Mechanism and significance of insulin resistance in non-insulin-dependent diabetes mellitus.

R. A. Rizza, L. J. Mandarino, J. E. Gerich

Research output: Contribution to journalArticle

108 Citations (Scopus)

Abstract

To determine whether receptor and/or postreceptor abnormalities of insulin action were responsible for insulin resistance in nonobese patients with non-insulin-dependent diabetes mellitus (NIDDM) and to assess the role of insulin resistance in their impaired glucose tolerance, insulin dose-response characteristics, insulin binding to monocytes, and insulin secretion were compared in 10 nonobese patients with NIDDM and six age-weight-matched nondiabetic volunteers. The insulin resistance of the diabetics was characterized by a shift to the right of their insulin dose-response curve (Km 81 +/- 4 microunits/ml vs. 58 +/- 2 microunits/ml in the nondiabetics P less than 0.001) but a normal maximal response to insulin. Although monocyte insulin binding was decreased in the diabetics (P less than 0.01), their response to insulin was appropriate for the number of insulin receptors occupied indicating normal postreceptor function. Insulin secretion was markedly reduced in diabetic subjects (52 +/- 22 vs. 471 +/- 90 microunits . ml-1 . 10 min-1 in the nondiabetic subjects, P less than 0.001) and was more strongly correlated with fasting plasma glucose (r = 0.92, P less than 0.001) and intravenous glucose tolerance (Kivgtt) (r = 0.98, P less than 0.001) than was insulin sensitivity (Km) (r = 0.23, NS, and r = 0.57, P less than 0.05, respectively). We conclude that in nonobese patients with NIDDM, insulin resistance is characterized by a shift to the right of the insulin dose-response curve, which can be accounted for solely by an insulin receptor defect. However, in these patients, impaired insulin secretion rather than insulin resistance appears to be the predominant metabolic abnormality.

Original languageEnglish (US)
Pages (from-to)990-995
Number of pages6
JournalDiabetes
Volume30
Issue number12
StatePublished - Dec 1981
Externally publishedYes

Fingerprint

Type 2 Diabetes Mellitus
Insulin Resistance
Insulin
Insulin Receptor
Monocytes
Glucose Intolerance
Glucose Tolerance Test
Volunteers
Fasting
Weights and Measures
Glucose

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Cite this

Rizza, R. A., Mandarino, L. J., & Gerich, J. E. (1981). Mechanism and significance of insulin resistance in non-insulin-dependent diabetes mellitus. Diabetes, 30(12), 990-995.

Mechanism and significance of insulin resistance in non-insulin-dependent diabetes mellitus. / Rizza, R. A.; Mandarino, L. J.; Gerich, J. E.

In: Diabetes, Vol. 30, No. 12, 12.1981, p. 990-995.

Research output: Contribution to journalArticle

Rizza, RA, Mandarino, LJ & Gerich, JE 1981, 'Mechanism and significance of insulin resistance in non-insulin-dependent diabetes mellitus.', Diabetes, vol. 30, no. 12, pp. 990-995.
Rizza, R. A. ; Mandarino, L. J. ; Gerich, J. E. / Mechanism and significance of insulin resistance in non-insulin-dependent diabetes mellitus. In: Diabetes. 1981 ; Vol. 30, No. 12. pp. 990-995.
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