Diabetes, Vol 39, Issue 5 597-601, Copyright © 1990 by American Diabetes Association
Increased basal glucose production and utilization in nondiabetic first-degree relatives of patients with NIDDM
K Osei
Department of Internal Medicine, Ohio State University Hospitals, Columbus.
To characterize the abnormalities in basal glucose homeostasis in people
who are at increased risk for non-insulin-dependent diabetes mellitus
(NIDDM), we measured the rates of basal hepatic glucose output (HGO),
glucose disappearance, and metabolic clearance of glucose (MCR) in 27
nondiabetic first-degree relatives of NIDDM patients and 16 age-, sex-, and
weight-matched healthy control subjects with no family history of NIDDM.
Mean fasting plasma glucose was significantly lower (P less than 0.05) in
control subjects (mean +/- SE 77 +/- 2 mg/dl) than in relatives (84 +/- 2
mg/dl). Mean basal insulin levels were not significantly different between
relatives and control subjects (10.0 +/- 1.5 vs. 7.7 +/- 1.0 microU/ml).
Mean basal HGO was significantly lower in control subjects compared with
relatives (1.83 +/- 0.07 vs. 2.20 +/- 0.10 mg.kg-1.min-1, P less than
0.05). Mean MCR was similar in relatives (2.58 +/- 0.12 mg.kg-1.min-1) and
control subjects (2.35 +/- 0.09 mg.kg-1.min-1). In summary, this study
demonstrates that basal hepatic glucose production and glucose utilization
are increased in glucose-tolerant first-degree relatives compared with
healthy control subjects. We conclude that impaired basal hepatic glucose
regulation rather than glucose disposal is present as an early defect in
glucose-tolerant first-degree relatives of NIDDM patients.