Why Test the Children?
Understanding insulin resistance, its complications, and its progression
- From the Department of Pediatrics, University of California at San Diego School of Medicine, Children’s Hospital, San Diego, La Jolla, California
In this issue of Diabetes Care, Goran et al. (1) review the results of their study of insulin resistance and the compensatory responses to it in 57 early pubertal children of different racial/ethnic backgrounds. They utilized the frequently sampled intravenous glucose tolerance test (GTT) to assess insulin sensitivity (Si), acute insulin response (AIR), and also calculated insulin secretion, hepatic insulin extraction, and insulin clearance. In these children, they found that SI, independent of adiposity, was greater in the Caucasian children than in those of African and Hispanic heritage, confirming the observations of others (2–4). They also discovered differences in the compensatory responses of Hispanic and African-American subjects, which they hypothesized would be similar. The Hispanic subjects had higher first- and second-phase insulin secretion. The African-American subjects showed a higher AIR and lower hepatic insulin extraction, with first- and second-phase insulin secretion closer to those of the Caucasian …
