Characterisation of subjects with early abnormalities of glucose tolerance in the Stockholm Diabetes Prevention Programme: the impact of sex and type 2 diabetes heredity

Abstract

Aims/hypothesis: We evaluated the impact of sex and type 2 diabetes heredity on the prevalence and pathogenesis of early abnormalities of glucose homeostasis in subjects participating in the Stockholm Diabetes Prevention Programme. Methods: A sample of 3,128 men and 4,821 women, of whom approximately half had a family history of type 2 diabetes (FHD) was categorised according to an OGTT: NGT, IFG, IGT, combined glucose intolerance and type 2 diabetes. The homeostasis model assessment was used to determine insulin sensitivity and beta cell function. Results: Prevalence of early abnormalities of glucose metabolism was two to three times higher in subjects with FHD and two to three times higher in men compared to women. Both maternal and paternal heredity of type 2 diabetes were associated with an increased risk of having early abnormalities of glucose metabolism. However, in women with type 2 diabetes heredity on the father's side seems to have less impact on an increased risk of having type 2 diabetes. Both waist circumference and systolic blood pressure were increased in subjects with abnormalities of glucose homeostasis, whereas insulin sensitivity and beta cell function were decreased. Subjects with IFG had more pronounced impairment of beta cell function and insulin sensitivity than subjects with IGT. Conclusion/interpretation: An FHD and male sex increased the prevalence of abnormalities of glucose homeostasis. Subjects with IFG had more pronounced defects of insulin secretion and action than subjects with IGT.

Insulin-like growth factor-binding protein-1 in the prediction and development of type 2 diabetes in middle-aged Swedish men

“…A similar pattern was seen for each group (IFG, IGT, IFG+IGT) when analysed separately. There was no significant change in fasting IGFBP-1 values in the 19 individuals with diabetes diagnosed on the basis of glucose values 2 h after oral glucose (20 μg/l [95% CI [15][16][17][18][19][20][21][22][23][24][25][26][27] and 20 μg/l [95% CI [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] at baseline and follow up, respectively). In those who developed diabetes, fasting IGFBP-1 concentrations were higher at the 10 years followup compared with baseline (paired t tests; Fig.…”

“…Study population The present study was an incident casecontrol study of Swedish white men who were part of a 10 year follow-up epidemiological survey, the Stockholm Diabetes Prevention Program (SDPP), which is described elsewhere [20][21][22]. The SDPP is a population-based study of individuals aged 35-56 years who were without known diabetes at the time of recruitment in 1992-1994.…”

“…In addition to patients with diabetes, individuals with impaired glucose tolerance (IGT) are also at increased risk of micro-and macrovascular disease and premature cardiovascular death [18,19]. We have recently shown that family history of diabetes (FHD) is associated with increased prevalence of abnormal glucose tolerance [20] especially in men [21]. The aim of the present study was to determine IGFBP-1 levels in this population, in order to evaluate their predictive role and change in concentrations during the development of abnormal glucose regulation.…”

Determinants of birth weight in boys and girls

“…More recently, along with the increasing prevalence of obesity, the female population has been subjected to more studies. it seems that adult obese women are more insulin sensitive compared with obese adult men (Vistisen et al 2008), and the prevalence of diabetes is two to three times higher in men than in women, respective of weight categories (Kuhl et al 2005). sheep models show that restriction of fetal growth induced by chronic restriction of placental growth results in features of the metabolic syndrome in adult male offspring, particularly impaired insulin action (Owens et al 2007).…”

The impact of family history of diabetes and lifestyle factors on abnormal glucose regulation in middle-aged Swedish men and women

“…We recently reported that a family history of diabetes (FHD) and male sex are associated with increased prevalence of type 2 diabetes and milder forms of glucose abnormalities [7]. The aim of the present study was to further explore the influence of FHD on type 2 diabetes, separately for men and women, and with particular focus on combinations of FHD and lifestyle-related risk factors, such as obesity, physical inactivity, smoking and a low sense of coherence (SOC), which were tested for biological interaction.…”