schliessen

Filtern

 

Bibliotheken

Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study

Summary Background Little is known about the timing of changes in glucose metabolism before occurrence of type 2 diabetes. We aimed to characterise trajectories of fasting and postload glucose, insulin sensitivity, and insulin secretion in individuals who develop type 2 diabetes. Methods We analysed... Full description

Journal Title: The Lancet (British edition) 2009, Vol.373 (9682), p.2215-2221
Main Author: Tabák, Adam G, Dr
Other Authors: Jokela, Markus, PhD , Akbaraly, Tasnime N, PhD , Brunner, Eric J, PhD , Kivimäki, Mika, Prof , Witte, Daniel R, MD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: Kidlington: Elsevier Ltd
ID: ISSN: 0140-6736
Zum Text:
SendSend as email Add to Book BagAdd to Book Bag
Staff View
recordid: cdi_proquest_miscellaneous_67431208
title: Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study
format: Article
creator:
  • Tabák, Adam G, Dr
  • Jokela, Markus, PhD
  • Akbaraly, Tasnime N, PhD
  • Brunner, Eric J, PhD
  • Kivimäki, Mika, Prof
  • Witte, Daniel R, MD
subjects:
  • Abridged Index Medicus
  • Adult
  • Biological and medical sciences
  • Biomarkers - metabolism
  • Blood Glucose - metabolism
  • Councils
  • Diabetes
  • Diabetes Mellitus, Type 2 - diagnosis
  • Diabetes Mellitus, Type 2 - epidemiology
  • Diabetes Mellitus, Type 2 - etiology
  • Diabetes Mellitus, Type 2 - metabolism
  • Diabetes. Impaired glucose tolerance
  • Diagnosis
  • Endocrine pancreas. Apud cells (diseases)
  • Endocrinopathies
  • Epidemiology
  • Etiopathogenesis. Screening. Investigations. Target tissue resistance
  • Fasting
  • Female
  • General aspects
  • Glucose Tolerance Test
  • Health care policy
  • Homeostasis
  • Humans
  • Insulin
  • Insulin - metabolism
  • Insulin Resistance - physiology
  • Insulin-Secreting Cells - metabolism
  • Internal Medicine
  • Linear Models
  • London - epidemiology
  • Male
  • Mass Screening
  • Medical research
  • Medical sciences
  • Mens health
  • Middle Aged
  • Pancreatic beta cells
  • Physiological aspects
  • Prediabetic State - complications
  • Prediabetic State - epidemiology
  • Prediabetic State - metabolism
  • Prospective Studies
  • Public health. Hygiene
  • Public health. Hygiene-occupational medicine
  • Risk Assessment - methods
  • Risk Factors
  • Statistical analysis
  • Studies
  • Time Factors
  • Type 2 diabetes
ispartof: The Lancet (British edition), 2009, Vol.373 (9682), p.2215-2221
description: Summary Background Little is known about the timing of changes in glucose metabolism before occurrence of type 2 diabetes. We aimed to characterise trajectories of fasting and postload glucose, insulin sensitivity, and insulin secretion in individuals who develop type 2 diabetes. Methods We analysed data from our prospective occupational cohort study (Whitehall II study) of 6538 (71% male and 91% white) British civil servants without diabetes mellitus at baseline. During a median follow-up period of 9·7 years, 505 diabetes cases were diagnosed (49·1% on the basis of oral glucose tolerance test). We assessed retrospective trajectories of fasting and 2-h postload glucose, homoeostasis model assessment (HOMA) insulin sensitivity, and HOMA β-cell function from up to 13 years before diabetes diagnosis (diabetic group) or at the end of follow-up (non-diabetics). Findings Multilevel models adjusted for age, sex, and ethnic origin confirmed that all metabolic measures followed linear trends in the group of non-diabetics (10 989 measurements), except for insulin secretion that did not change during follow-up. In the diabetic group (801 measurements), a linear increase in fasting glucose was followed by a steep quadratic increase (from 5·79 mmol/L to 7·40 mmol/L) starting 3 years before diagnosis of diabetes. 2-h postload glucose showed a rapid increase starting 3 years before diagnosis (from 7·60 mmol/L to 11·90 mmol/L), and HOMA insulin sensitivity decreased steeply during the 5 years before diagnosis (to 86·7%). HOMA β-cell function increased between years 4 and 3 before diagnosis (from 85·0% to 92·6%) and then decreased until diagnosis (to 62·4%). Interpretation In this study, we show changes in glucose concentrations, insulin sensitivity, and insulin secretion as much as 3–6 years before diagnosis of diabetes. The description of biomarker trajectories leading to diabetes diagnosis could contribute to more-accurate risk prediction models that use repeated measures available for patients through regular check-ups. Funding Medical Research Council (UK); Economic and Social Research Council (UK); British Heart Foundation (UK); Health and Safety Executive (UK); Department of Health (UK); National Institute of Health (USA); Agency for Health Care Policy Research (USA); the John D and Catherine T MacArthur Foundation (USA); and Academy of Finland (Finland).
