HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Greenbaum, C. J. Articles by Krischer, J. P. Search for Related Content PubMed PubMed Citation Articles by Greenbaum, C. J. Articles by Krischer, J. P. Social Bookmarking                What's this?

Type 1 Diabetes Manifested Solely by 2-h Oral Glucose Tolerance Test Criteria

From the Department of Veterans Affairs (C.J.G.), Puget Sound Health Care System and the Department of Medicine (C.J.G.), University of Washington, Seattle, Washington; and the H. Lee Moffitt Cancer Center and Research Institute (D.C., J.P.K.), University of South Florida, Tampa, Florida.

Address correspondence and reprint requests to Carla Greenbaum MD, Diabetes Clinical Research Unit, Clinical Research Center, Virginia Mason Research Center, 1201 9th Ave., Seattle, WA 98101. E-mail: cjgreen{at}vmresearch.org .

The clinical presentation of type 1 diabetes usually involves symptoms such as polyuria and polydipsia. However, investigators in the Diabetes Prevention Trial of Type 1 Diabetes (DPT-1) have detected a group of subjects with type 1 diabetes who have a different phenotype. These subjects are asymptomatic, have normal (<6.1 mmol/l) (group A) or impaired (6.1- <7.0 mmol/l) (group B) fasting glucose, but have 2-h glucose values >11.1 mmol/l on their oral glucose tolerance tests (OGTT). Of the 585 OGTTs performed on islet cell antibody (ICA)-positive relatives with insulin autoantibodies (IAA) or low first-phase insulin response (FPIR), normal glucose tolerance (NGT) was found in 427 subjects; impaired glucose tolerance (IGT) was found in 87 subjects, and diabetes was found by 2-h OGTT criteria alone in 61 subjects. Despite marked differences in 2-h glucose values (NGT 5.8 ± 1.1 mmol/l, IGT 8.9 ± 0.9 mmol/l, and group A 13.5 ± 2.5 mmol/l), there were no significant differences in fasting glucose values among NGT (4.8 ± 0.5 mmol/l), IGT (5.03 ± 0.5 mmol/l), and group A (4.99 ± 0.7 mmol/l) categories. Mean FPIR was higher in subjects with NGT compared with subjects with IGT and subjects diagnosed by 2-h OGTT criteria alone. However, the correlation between FPIR and 2-h glucose value was low (r² = 0.14). Multivariate analysis demonstrated that additional independent variables provide smaller contributions to the 2-h glucose value. In conclusion, there are asymptomatic type 1 diabetic subjects whose diabetes was diagnosed by the 2-h criteria on OGTT alone. Despite the importance of ß-cell dysfunction in the pathogenesis of type 1 diabetes, factors other than impaired FPIR must also contribute to postprandial glucose tolerance in these subjects.

CiteULike

Del.icio.us

Digg

Reddit

Technorati

This article has been cited by other articles:

				P. Xu, D. Cuthbertson, C. Greenbaum, J. P. Palmer, J. P. Krischer, and for the Diabetes Prevention Trial Type 1 Study Gro Role of Insulin Resistance in Predicting Progression to Type 1 Diabetes Diabetes Care, September 1, 2007; 30(9): 2314 - 2320. [Abstract] [Full Text] [PDF]

				R. D. G. Leslie, R. Williams, and P. Pozzilli Type 1 Diabetes and Latent Autoimmune Diabetes in Adults: One End of the Rainbow J. Clin. Endocrinol. Metab., May 1, 2006; 91(5): 1654 - 1659. [Abstract] [Full Text] [PDF]

				J. M. Barker Type 1 Diabetes-Associated Autoimmunity: Natural History, Genetic Associations, and Screening J. Clin. Endocrinol. Metab., April 1, 2006; 91(4): 1210 - 1217. [Abstract] [Full Text] [PDF]

				J. M. Sosenko, J. P. Palmer, C. J. Greenbaum, J. Mahon, C. Cowie, J. P. Krischer, H. P. Chase, N. H. White, B. Buckingham, K. C. Herold, et al. Patterns of metabolic progression to type 1 diabetes in the diabetes prevention trial-type 1. Diabetes Care, March 1, 2006; 29(3): 643 - 649. [Abstract] [Full Text] [PDF]

				N. A. Sherry, E. B. Tsai, and K. C. Herold Natural History of {beta}-Cell Function in Type 1 Diabetes Diabetes, December 1, 2005; 54(suppl_2): S32 - S39. [Abstract] [Full Text] [PDF]

				M. I. Hawa, R. Bonfanti, C. Valeri, M. Delli Castelli, H. Beyan, and R. D. G. Leslie No Evidence for Genetically Determined Alteration in Insulin Secretion or Sensitivity Predisposing to Type 1 Diabetes: A study of identical twins Diabetes Care, June 1, 2005; 28(6): 1415 - 1418. [Abstract] [Full Text] [PDF]

				R. D. G. Leslie and M. D. Castelli Age-Dependent Influences on the Origins of Autoimmune Diabetes: Evidence and Implications Diabetes, December 1, 2004; 53(12): 3033 - 3040. [Full Text] [PDF]

				C. J. Greenbaum and L. C. Harrison Guidelines for Intervention Trials in Subjects With Newly Diagnosed Type 1 Diabetes Diabetes, May 1, 2003; 52(5): 1059 - 1065. [Full Text] [PDF]

				C. J. Greenbaum, R. L. Prigeon, and D. A. D'Alessio Impaired {beta}-Cell Function, Incretin Effect, and Glucagon Suppression in Patients With Type 1 Diabetes Who Have Normal Fasting Glucose Diabetes, April 1, 2002; 51(4): 951 - 957. [Abstract] [Full Text] [PDF]

				T. A Chowdhury and S. S Lasker Subclinical type 1 diabetes J R Soc Med, January 4, 2002; 95(4): 203 - 204. [Full Text] [PDF]