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Diabetes Care 27:1842-1843, 2004
© 2004 by the American Diabetes Association, Inc.

Letters: Observations

Normal Insulin Sensitivity During the Late Preclinical Stage of Type 1 Diabetes

Etienne Larger, MD, PHD1, Benjamin Rakotoaminina, MD2, Mohammed Eddouks, PHD1, José Timsit, MD3, Christian Boitard, MD3, Roger Assan, MD1,{dagger}, Rémy Burcelin, PHD1 and Jean-Jacques Robert, MD, PHD2

1 Service d’endocrinologie-diabétologie, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France
2 Unité Diabète de l’Enfant et de l’Adolescent, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
3 Service d’immunologie clinique, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France

Address correspondence to Dr. Etienne Larger, Service d’endocrinologie-diabétologie, Hôpital Bichat, 46 rue H. Huchard, 75877 Paris cedex 18, France. E-mail: etienne.larger@bch.ap-hop-paris.fr

The first 20% of the full text of this article appears below.

In most cases, type 1 diabetes is the late consequence of a ß-cell autoimmune destruction leading to absolute insulin deficiency (1). At onset of clinical diabetes, ß-cell mass is thought to be reduced by 80–90% (2), and 73% of adult patients have ketosis or ketoacidosis at diagnosis (3). Patients with type 1 diabetes have major defects in insulin sensitivity at diagnosis of overt diabetes (4–8). However, the fact that pre-diabetic patients can maintain normal blood glucose levels in spite of dramatically low insulin secretory capacities suggests that their insulin sensitivity is normal.

Here we report that insulin sensitivity, measured by the glucose clamp method in nine patients, remains normal even during the very late preclinical stage of . . . [Full Text of this Article]


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Copyright © 2004 by the American Diabetes Association.