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KMID : 0350519950480041215
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Journal of Catholic Medical College
1995 Volume.48 No. 4 p.1215 ~ p.1229
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Risk Factors Related to the Development of Impaired Glucose Tolerance and Diabetes Mellitus in Offspring of Parents with NIDDM
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Abstract
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This study was designed to analyze the glucose tolerance and insulin secretion pattern, and to identify risk factors for development of impaired glucose tolerance and diabetes mellitus in offspring of parents with NIDDM.
Furtnermore, it was aimed at developing a primary nursing program wihich might be useful for the early detection of diabetes mellitus, and for reducing the risk factors of diabetes mellitus.
The subjects consisted of 42 offsprings of 20 parents with NIDDM who had been admitted to the department of internal medicine or had been seen in the out-patient clinic at Kangnam St. Mary's Hospital, Catholic University Medical College between
Feb, and
May 1995. As a control group, 42 healthy peole without a family history of diabetes mellitus were matched by sex, age and body mass index (BMI).
The glucose tolerance and nsulin secretion pattern as shown through the oral glucose tolerance test were analyed and the risk factors of diabetes mellitus occurrence were analyzed in this study.
@ES The results were as follows :
@EN 1. The prevalence of impaired glucose tolerance and diabetes mellitus was 13.4 % and 2.4 % in offspring and cotrol subjects, repectively (P<0.05).
2. The insulin secretion pattern in offspring and control subjects with normal glucose tolerance showed ;
1) Insulin/glucose ratio in offspring was significantly greater than in control subjects (P<0.05).
2) Insulin/glucose ratio in both obese and nonobese offspring was significantly greater than in both obese and nonobese control subjects(P<0.05).
3) Total insulin area and insulin glucose ration in the 20 year age group in offspring were significantly higher than those in 30 and 40 year age groupo(P<0.05).
3. Comparison of insulin secretion patterns between normal glucose tolerance and impaired glucose tolerance in offspring and control subjects showed;
1) Total glucose areas in offspring and control subjects with impaired glucose tolerance were significantly higher than those with normal glucose tolerance (P<0.01).
2) Total insulin areas in obese offspring and obese control subjects were significantly higher than those in nonobese offspring and nonobese control subjects (P<0.01).
3) Insulin/glucose ratio in ninobese offspring with impaired glucose tolerance was significantly lower than for those with normal glucose tolerance (P<0.01).
4) The major factors related to the total insulin area were age, WHR and free fatty acid (R*=0.4513).
5) Systolic blood pressure, diastolic blood pressure, waist hip ratio, BMI and skinfold thickness (biceps, subscapular and subcostal) were significantly higher for those with impaired glucose tolerance and diabetes mellitus than for those with
normal
glucose toerance.
6) The risk factors related to the development of impaired glucose tolerance and diabetes mellitus by multiple logistic analysis were BMI (P<0.01), age (P<0.05) and diabetic family history (P<0.06).
In the light of the results, it may seem that insulin resistance is associated with the development of diabetes mellitus in obese offspring of parents with NIDDM. However, an insulin secretion defect was identified only in nonobese offspring with
impaired glucose tolerance. And the risk factors related to the development of impaired glucose tolerance and diabetes mellitus were age, body mass index, WHR, free fatty acid value and diabetic family history.
It is suggested that the early detection of these factors might provide a powerful tool to prevent the development of diabetes mellitus, and various nursing educational programs reducing obesity could be appled to offspring of parents with NIDDM
to
prevent the development of diabetes mellitus.
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KEYWORD
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