Few data exist on predictors of non-insulin-dependent (type II) diabetes mellitus. We examined body mass index (BMI), ratio of subscapular-to-triceps skin fold (centrality index), and fasting glucose and insulin concentrations as predictors of decompensation to type II diabetes in Mexican Americans, a population at high risk for this disorder. Twenty-eight of 474 initially nondiabetic Mexican Americans developed type II diabetes after 8 yr of follow-up. Converters to diabetes were older and had higher BMIs, centrality indices, and fasting glucose and insulin concentrations than nonconverters. Subjects in the highest quartile of the insulin distribution had 6.6 times the risk of developing type II diabetes as subjects in the remaining three quartiles combined (95% confidence interval [CI] = 3.14–13.7). In multivariate analysis, fasting glucose (odds ratio [OR] = 5.80, 95% CI = 2.57–13.1) and insulin (OR = 3.12, 95% CI = 1.36–7.14) remained significantly related to conversion to diabetes. However, BMI and centrality index, which were significantly related to conversion in the univariate analysis, were no longer significant in the multivariate analysis once glucose and insulin concentrations were taken into consideration, suggesting that the effect of these variables may be mediated by insulin resistance. Nearly half of the incident cases developed in a subset of the population who were simultaneously in the highest quartile of both fasting insulin and glucose concentrations (population-attributable risk 44.2%). Our results support the insulin resistance/pancreatic exhaustion theory of type II diabetes.
Skip Nav Destination
Article navigation
Original Articles|
March 01 1990
Incidence of Type II Diabetes in Mexican Americans Predicted by Fasting Insulin and Glucose Levels, Obesity, and Body-Fat Distribution
Steven M Haffner;
Steven M Haffner
Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio
San Antonio, Texas
Search for other works by this author on:
Michael P Stern;
Michael P Stern
Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio
San Antonio, Texas
Search for other works by this author on:
Braxton D Mitchell;
Braxton D Mitchell
Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio
San Antonio, Texas
Search for other works by this author on:
Helen P Hazuda;
Helen P Hazuda
Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio
San Antonio, Texas
Search for other works by this author on:
Judith K Patterson
Judith K Patterson
Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio
San Antonio, Texas
Search for other works by this author on:
Address correspondence and reprint requests to Steven M. Haffner, MD, MPH, Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284.
Diabetes 1990;39(3):283–288
Article history
Received:
April 28 1989
Revision Received:
October 20 1989
Accepted:
October 20 1989
PubMed:
2407581
Citation
Steven M Haffner, Michael P Stern, Braxton D Mitchell, Helen P Hazuda, Judith K Patterson; Incidence of Type II Diabetes in Mexican Americans Predicted by Fasting Insulin and Glucose Levels, Obesity, and Body-Fat Distribution. Diabetes 1 March 1990; 39 (3): 283–288. https://doi.org/10.2337/diab.39.3.283
Download citation file:
198
Views