Over the past 30 years, in prospective longitudinal studies of the development of T2DM and its risk factors, within-subject individual variable trajectories (as characterized in nonhuman primates (NHPs) have shown very different individual profiles compared to data synchronized retrospectively on the time point of DM diagnosis (DM DX) (e.g., Whitehall II or ARIC studies). About 30% of unrelated NHPs naturally and spontaneously develop T2DM at an average age of 19.2 ± 5.4 years (equivalent to ∼60 years in humans). New trajectory analyses of the standardized fasting glucose (FPG), fasting insulin (FPI) and β- cell function of those monkeys that became DM while under longitudinal study indicate that the functional β-cell changes in the pre-DM period, applying the usual epidemiological analytical approach used in humans, is likely to be highly misleading. The NHP DM progression data of 24 adult monkeys studied for an average of 8 years, with pre-DM data obtained up to 18 years pre-DM DX show that these trajectories must be analyzed individually and then standardized for rate of progression, timing of progression and amplitude of changes in order to establish the valid naturally-occurring patterns of the pre-DM progression seen below.
B.C. Hansen: None. J.D. Newcomb: None. P.K. Lin: None. K. Jen: None.
National Institutes of Health