Type 2 diabetes in youth: are there racial differences in beta-cell responsiveness relative to insulin sensitivity

Pediatric Diabetes, 04/24/2012

Bacha F et al. – Racial differences in insulin secretion can be demonstrated with the clamp technique in obese adolescents with T2DM. Similar to non–diabetic youth, African American (AA) adolescents with T2DM compared with their American White (AW) counterparts have an upregulated beta–cell function relative to IS, the reasons for which remain to be investigated.

Methods

  • Fourteen AAs and 14 AWs T2DM adolescents underwent evaluation of IS and clearance (hyperinsulinemic–euglycemic clamp), first- and second-phase insulin and C-peptide secretion (hyperglycemic clamp); body composition (DEXA); and abdominal adiposity (CT).

Results

  • AA and AW T2DM had similar HbA1c, diabetes duration, BMI, and % body fat, with lower visceral fat in AAs (p = 0.013).
  • While insulin-stimulated glucose disposal was similar in AA and AW (7.5 ± 1.0 vs. 7.3 ± 0.9 mg/kg FFM/min), IS tended to be lower.
  • First-phase insulin and second-phase insulin, and first-phase C-peptide and second-phase C-peptide were higher in AA. beta-Cell function relative to IS was higher in AA vs. AW.

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