The insulin and glucose response to an oral glucose load in non-insulin-dependent diabetes in the young

Non-insulin-dependent diabetes with age of onset under 35 years was studied in 85 Indian patients. Eighty-one per cent of the group were females, the mean age of onset of diabetes was 27 years while the mean duration was 6.3 years. The mean percentage desirable mass of the patients was 122%, obesity being present in 55% of the group. Eighty-two per cent of patients gave a positive family history; closer analysis revealed that 75% of the propositi had a diabetic parent and 41% a diabetic sibling; while three-generation transmission was present in 7%. Eighty-one patients consented to a 100 g oral glucose load. The insulin and glucose response during a 3-hour period revealed fasting hyperinsulinism with a delayed and attenuated insulin response, a much lower insulin area and higher glucose area, a lower insulin-glucose ratio and a lower modified Seltzer insulinogenic index when compared with 50 non-diabetic reference subjects. There was no difference in insulin and glucose responses in obese and non-obese diabetics. However, subdivision of the group into those with moderate and those with severe diabetes demonstrated that the latter had significantly higher plasma glucose levels and lower insulin levels at all times, except in the fasting state, during which the insulin levels were not significantly different.