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


@attributes
NO1
SEARCH_ENGINEprimo_central_multiple_fe
SEARCH_ENGINE_TYPEPrimo Central Search Engine
RANK2.7362356
LOCALfalse
PrimoNMBib
record
control
sourceidgale_proqu
recordidTN_cdi_proquest_miscellaneous_67431208
sourceformatXML
sourcesystemPC
galeidA202492639
sourcerecordidA202492639
originalsourceidFETCH-LOGICAL-1627t-d02293be28d8951e27583aa9b0bc1e8857f453b47c549cc777fb1f4e6dfdc3843
addsrcrecordideNqFkn1r1TAUxosobk4_glIURWF3Jm2atArKGL4MBv7hxPtfSNPTe8_W28ycdNCv4Sc2vfeyN4SRkEDyex7OSZ4kec7ZAWdcvv_JuGAzqXL5llXvJJO8ms0fJLtcKDErhJo_THavkJ3kCdEZY0xIVjxOdnhV8EJwtpv8PfXmDGxwHoFS16aLbrQGVmj2U-xp6LBPCXrCgJcYxv3U9M2NC-shoOvTGlrnIW3QLHpHuHYK4wWk2XRWQwD6EKVxmm6c7lvvVmlYQvp7iQGWpuvS4-OUwtCMT5NHrekInm33veTX1y-nR99nJz--HR8dnsy4zFSYNSzLqryGrGzK2A5kqihzY6qa1ZZDWRaqFUVeC2ULUVmrlGpr3gqQTdvYvBT5XvJm43vh3Z8BKOgVkoWuMz24gbRUIucZKyP48g545gYfOyHNq4rlQioVoVcbaGE60Ni3LnhjJ0d9mLFMVJnMq0gd_IeKo4lPbl0PLcbzW4L9G4J6IOyB4kK4WAZamIHoNl5scOsdkYdWX3hcGT9qzvSUG73OjZ5CoVml17nR86h7sW1xqFfQXKu2QYnA6y1gyJqu9aa3SFdcxqWQhcoj9_FOARaDmTISG8Xu3jI-b9QQ__0SwWuyCL2FBn0MqW4c3uvw6Y6DjUnFWPI5jEDXH6cp02xjMnmwau0wz_8BP7AGvA
sourcetypeAggregation Database
isCDItrue
recordtypearticle
pqid199034677
display
typearticle
titleTrajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study
sourceAlma/SFX Local Collection
creatorTabák, Adam G, Dr ; Jokela, Markus, PhD ; Akbaraly, Tasnime N, PhD ; Brunner, Eric J, PhD ; Kivimäki, Mika, Prof ; Witte, Daniel R, MD
creatorcontribTabák, Adam G, Dr ; Jokela, Markus, PhD ; Akbaraly, Tasnime N, PhD ; Brunner, Eric J, PhD ; Kivimäki, Mika, Prof ; Witte, Daniel R, MD
descriptionSummary Background Little is known about the timing of changes in glucose metabolism before occurrence of type 2 diabetes. We aimed to characterise trajectories of fasting and postload glucose, insulin sensitivity, and insulin secretion in individuals who develop type 2 diabetes. Methods We analysed data from our prospective occupational cohort study (Whitehall II study) of 6538 (71% male and 91% white) British civil servants without diabetes mellitus at baseline. During a median follow-up period of 9·7 years, 505 diabetes cases were diagnosed (49·1% on the basis of oral glucose tolerance test). We assessed retrospective trajectories of fasting and 2-h postload glucose, homoeostasis model assessment (HOMA) insulin sensitivity, and HOMA β-cell function from up to 13 years before diabetes diagnosis (diabetic group) or at the end of follow-up (non-diabetics). Findings Multilevel models adjusted for age, sex, and ethnic origin confirmed that all metabolic measures followed linear trends in the group of non-diabetics (10 989 measurements), except for insulin secretion that did not change during follow-up. In the diabetic group (801 measurements), a linear increase in fasting glucose was followed by a steep quadratic increase (from 5·79 mmol/L to 7·40 mmol/L) starting 3 years before diagnosis of diabetes. 