Explore the occurrence and development of β cell dysfunction and insulin resistance according to the stratification on normal glucose tolerance

After the stratification of the normal glucose tolerance, the changes of insulin resistance and β cell function in the development of type 2 diabetes mellitus were investigated. A retrospective analysis on data of 275 cases with oral glucose insulin releasing tests. The area under the insulin curve(AUCINS)108.43 mU/L was taken as the critical value of diagnosis. Normal glucose tolerance subjects were divided into the NGT-a group(AUCINS prediabetes group>NGT-a group>type 2 diabetes mellitus group. The NGT-b group was always the highest, prediabetes group was lower, NGT-a group and type 2 diabetes mellitus group were the lowest, there were significant differences(all P<0.05). Making the NGT-a group as the basic state, in the NGT-b group, β cell function has begun to appear compensation and insulin resistance, and β cell function compensation reached the peak, the β cell function in the prediabetes group was beginning to compensate for the deficiency, the function of β cell in type 2 diabetes mellitus group decreased further. These findings suggest that the development process of type 2 diabetes mellitus could be the following four stages according to the function of β cell: β cell function normal, β cell functional compensation, β cell function loss of compensation, and finally β cell function failure. (Chin J Endocrinol Metab, 2017, 33: 741-744) Key words: Diabetes mellitus, type 2; Normal glucose tolerance; Insulin resistance; β cell function; Area under curve of insulin; Oral glucose insulin release test