The Missing Link Between Pre-Diabetes and Type 2 Diabetes

New research suggests a "missing link" between the pre-diabetes state and the clinical diagnosis of type 2 diabetes mellitus and can be explained by the decrease in glucose clearance

Both impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are intermediate states in the transition from normal glucose tolerance (NGT) toT2DM and have been termed as "pre-diabetes". They are associated with a high risk for progression to T2DM.

 

Hepatic glucose production (HGP) is the principal determinant of fasting plasma glucose (FPG). In the current study, the authors have demonstrated that, in the non-diabetic range, the rise in fasting plasma glucose (FPG) concentration is associated with a mild decrease in hepatic glucose production (HGP) and a marked decrease in the glucose clearance rate.

"During the fasting state, the decrease in glucose clearance results in an increase in FPG concentration which stimulates basal insulin secretion. The rise in fasting plasma insulin concentration, in turn, inhibits HGP, thus attenuating the rise in FPG," Rucha Jani, MD, the study’s author said. "The high fasting blood glucose in these subjects can thus be explained by the decrease in glucose clearance. This is an important observation as it provides insight into the pathogenic mechanisms that characterize the ‘pre-diabetic’ stage."

"Pinpointing the missing link is quite important," Dr. Jani said. "It allows us to identify potential future targets in order to develop effective therapies to prevent the progression from pre-diabetes to type 2 diabetes."

American Association of Clinical Endocrinologists (AACE), These findings will be presented at the American Association of Clinical Endocrinologists (AACE) Sixteenth Annual Meeting and Clinical Congress, which will be held April 11-16 at the Washington State Convention & Trade Center in Seattle.

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DID YOU KNOW:
Commonly Used Drugs May Increase Hypertension: A Boston-based study has found that the frequency of non-narcotic analgesic use appears to be independently associated with a moderate increase in the risk of incident hypertension. The study group examined the effect of 16,031 male health professionals for frequent use of acetaminophen, NSAIDs, and aspirin to determine the risk for hypertension. When used consistently for six or seven days a week, the researchers observed the following:

• Men who used acetaminophen had a 34% higher risk for hypertension.
• Men who used NSAIDs had a 38% higher risk for hypertension.
• Men who used aspirin had a 26% higher risk for hypertension.

“Given the widespread use of these medications and the high prevalence of hypertension, these results may have important public health implications,” the authors concluded. The study was published in the February 26, 2007 Archives of Internal Medicine. An abstract of this study is available at  https://archinte.ama-assn.org/cgi/content/abstract/167/4/394