2-h postload glucose showed a rapid increase starting 3 years before diagnosis (from 7·60 mmol/L to 11·90 mmol/L), and HOMA insulin sensitivity decreased steeply during the 5 years before diagnosis (to 86·7%). HOMA β-cell function increased between years 4 and 3 before diagnosis (from 85·0% to 92·6%) and then decreased until diagnosis (to 62·4%). Interpretation In this study, we show changes in glucose concentrations, insulin sensitivity, and insulin secretion as much as 3–6 years before diagnosis of diabetes. The description of biomarker trajectories leading to diabetes diagnosis could contribute to more-accurate risk prediction models that use repeated measures available for patients through regular check-ups. Funding Medical Research Council (UK); Economic and Social Research Council (UK); British Heart Foundation (UK); Health and Safety Executive (UK); Department of Health (UK); National Institute of Health (USA); Agency for Health Care Policy Research (USA); the John D and Catherine T MacArthur Foundation (USA); and Academy of Finland (Finland).
identifier
0ISSN: 0140-6736
1EISSN: 1474-547X
2DOI: 10.1016/S0140-6736(09)60619-X
3PMID: 19515410
4CODEN: LANCAO
languageeng
publisherKidlington: Elsevier Ltd
subjectAbridged Index Medicus ; Adult ; Biological and medical sciences ; Biomarkers - metabolism ; Blood Glucose - metabolism ; Councils ; Diabetes ; Diabetes Mellitus, Type 2 - diagnosis ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes Mellitus, Type 2 - etiology ; Diabetes Mellitus, Type 2 - metabolism ; Diabetes. Impaired glucose tolerance ; Diagnosis ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Epidemiology ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Fasting ; Female ; General aspects ; Glucose Tolerance Test ; Health care policy ; Homeostasis ; Humans ; Insulin ; Insulin - metabolism ; Insulin Resistance - physiology ; Insulin-Secreting Cells - metabolism ; Internal Medicine ; Linear Models ; London - epidemiology ; Male ; Mass Screening ; Medical research ; Medical sciences ; Mens health ; Middle Aged ; Pancreatic beta cells ; Physiological aspects ; Prediabetic State - complications ; Prediabetic State - epidemiology ; Prediabetic State - metabolism ; Prospective Studies ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Risk Assessment - methods ; Risk Factors ; Statistical analysis ; Studies ; Time Factors ; Type 2 diabetes
ispartofThe Lancet (British edition), 2009, Vol.373 (9682), p.2215-2221
rights
0Elsevier Ltd
12009 Elsevier Ltd
22009 INIST-CNRS
3COPYRIGHT 2009 Elsevier B.V.
