5 :: KDA, Korean Diabetes Association ::
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Subject    :    [2015 Oct;39(5)] Changing Clinical Characteristics according to Insulin Resistance and Insulin Secretion in Newly Diagnosed Type 2 Diabetic Patients in Korea
Writer KDA
Date 2015-12-08 10:15:01 Hit 5,866
Diabetes Metab J. 2015 Oct;39(5):387-394. English. Published online Oct 22, 2015.  http://dx.doi.org/10.4093/dmj.2015.39.5.387 
Copyright © 2015 Korean Diabetes Association
   
Changing Clinical Characteristics according to Insulin Resistance and Insulin Secretion in Newly Diagnosed Type 2 Diabetic Patients in Korea
Jang Won Son,1,* Cheol-Young Park,2,* Sungrae Kim,1 Han-Kyu Lee,3 Yil-Seob Lee,3 and Insulin Resistance as Primary Pathogenesis in Newly Diagnosed, Drug Naïve Type 2 Diabetes Patients in Korea (SURPRISE) Study Group
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
2Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
3GlaxoSmithKline, Seoul, Korea.
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
Contributed by footnote: *Jang Won Son and Cheol-Young Park contributed equally to this study as first authors.
 
Received July 01, 2014; Accepted September 18, 2014.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

 
Abstract
Background

The role of increased insulin resistance in the pathogenesis of type 2 diabetes has been emphasized in Asian populations. Thus, we evaluated the proportion of insulin resistance and the insulin secretory capacity in patients with early phase type 2 diabetes in Korea.

Methods

We performed a cross-sectional analysis of 1,314 drug-naive patients with newly diagnosed diabetes from primary care clinics nationwide. The homeostasis model assessment of insulin resistance (HOMA-IR) was used as an index to measure insulin resistance, which was defined as a HOMA-IR ≥2.5. Insulin secretory defects were classified based on fasting plasma C-peptide levels: severe (

Results

The mean body mass index (BMI) was 25.2 kg/m2; 77% of patients had BMIs >23.0 kg/m2. Up to 50% of patients had central obesity based on their waist circumference (≥90 cm in men and 85 cm in women), and 70.6% had metabolic syndrome. Overall, 59.5% of subjects had insulin resistance, and 20.2% demonstrated a moderate to severe insulin secretory defect. Among those with insulin resistance, a high proportion of subjects (79.0%) had a mild or no insulin secretory defect. Only 2.6% of the men and 1.9% of the women had both insulin resistance and a moderate to severe insulin secretory defect.

Conclusion

In this study, patients with early phase type 2 diabetes demonstrated increased insulin resistance, but preserved insulin secretion, with a high prevalence of obesity and metabolic syndrome.

   

Keywords: Diabetes mellitus, type 2, Insulin resistance, Obesity.

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