Insulin Response in Relation to Insulin Sensitivity: An Appropriate β-Cell Response in Black South African Women
Response to Joffe and Distiller
- Julia H. Goedecke, PHD1,2,
- Estelle V. Lambert, PHD1,
- Naomi S. Levitt, MB, CHB, MD3,
- Tommy Olsson, MD4,
- Jonathan R. Seckl, MB, PHD5,
- Brian R. Walker, MD5 and
- Steven E. Kahn, MB, CHB6
- 1University of Cape Town/South African Medical Research Council Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa;
- 2South African Medical Research Council, Cape Town, South Africa;
- 3Endocrine Unit, Department of Medicine, University of Cape Town, Cape Town, South Africa;
- 4Department of Medicine, Umeå University, Umeå, Sweden;
- 5Endocrinology Unit, Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland;
- 6Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, U.S. Department of Veterans Affairs' Puget Sound Health Care System and the University of Washington, Seattle, Washington.
- Corresponding author: Julia H. Goedecke, julia.goedecke{at}uct.ac.za.
We are in agreement with Joffe and Distiller (1) that the pathogenesis of type 2 diabetes in black South Africans cannot be inferred from limited studies of insulin responses in small cross-sectional studies. In our cross-sectional study, we only examined black and white premenopausal normoglycemic South African women to determine whether there were differences in insulin sensitivity and β-cell function in the absence of the potential confounding effects of hyperglycemia. We thus did not extrapolate our findings to diabetic individuals, but rather recommended “longitudinal studies to determine whether the β-cell will continue to compensate in the black women with increasing age or whether it will fail over time leading to disturbances in glucose tolerance” (2).
Acknowledgments
No potential conflicts of interest relevant to this article were reported.
- © 2009 by the American Diabetes Association.