4Copyright Elsevier Limited Jun 27-Jul 3, 2009
lds50peer_reviewed
oafree_for_read
citedbyFETCH-LOGICAL-1627t-d02293be28d8951e27583aa9b0bc1e8857f453b47c549cc777fb1f4e6dfdc3843
citesFETCH-LOGICAL-1627t-d02293be28d8951e27583aa9b0bc1e8857f453b47c549cc777fb1f4e6dfdc3843
links
openurl$$Topenurl_article
openurlfulltext$$Topenurlfull_article
thumbnail$$Usyndetics_thumb_exl
backlink
0$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21646573$$DView record in Pascal Francis
1$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19515410$$D View this record in MEDLINE/PubMed
search
creatorcontrib
0Tabák, Adam G, Dr
1Jokela, Markus, PhD
2Akbaraly, Tasnime N, PhD
3Brunner, Eric J, PhD
4Kivimäki, Mika, Prof
5Witte, Daniel R, MD
title
0Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study
1The Lancet (British edition)
addtitleLancet
descriptionSummary Background Little is known about the timing of changes in glucose metabolism before occurrence of type 2 diabetes. We aimed to characterise trajectories of fasting and postload glucose, insulin sensitivity, and insulin secretion in individuals who develop type 2 diabetes. Methods We analysed data from our prospective occupational cohort study (Whitehall II study) of 6538 (71% male and 91% white) British civil servants without diabetes mellitus at baseline. During a median follow-up period of 9·7 years, 505 diabetes cases were diagnosed (49·1% on the basis of oral glucose tolerance test). We assessed retrospective trajectories of fasting and 2-h postload glucose, homoeostasis model assessment (HOMA) insulin sensitivity, and HOMA β-cell function from up to 13 years before diabetes diagnosis (diabetic group) or at the end of follow-up (non-diabetics). Findings Multilevel models adjusted for age, sex, and ethnic origin confirmed that all metabolic measures followed linear trends in the group of non-diabetics (10 989 measurements), except for insulin secretion that did not change during follow-up. In the diabetic group (801 measurements), a linear increase in fasting glucose was followed by a steep quadratic increase (from 5·79 mmol/L to 7·40 mmol/L) starting 3 years before diagnosis of diabetes. 2-h postload glucose showed a rapid increase starting 3 years before diagnosis (from 7·60 mmol/L to 11·90 mmol/L), and HOMA insulin sensitivity decreased steeply during the 5 years before diagnosis (to 86·7%). HOMA β-cell function increased between years 4 and 3 before diagnosis (from 85·0% to 92·6%) and then decreased until diagnosis (to 62·4%). Interpretation In this study, we show changes in glucose concentrations, insulin sensitivity, and insulin secretion as much as 3–6 years before diagnosis of diabetes. The description of biomarker trajectories leading to diabetes diagnosis could contribute to more-accurate risk prediction models that use repeated measures available for patients through regular check-ups. Funding Medical Research Council (UK); Economic and Social Research Council (UK); British Heart Foundation (UK); Health and Safety Executive (UK); Department of Health (UK); National Institute of Health (USA); Agency for Health Care Policy Research (USA); the John D and Catherine T MacArthur Foundation (USA); and Academy of Finland (Finland).
