an earlier diagnosis of GDM and a smaller weight at PPT 6 week than prepregnant weight were independent predictors for deterioration of glucose tolerance between PPT 1 and 6 week. In conclusion, OGTT done at PPT 1 week can substitute OGTT at PPT 6 week in a large subgroup of GDM patients who has NGT at PPT 1 week without any risk factors for deterioration in glucose tolerance.
The Appropriteness of New ADA Diagnostin Criteria for Diabetes Mellitus in Korean Population.
Moon kyu Lee, Myung Shik Lee, Young Ki Min, Sung Hoon Kim, Byoung Joon Kim, Dong Jun Kim, Jong Ryeal Hahm, Eun Young Oh, Yun Jae Chung, Kyoung Ah Kim, Jae Hoon Chung, Kwang Won Kim
Korean Diabetes J. 1999;23(3):336-351.   Published online January 1, 2001
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AbstractAbstract PDF
BACKGROUND
The ADA has proposed a new diagnostic criteria for diabetes based on fasting plasma glucose, redefining diabetes as fasting plasma glucose 7.0 mmol/L. Since only a few studies for the appropriateness of tbis new ADA criteria were undertaken in the Korean population, we examined the appropriateness of the new ADA criteria by analyzing the results of oral glucose tolerance tests done in our hospital. METHODS: 507 oral glucose tolerance tests were conducted. Cases with diabetes and diseases that could affect the glucose tolerance were excluded. Plasma glucose was measured by the hexokinase method. Three groups of NGT, IGT, and DM by the WHO criteria of 2 hour-plasma glucose were redivided at each level of fasting plasma glucose. We calculated the sensitivity and specificity of each level of fasting plasma glucose (FPG), and the FPG value of maximum accuracy to diagnose diabetes with reference to the WHO criteria of 2 hour-plasma glucose. RESULTS: Correlation between the levels of fasting plasma glucose and 2 hour-plasma glucose was relatively low (r=0.676). FPG of 7.0 mmol/L for diagnosing diabetes was relatively specific (specificity=0.934), but not sensitive (sensitivity= 0.552). FPG value of maximum accuracy for diagnosing diabetes was 6.8 mmol/L. 39 % of IFG (> 6.1mmol/L and < 7.0mmol/L) was reclassified as diabetes by the criteria of 2 hour plasma glucose 11.1 mmol/L and 34 % of NFG (<6.1mmol/L) was reclassified as impaired glucose tolerance by the criteria of 2 hour plasma glucose > 7.8 mmol/L. CONCLUSION: The fasting plasma glucose of 7.0 mmol/L was relatively specific for diagnosing diabetes. However, the new ADA criteria tended to underestimate the prevalence of diabetes and impaired glucose tolerance in the Korean population. Therefore, oral glucose tolerance test may be needed to diagnose diabetes in high risk subjects. Large-scale cross-sectional and prospective studies will be needed to clarify these points.
Changes in Serum True Insulin and C-peptide Levels during Oral Glucose Tolerance Test in Koreans with Glucose Intolerance.
Young Il Kim, Chul Soo Choi, Sang Wook Kim, Hong Kyu Kim, Chul Hee Kim, Joong Yeol Park, Sung Kwan Hong, Ki Up Lee
Korean Diabetes J. 1998;22(2):192-198.   Published online January 1, 2001
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AbstractAbstract PDF
BACKGROUND
Previous studies have shown that progression from normal glucose tolerance(NGT) to impaired glucose tolerance(IGT) is associated with the development of insulin resistance and hyper-insulinemia, while further progression from IGT to NIDDM results from an inability of the 8-cell to maintain high rate of insulin secretion. However, it is not established whether similar findings are also observed in Korean subjects with glucose intolerance. The aim of this study was to examine insulin secretory response after oral glucose stimulation in obese and non-obese Korean subjects according to varying degree of glucose intolerance. METHODS: Eighty eight Korean men underwent 75g oral glucose tolerance test. The subjects were classified into NGT(n=30), IGT(n=23), NIDDM(n= 35) according to National Diabetes Data Group criteria. Obesity was defined as body mass index (BMI) > 25 kg/m . Serum true insulin and C-peptide concentrations were measured by radioimmunoassay. RESULTS: Fasting serum true insulin and C-peptide levels were not different from each other among NGT, IGT and NIDDM groups, both in obese and non-obese subjects. Obese subjects with IGT had significantly higher serum true insulin and C-peptide levels at 120 min than those in NGT subjects, but the levels at 30 and 60 min were not different. On the other hand, non-obese subjects with IGT had lower serum true insulin level at 30 min and lower serum C-pepitde level at 60 min compared to those in NGT subjects. True insulin and C-pepitde levels at 30 and 60 min were significantly lower in patients with NIDDM than in those with NGT, both in obese and non-obese subjects. CONCLUSION: Hyperinsulinemia, especially at a later phase of oral glucose tolerance test, is apparent in obese subjects with IGT. On the other hand, early phase insulin secretory defect is prominent in non-obese subjects with IGT. These results suggest that impaired insulin secretion may play a primary role in the pathogenesis of non-obese NIDDM in Korea.

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