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You can read the whole study here very interesting :
http://www.townsendletter.com/Jan2017/insulin0117.html
Shifting Focus From Glycemic Status to Insulin Homeostasis for Stemming Global Tides of Hyperinsulinism and Type 2 Diabetes
ABSTRACT
Objectives: A retrospective survey of insulin responses to a 75-gram glucose challenge in 684 subjects in New York metropolitan area was conducted to investigate: (1) prevalence of hyperinsulinemia in New York metropolitan area; (2) characteristics of optimal insulin homeostasis; (3) stratification of hyperinsulinism for optimal clinical use; and (4) mechanisms of action of risk factors of hyperinsulinism and type 2 diabetes (T2D).
Methods: Post-glucose blood insulin and glucose levels were measured with fasting and ½ hr, 1- hr, 2-hr, and 3-hr samples at university and large commercial laboratories. Guided by the initial 100 profiles, a profile peak insulin concentration of <40 uIU/mL accompanied by unimpaired glucose tolerance was defined as the cut-off point for optimal insulin homeostasis. Hyperinsulinism was stratified into three categories based on the doubling of peak insulin values as follows: (1) mild, 40 to <80 uIU/mL; (2) moderate, 80 to <160 uIU/mL; and (3) severe, >160 uIU/mL.
Results: The overall prevalence of hyperinsulinism in the general New York metropolitan population without type 2 diabetes was 75.1%. The rates of optimal insulin homeostasis and the degrees of hyperinsulinism (mild, moderate, severe) in 506 subjects without T2D were 24.9%, 38.9%, 26.5%, and 9.7% respectively. The corresponding rates for three degrees of hyperinsulinism in 178 subjects with T2D were 29%, 24%, and 13.9% (with the overall rate of 66.9%). The remaining 33.1% in the type 2 diabetes group showed insulin deficit of varying degrees. The profile peak insulin concentrations ranged from 11 uIU/mL to 718 uIU/mL.
Conclusions: Our findings call for further study of insulin homeostasis in other general populations in the United States. In addition, we recommend viewing data in the broader context of mitochondrial dysfunction related to recognized dietary, environmental, and other risk factors of hyperinsulinism-to-T2D continuum; a need for a shift of focus from glycemic status to insulin homeostasis for stemming the global tides of hyperinsulinism and T2D is recognized.
http://www.townsendletter.com/Jan2017/insulin0117.html
Shifting Focus From Glycemic Status to Insulin Homeostasis for Stemming Global Tides of Hyperinsulinism and Type 2 Diabetes
ABSTRACT
Objectives: A retrospective survey of insulin responses to a 75-gram glucose challenge in 684 subjects in New York metropolitan area was conducted to investigate: (1) prevalence of hyperinsulinemia in New York metropolitan area; (2) characteristics of optimal insulin homeostasis; (3) stratification of hyperinsulinism for optimal clinical use; and (4) mechanisms of action of risk factors of hyperinsulinism and type 2 diabetes (T2D).
Methods: Post-glucose blood insulin and glucose levels were measured with fasting and ½ hr, 1- hr, 2-hr, and 3-hr samples at university and large commercial laboratories. Guided by the initial 100 profiles, a profile peak insulin concentration of <40 uIU/mL accompanied by unimpaired glucose tolerance was defined as the cut-off point for optimal insulin homeostasis. Hyperinsulinism was stratified into three categories based on the doubling of peak insulin values as follows: (1) mild, 40 to <80 uIU/mL; (2) moderate, 80 to <160 uIU/mL; and (3) severe, >160 uIU/mL.
Results: The overall prevalence of hyperinsulinism in the general New York metropolitan population without type 2 diabetes was 75.1%. The rates of optimal insulin homeostasis and the degrees of hyperinsulinism (mild, moderate, severe) in 506 subjects without T2D were 24.9%, 38.9%, 26.5%, and 9.7% respectively. The corresponding rates for three degrees of hyperinsulinism in 178 subjects with T2D were 29%, 24%, and 13.9% (with the overall rate of 66.9%). The remaining 33.1% in the type 2 diabetes group showed insulin deficit of varying degrees. The profile peak insulin concentrations ranged from 11 uIU/mL to 718 uIU/mL.
Conclusions: Our findings call for further study of insulin homeostasis in other general populations in the United States. In addition, we recommend viewing data in the broader context of mitochondrial dysfunction related to recognized dietary, environmental, and other risk factors of hyperinsulinism-to-T2D continuum; a need for a shift of focus from glycemic status to insulin homeostasis for stemming the global tides of hyperinsulinism and T2D is recognized.