subject
0Abridged Index Medicus
1Adult
2Biological and medical sciences
3Biomarkers - metabolism
4Blood Glucose - metabolism
5Councils
6Diabetes
7Diabetes Mellitus, Type 2 - diagnosis
8Diabetes Mellitus, Type 2 - epidemiology
9Diabetes Mellitus, Type 2 - etiology
10Diabetes Mellitus, Type 2 - metabolism
11Diabetes. Impaired glucose tolerance
12Diagnosis
13Endocrine pancreas. Apud cells (diseases)
14Endocrinopathies
15Epidemiology
16Etiopathogenesis. Screening. Investigations. Target tissue resistance
17Fasting
18Female
19General aspects
20Glucose Tolerance Test
21Health care policy
22Homeostasis
23Humans
24Insulin
25Insulin - metabolism
26Insulin Resistance - physiology
27Insulin-Secreting Cells - metabolism
28Internal Medicine
29Linear Models
30London - epidemiology
31Male
32Mass Screening
33Medical research
34Medical sciences
35Mens health
36Middle Aged
37Pancreatic beta cells
38Physiological aspects
39Prediabetic State - complications
40Prediabetic State - epidemiology
41Prediabetic State - metabolism
42Prospective Studies
43Public health. Hygiene
44Public health. Hygiene-occupational medicine
45Risk Assessment - methods
46Risk Factors
47Statistical analysis
48Studies
49Time Factors
50Type 2 diabetes
issn
00140-6736
11474-547X
fulltexttrue
rsrctypearticle
creationdate2009
recordtypearticle
recordideNqFkn1r1TAUxosobk4_glIURWF3Jm2atArKGL4MBv7hxPtfSNPTe8_W28ycdNCv4Sc2vfeyN4SRkEDyex7OSZ4kec7ZAWdcvv_JuGAzqXL5llXvJJO8ms0fJLtcKDErhJo_THavkJ3kCdEZY0xIVjxOdnhV8EJwtpv8PfXmDGxwHoFS16aLbrQGVmj2U-xp6LBPCXrCgJcYxv3U9M2NC-shoOvTGlrnIW3QLHpHuHYK4wWk2XRWQwD6EKVxmm6c7lvvVmlYQvp7iQGWpuvS4-OUwtCMT5NHrekInm33veTX1y-nR99nJz--HR8dnsy4zFSYNSzLqryGrGzK2A5kqihzY6qa1ZZDWRaqFUVeC2ULUVmrlGpr3gqQTdvYvBT5XvJm43vh3Z8BKOgVkoWuMz24gbRUIucZKyP48g545gYfOyHNq4rlQioVoVcbaGE60Ni3LnhjJ0d9mLFMVJnMq0gd_IeKo4lPbl0PLcbzW4L9G4J6IOyB4kK4WAZamIHoNl5scOsdkYdWX3hcGT9qzvSUG73OjZ5CoVml17nR86h7sW1xqFfQXKu2QYnA6y1gyJqu9aa3SFdcxqWQhcoj9_FOARaDmTISG8Xu3jI-b9QQ__0SwWuyCL2FBn0MqW4c3uvw6Y6DjUnFWPI5jEDXH6cp02xjMnmwau0wz_8BP7AGvA
startdate2009
enddate2009
creator
0Tabák, Adam G, Dr
1Jokela, Markus, PhD
2Akbaraly, Tasnime N, PhD
3Brunner, Eric J, PhD
4Kivimäki, Mika, Prof
5Witte, Daniel R, MD
general
0Elsevier Ltd
1Elsevier
2Elsevier B.V
3Elsevier Limited
scope
06I.
1AAFTH
2IQODW
3CGR
4CUY
5CVF
6ECM
7EIF
8NPM
9AAYXX
10CITATION
11BSHEE
120TT
130TZ
140U~
153V.
167QL
177QP
187RV
197TK
207U7
217U9
227X7
237XB
2488A
2588C
2688E
2788G
2888I
298AF
308AO
318C1
328C2
338FE
348FH
358FI
368FJ
378FK
388G5
39ABUWG
40AN0
41ASE
42AZQEC
43BBNVY
44BEC
45BENPR
46BHPHI
47C1K
48DWQXO
49FPQ
50FYUFA
51GHDGH
52GNUQQ
53GUQSH
54H94
55HCIFZ
56K6X
57K9-
58K9.
