Subject    :    [2018 Apr;42(2)] Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index
Writer KDA
Date 2019-03-05 18:00:17 Hit 300
Diabetes Metab J. 2018 Apr;42(2):137-146. English.
Published online Feb 14, 2018.  https://doi.org/10.4093/dmj.2018.42.2.137 
Copyright © 2018 Korean Diabetes Association
   
Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index
Kyoung Hwa Ha,1,2 Cheol Young Park,3 In Kyung Jeong,4 Hyun Jin Kim,5 Sang-Yong Kim,6 Won Jun Kim,7 Ji Sung Yoon,8 In Joo Kim,9 Dae Jung Kim,1,2 and Sungrae Kim10
1Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
2Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea.
3Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
4Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.
5Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
6Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea.
7Department of Endocrinology and Metabolism, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
8Department of Endocrinology and Metabolism, Yeungnam University College of Medicine, Daegu, Korea.
9Department of Endocrinology and Metabolism, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
10Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.

Corresponding author: Dae Jung Kim. Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon 16499, Korea. Email: djkim@ajou.ac.kr Corresponding author: Sungrae Kim. Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Wonmi-gu, Bucheon 14647, Korea. Email: kimsungrae@catholic.ac.kr 
 
Received August 24, 2017; Accepted October 31, 2017.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



Abstract

Background

We evaluated the clinical characteristics of insulin resistance and β-cell dysfunction in newly diagnosed, drug-naive people with type 2 diabetes by analyzing nationwide cross-sectional data.

Methods

We collected the clinical data of 912 participants with newly diagnosed diabetes from 83 primary care clinics and hospitals nationwide from 2015 to 2016. The presence of insulin resistance and β-cell dysfunction was defined as a homeostatic model assessment of insulin resistance (HOMA-IR) value ≥2.5 and fasting C-peptide levels <1.70 ng/mL, respectively.

Results

A total of 75.1% and 22.6% of participants had insulin resistance and β-cell dysfunction, respectively. The proportion of participants with insulin resistance but no β-cell dysfunction increased, and the proportion of participants with β-cell dysfunction but no insulin resistance decreased as body mass index (BMI) increased. People diagnosed with diabetes before 40 years of age had significantly higher HOMA-IR and BMI than those diagnosed over 65 years of age (HOMA-IR, 5.0 vs. 3.0; BMI, 28.7 kg/m2 vs. 25.1 kg/m2). However, the β-cell function indices were lower in people diagnosed before 40 years of age than in those diagnosed after 65 years of age (homeostatic model assessment of β-cell function, 39.3 vs. 64.9; insulinogenic index, 10.3 vs. 18.7; disposition index, 0.15 vs. 0.25).

Conclusion

We observed that the main pathogenic mechanism of type 2 diabetes is insulin resistance in participants with newly diagnosed type 2 diabetes. In addition, young adults with diabetes are more likely to have higher insulin resistance with obesity and have higher insulin secretory defect with severe hyperglycemia in the early period of diabetes than older populations.

   
Keywords:
Diabetes mellitus, type 2Insulin resistanceInsulin secretion
 

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