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Insulin resistance versus β-cell dysfunction in type 2 diabetes: where public and personalised health meet.
The Lancet Diabetes & Endocrinology ( IF 44.0 ) Pub Date : 2019-12-23 , DOI: 10.1016/s2213-8587(19)30421-8 Elaine Y K Chow 1 , Juliana C N Chan 1
The Lancet Diabetes & Endocrinology ( IF 44.0 ) Pub Date : 2019-12-23 , DOI: 10.1016/s2213-8587(19)30421-8 Elaine Y K Chow 1 , Juliana C N Chan 1
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In the past few decades, China has witnessed an epidemic of obesity, prediabetes, and diabetes as it undergoes unprecedented socioeconomic, cultural, and environmental transition, characterised by physical inactivity and consumption of energy-dense foods. In 2019, 11% of the population—some 116 million people—were thought to have diabetes in China. β-cell dysfunction and insulin resistance are key mechanisms in the development of type 2 diabetes. In an analysis of the hyperbolic relationships between insulin sensitivity index and acute insulin response to glucose among east Asians, Africans, and Caucasians, east Asians had a substantial decline in insulin response despite a small increase in insulin resistance. This finding was in contrast to the compensatory increase in insulin response observed in Africans and Caucasians. The authors concluded that this unstable relationship substantially increased the risk of diabetes in east Asians compared with Caucasians. Conversely, other researchers reported similar disposition indices based on glucose and insulin measurements during oral glucose tolerance tests between Japanese individuals and Caucasians at all glucose tolerance states. They further commented that differences in metabolic indices were determined mainly by body composition including BMI and distribution of adipose tissue.
更新日期：2020-01-22
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