Basal State Hyperinsulinemia in Healthy Normoglycemic Adults is Predictive of Type 2 Diabetes over a 24-year Follow Up: A preliminary report
- Rachel Dankner, M.D. (racheld{at}gertner.health.gov.il)1,2,
- Angela Chetrit, M.A.1,
- Michael H Shanik, M.D.3,4,
- Itamar Raz, M.D.5 and
- Jesse Roth, M.D.6,7
- 1. The Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer, Israel
- 2. Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- 3. Island Endocrinology, Smithtown, New York
- 4. Department of Internal Medicine, Stony Brook University Hospital, Stony Brook, New York
- 5. Diabetes Unit, Department of Internal Medicine, Hadassah University Hospital, Jerusalem, Israel
- 6. Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, New York
- 7. Albert Einstein College of Medicine, Yeshiva University, Bronx, New York
Abstract
Objective: We examined the predictive value of hyperinsulinemia in the basal state on the 24-year progression from normoglycemia to dysglycemia.
Research Design and Methods: A sample of 515 normoglycemic men and women were studied again after 24 years for glycemic status.
Results: Half of the participants developed dysglycemia: 11.1% progressed to impaired fasting glucose (IFG), 9.9% to impaired glucose tolerance (IGT), 4.5% to both IFG+IGT and another 24.3% to type 2 diabetes. Elevated levels of overnight fasting (basal) insulin, triglycerides, BMI≥27kg/M2, fasting blood glucose, blood pressure, North African or Yemenit background, and male sex each favored conversion to dysglycemia after 24 years. In Multiple Ordered Logistic Regression analysis, the most significant predictor of progression to dysglycemia was hyperinsulinemia (upper quintile), after adjusting for BMI, ethnic origin, sex, age, smoking, physical-activity, blood pressure and triglycerides.
Conclusions: Basal hyperinsulinemia in normoglycemic adults constitutes an independent risk factor for developing dysglycemia over 24 years.
Footnotes
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- Received January 26, 2009.
- Accepted May 3, 2009.
- Copyright © American Diabetes Association
