The metabolic responses induced by acute dexamethasone predict glucose tolerance and insulin secretion over 10 years in relatives of type 2 diabetic subjects

Background This study aimed to compare the metabolic and insulin secretory responses to dexamethasone with the metabolic responses observed at 10 years in normoglycaemic relatives of type 2 diabetic and healthy control subjects. Methods Twenty relatives and 20 matched control subjects were studied t...

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Published in:Diabetes/metabolism research and reviews 2013-09, Vol.29 (6), p.492-498
Main Authors: Durck, Tina Trier, Henriksen, Jan Erik, Egede, Mette Brogaard, Levin, Klaus, Rantzau, Christian, Ward, Glenn, Beck-Nielsen, Henning, Alford, Frank P.
Format: Article
Language:English
Subjects:
10-year metabolic status
Adult
Blood Glucose - drug effects
Blood Glucose - metabolism
Case-Control Studies
dexamethasone
Dexamethasone - administration & dosage
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - metabolism
Family
Female
Follow-Up Studies
Glucose Intolerance - complications
Glucose Intolerance - diagnosis
Glucose Intolerance - metabolism
Glucose Tolerance Test - methods
Humans
Insulin - metabolism
Insulin Secretion
insulin sensitivity
Male
normoglycaemic relatives
Prognosis
β-cell function
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Summary:Background This study aimed to compare the metabolic and insulin secretory responses to dexamethasone with the metabolic responses observed at 10 years in normoglycaemic relatives of type 2 diabetic and healthy control subjects. Methods Twenty relatives and 20 matched control subjects were studied twice at 0 year (pre‐ and post‐dexamethasone) and at 10 years, employing a 75‐g oral glucose tolerance test (OGTT), with serial measurements of glucose and insulin, for determination of glucose tolerance and calculations of acute insulin release (ΔI30/ΔG30; insulinogenic index) and insulin sensitivity (SIHOMA). Results Following dexamethasone, the relatives group developed varying degrees of glucose intolerance, associated with reduced insulin sensitivity and insulinogenic index. By 10 years, fasting glucose and 2‐h OGTT glucose were raised in the relatives group, especially in the relatives most metabolically affected by dexamethasone, including a reduced insulinogenic index. Multiple regression analysis of the data in relatives demonstrated that the 2‐h OGTT glucose and fasting glucose values at 10 years depended on the 0‐year post‐dexamethasone 2‐h OGTT glucose, post‐dexamethasone fasting glucose and post‐dexamethasone insulin sensitivity, r2adj = 56% (p 
ISSN:1520-7552
1520-7560
DOI:10.1002/dmrr.2418