59KB0
60KB~
61LK8
62M0R
63M0S
64M0T
65M1P
66M2M
67M2O
68M2P
69M7N
70M7P
71MBDVC
72NAPCQ
73PQEST
74PQQKQ
75PQUKI
76Q9U
77S0X
787X8
sort
creationdate2009
titleTrajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study
authorTabák, Adam G, Dr ; Jokela, Markus, PhD ; Akbaraly, Tasnime N, PhD ; Brunner, Eric J, PhD ; Kivimäki, Mika, Prof ; Witte, Daniel R, MD
facets
frbrtype5
frbrgroupidcdi_FETCH-LOGICAL-1627t-d02293be28d8951e27583aa9b0bc1e8857f453b47c549cc777fb1f4e6dfdc3843
rsrctypearticles
prefilterarticles
languageeng
creationdate2009
topic
0Abridged Index Medicus
1Adult
2Biological and medical sciences
3Biomarkers - metabolism
4Blood Glucose - metabolism
5Councils
6Diabetes
7Diabetes Mellitus, Type 2 - diagnosis
8Diabetes Mellitus, Type 2 - epidemiology
9Diabetes Mellitus, Type 2 - etiology
10Diabetes Mellitus, Type 2 - metabolism
11Diabetes. Impaired glucose tolerance
12Diagnosis
13Endocrine pancreas. Apud cells (diseases)
14Endocrinopathies
15Epidemiology
16Etiopathogenesis. Screening. Investigations. Target tissue resistance
17Fasting
18Female
19General aspects
20Glucose Tolerance Test
21Health care policy
22Homeostasis
23Humans
24Insulin
25Insulin - metabolism
26Insulin Resistance - physiology
27Insulin-Secreting Cells - metabolism
28Internal Medicine
29Linear Models
30London - epidemiology
31Male
32Mass Screening
33Medical research
34Medical sciences
35Mens health
36Middle Aged
37Pancreatic beta cells
38Physiological aspects
39Prediabetic State - complications
40Prediabetic State - epidemiology
41Prediabetic State - metabolism
42Prospective Studies
43Public health. Hygiene
44Public health. Hygiene-occupational medicine
45Risk Assessment - methods
46Risk Factors
47Statistical analysis
48Studies
49Time Factors
50Type 2 diabetes
toplevel
0peer_reviewed
1online_resources
creatorcontrib
0Tabák, Adam G, Dr
1Jokela, Markus, PhD
2Akbaraly, Tasnime N, PhD
3Brunner, Eric J, PhD
4Kivimäki, Mika, Prof
5Witte, Daniel R, MD
collection
0ScienceDirect Open Access Titles
1Elsevier:ScienceDirect:Open Access
2Pascal-Francis
3Medline
4MEDLINE
5MEDLINE (Ovid)
6MEDLINE
7MEDLINE
8PubMed
9CrossRef
10Academic OneFile (A&I only)
11News PRO
12Pharma and Biotech Premium PRO
13Global News & ABI/Inform Professional
14ProQuest Central (Corporate)
15Bacteriology Abstracts (Microbiology B)
16Calcium & Calcified Tissue Abstracts
17Nursing & Allied Health Database
18Neurosciences Abstracts
19Toxicology Abstracts
20Virology and AIDS Abstracts
21Health & Medical Collection
22ProQuest Central (purchase pre-March 2016)
23Biology Database (Alumni Edition)
24Healthcare Administration Database (Alumni)
25Medical Database (Alumni Edition)
26Psychology Database (Alumni)
27Science Database (Alumni Edition)
28STEM Database
29ProQuest Pharma Collection
30Public Health Database
31Lancet Titles
32ProQuest SciTech Collection
33ProQuest Natural Science Collection
34Hospital Premium Collection
35Hospital Premium Collection (Alumni Edition)
36ProQuest Central (Alumni) (purchase pre-March 2016)
37Research Library (Alumni Edition)
38ProQuest Central (Alumni Edition)
39British Nursing Database
40British Nursing Index
41ProQuest Central Essentials
42Biological Science Collection
43eLibrary
44ProQuest Central
45Natural Science Collection
46Environmental Sciences and Pollution Management
47ProQuest Central Korea
48British Nursing Index (BNI) (1985 to Present)
49Health Research Premium Collection
50Health Research Premium Collection (Alumni)
51ProQuest Central Student
52Research Library Prep
53AIDS and Cancer Research Abstracts
54SciTech Premium Collection
55British Nursing Index
56Consumer Health Database (Alumni Edition)
