Diabetes 51:1271-1280, 2002
© 2002 by the American Diabetes Association, Inc.
Early Differential Defects of Insulin Secretion and Action in 19-Year-Old Caucasian Men Who Had Low Birth Weight
Christine B. Jensen1,
Heidi Storgaard1,
Flemming Dela2,3,
Jens Juul Holst4,
Sten Madsbad1, and
Allan A. Vaag1,5
1 Department of Endocrinology and Clinical Research Unit, Hvidovre University Hospital, Hvidovre, Denmark
2 Copenhagen Muscle Research Center, Rigshospitalet, Copenhagen, Denmark
3 Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, Herlev, Denmark
4 Department of Medical Physiology, the Panum Institute, Copenhagen, Denmark
5 Steno Diabetes Center, Gentofte, Denmark
Several studies have linked low birth weight (LBW) and type 2 diabetes. We investigated hepatic and peripheral insulin action including intracellular glucose metabolism in 40 19-year-old men (20 LBW, 20 matched control subjects), using the hyperinsulinemic-euglycemic clamp technique at two physiological insulin levels (10 and 40 mU/m2 per min), indirect calorimetry, and [3-3H]glucose. Insulin secretion was examined during an oral and intravenous glucose tolerance test. Fasting p-glucose was higher in the LBW group (5.6 ± 0.1 vs. 5.4 ± 0.1; P < 0.05). Basal plasma glycerol concentrations were significantly lower in the LBW group. Insulin-stimulated glycolytic flux was significantly reduced, and suppression of endogenous glucose production was enhanced in the LBW group. Nevertheless, basal and insulin-stimulated rates of whole-body peripheral glucose disposal, glucose oxidation, lipid oxidation, exogenous glucose storage, and nonoxidative glucose metabolism were similar in the two groups. Insulin secretion was reduced by 30% in the LBW group, when expressed relative to insulin sensitivity (disposition index = insulin secretion x insulin action). We propose that reduced insulin-stimulated glycolysis precedes overt insulin resistance in LBW men. A lower insulin secretion may contribute to impaired glucose tolerance and ultimately lead to diabetes.

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Copyright © 2002 by the American Diabetes Association.
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