Can insulin resistance exist as a primary defect in noninsulin-dependent diabetes mellitus?

Arthur L Swislocki, C. C. Donner, E. Fraze, Y. D. Chen, G. M. Reaven

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


In this study we have attempted to quantify the plasma insulin response to glucose and insulin action in 22 nonobese subjects: 11 with normal glucose tolerance and 11 with mild [mean fasting plasma glucose concentration, 128 ± (± SEM) 5 mg/dL] noninsulin-dependent diabetes mellitus (NIDDM). Estimates of the plasma insulin response were made by determining the plasma insulin concentration at hourly intervals from 0800-1600 h, before and after mixed meals consumed at 0800 h (breakfast) and 1200 h (lunch). Insulin action was assessed by measuring glucose uptake during insulin clamp studies performed at steady state plasma insulin levels of approximately 10 and 60 μU/mL, with the difference between the 2 values defined as insulin-stimulated glucose uptake. Plasma glucose (P < 0.001) and insulin (P < 0.001) concentrations were significantly higher in patients with NIDDM throughout the 8-h period (by two-way analysis of variance). However, mean (± SEM) insulin-stimulated glucose uptake by markedly reduced (P < 0.001) in patients with type 2 diabetes mellitus (112 ± 72 vs. 336 ± 44 mg/m2 min-1). Thus, patients with NIDDM and mild fasting hyperglycemia were both insulin resistant and hyperinsulinemic compared to normal individuals. These data indicate that a defect in insulin-stimulated glucose uptake can occur in NIDDM in the absence of significant hyperglycemia and/or hypoinsulinemia.

Original languageEnglish (US)
Pages (from-to)778-782
Number of pages5
JournalJournal of Clinical Endocrinology and Metabolism
Issue number4
StatePublished - 1987
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism


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