57ProQuest Health & Medical Complete (Alumni)
58Nursing & Allied Health Database (Alumni Edition)
59ProQuest Newsstand Professional
60ProQuest Biological Science Collection
61Consumer Health Database
62Health & Medical Collection (Alumni Edition)
63Healthcare Administration Database
64Medical Database
65Psychology Database
66Research Library
67Science Database
68Algology Mycology and Protozoology Abstracts (Microbiology C)
69Biological Science Database
70Research Library (Corporate)
71Nursing & Allied Health Premium
72ProQuest One Academic Eastern Edition
73ProQuest One Academic
74ProQuest One Academic UKI Edition
75ProQuest Central Basic
76SIRS Editorial
77MEDLINE - Academic
jtitleThe Lancet (British edition)
delivery
delcategoryRemote Search Resource
fulltextfulltext
addata
au
0Tabák, Adam G, Dr
1Jokela, Markus, PhD
2Akbaraly, Tasnime N, PhD
3Brunner, Eric J, PhD
4Kivimäki, Mika, Prof
5Witte, Daniel R, MD
formatjournal
genrearticle
ristypeJOUR
atitleTrajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study
jtitleThe Lancet (British edition)
addtitleLancet
date2009
risdate2009
volume373
issue9682
spage2215
epage2221
pages2215-2221
issn0140-6736
eissn1474-547X
codenLANCAO
abstractSummary Background Little is known about the timing of changes in glucose metabolism before occurrence of type 2 diabetes. We aimed to characterise trajectories of fasting and postload glucose, insulin sensitivity, and insulin secretion in individuals who develop type 2 diabetes. Methods We analysed data from our prospective occupational cohort study (Whitehall II study) of 6538 (71% male and 91% white) British civil servants without diabetes mellitus at baseline. During a median follow-up period of 9·7 years, 505 diabetes cases were diagnosed (49·1% on the basis of oral glucose tolerance test). We assessed retrospective trajectories of fasting and 2-h postload glucose, homoeostasis model assessment (HOMA) insulin sensitivity, and HOMA β-cell function from up to 13 years before diabetes diagnosis (diabetic group) or at the end of follow-up (non-diabetics). Findings Multilevel models adjusted for age, sex, and ethnic origin confirmed that all metabolic measures followed linear trends in the group of non-diabetics (10 989 measurements), except for insulin secretion that did not change during follow-up. In the diabetic group (801 measurements), a linear increase in fasting glucose was followed by a steep quadratic increase (from 5·79 mmol/L to 7·40 mmol/L) starting 3 years before diagnosis of diabetes. 2-h postload glucose showed a rapid increase starting 3 years before diagnosis (from 7·60 mmol/L to 11·90 mmol/L), and HOMA insulin sensitivity decreased steeply during the 5 years before diagnosis (to 86·7%). HOMA β-cell function increased between years 4 and 3 before diagnosis (from 85·0% to 92·6%) and then decreased until diagnosis (to 62·4%). Interpretation In this study, we show changes in glucose concentrations, insulin sensitivity, and insulin secretion as much as 3–6 years before diagnosis of diabetes. The description of biomarker trajectories leading to diabetes diagnosis could contribute to more-accurate risk prediction models that use repeated measures available for patients through regular check-ups. Funding Medical Research Council (UK); Economic and Social Research Council (UK); British Heart Foundation (UK); Health and Safety Executive (UK); Department of Health (UK); National Institute of Health (USA); Agency for Health Care Policy Research (USA); the John D and Catherine T MacArthur Foundation (USA); and Academy of Finland (Finland).
copKidlington
pubElsevier Ltd
pmid19515410
doi10.1016/S0140-6736(09)60619-X
oafree_for_read