Long-Term Follow-Up of Oral Glucose Tolerance Test-Derived Glucose Tolerance and Insulin Secretion and Insulin Sensitivity Indexes in Subjects With Glucokinase Mutations (MODY2)

• Published in: Diabetes care Vol. 31; no. 7; pp. 1321 - 1323
• Main Authors: Martin, Delphine, Bellanné-Chantelot, Christine, Deschamps, Inge, Froguel, Philippe, Robert, Jean-Jacques, Velho, Gilberto
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.07.2008
• Subjects: Adult; Area Under Curve; Biological and medical sciences; Blood Glucose - metabolism; Clinical Care/Education/Nutrition/Psychosocial Research; Control; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - enzymology; Diabetes Mellitus, Type 2 - genetics; Diabetes. Impaired glucose tolerance; Diagnosis; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Follow-Up Studies; Gene mutations; glucokinase; Glucokinase - genetics; glucose; glucose tolerance; Glucose Tolerance Test; Glucose tolerance tests; Humans; Hyperglycemia; Hyperglycemia - blood; Hyperglycemia - enzymology; Hyperglycemia - genetics; Insulin; Insulin - blood; Insulin - metabolism; insulin resistance; Insulin Secretion; Insulin-Secreting Cells - enzymology; Male; Medical sciences; Metabolic diseases; Methods; Miscellaneous; Mutation; natural history; noninsulin-dependent diabetes mellitus; Physiological aspects; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk factors; France; Endocrinopathy; Human; Maturity onset diabetes young; Pancreatic hormone; Nutrition; Enzyme; Secretion; Insulin sensitivity; Transferases; Oral administration; Tolerance; Metabolic diseases; Glucose tolerance test; Index; Glucose; Insulin; Long term; Genetic disease; Surveillance; Follow up study; Glucokinase; Genetics; Mutation; Endocrinology
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc07-2017

OBJECTIVE:--We investigated the natural history of glucokinase (GCK)-related maturity-onset diabetes of the young type 2 (MODY2), notably the factors associated with deterioration of hyperglycemia over time. RESEARCH DESIGN AND METHODS--We report an 11-year follow-up of glucose tolerance and indexes of insulin secretion and insulin sensitivity derived from oral glucose tolerance tests in 33 MODY2 subjects. RESULTS:--The variation between tests of glucose tolerance (expressed as the area under the glucose curve) was 6.9 ± 3.2% (mean ± SEM), but individual results ranged from -20 to 61%. Deterioration of glucose tolerance between tests was associated with decreased insulin sensitivity, while insulin secretion remained stable. CONCLUSIONS:--Glucose tolerance can remain stable over many years in subjects with MODY2 due to the relative stability of the GCK-related β-cell defect. However, the development of insulin resistance may have an important role in the deterioration of the glucose tolerance and in the long-term evolution of the disorder.