SUMMATION OF INSULIN-2: DIAGNOSTIC TEST FOR INSULIN REQUIRING DIABETICS WHO ARE MISDIAGNOSED AS REQUIRING ONLY ORAL AGENTS

IRB PROTOCOL: PROVIDENCE HOSPITAL, SOUTHFIELD, MICHIGAN     1997-#601

EDWARD M. LICHTEN, M.D. 180 East Brown St., Birmingham, MI 48009 tele: 248.593.9999
            GLUCOSE TOL   INSULIN            
    NIDDM HEIGHT WEIGHT   1HR 2HR 3HR 1-HR 2-HR 3-HR HGBA1C CPEP SUM I TESTOSTERONE SHBG FAI
Michael   O-M 72 216   307 423 448 4 9 8 13 4.18 21.00 277 12 0.77
Bob   O-M&S 66 209   136 331 337 3 13 16 9.4 9.25 32.00 159 16 0.33
Joel   O-S 72 200   175 320 294 6.9 10.1 15.7   2.8 32.70      
Joseph   O-M 71 164   379 375 454 5 10.5 17.5 12   33.00 270 33 0.27
David   O-A 71 225   201 309 340 7 17 13 7.9 5.23 37.00 331 34 0.32
James   O-M 69 250   201 401 342 6.6 20 11.5 6.1   38.10 256 22 0.39
Paul   O-A&M 70     129 265 342 11 13 17 7.6 6.57 41.00 352 33 0.36
Robert   O-S&A 74 252   135 216 266 4.7 17.1 20.7 8.3 2.92 42.50 363 21 0.58
Michael   O 72 242   128 348 263 9 39 30 8.6   78.00 178 19 0.31
Robert   diet  71 206   163 317 298 14.1 37.3 34.1 7.2 2.92 85.50 161 14 0.38
Jon   O-M 71 186   163 389 322 16.3 34.6 53 9.1   103.90 320 48 0.22
Larry   none 73 345   111 201 170 22.8 80 23.4     126.20 205 19 0.36
Raymond   O-S 69 251   200 312 310 69.8 25.7 100 6.7 7.74 195.70 202 21 0.32
Raymond   diet/O-A/I 71 258   180           7.6     450 26 0.58
James   none 72 217   101     22.3     9.7 3.53   373 32 0.39
Albert   Actos, Insulin 69 289   152 236 298 15 29 27 6.5 5.6 71 278 29 0.32
John   Glucotrol 71 326   100 234 126 30 99 101 5.4 17.86 230 165 10 0.55
Douglas   Glucotrol 72 250   123 249 193 23 20 23       268 31 0.29
Joel   oral 68 198   178 320 294 6.9 10.1 15.7 8.8 2.8 32.7 140 40 0.12
                                   
                              AVER AGE 0.37

EXPLANATION

1.    THE MAJORITY OF VOLUNTEERS WERE FOUND TO BE 'INSULIN REQUIRING' BASED ON THE INSULIN RESPONSE TO THE 2-HOUR GLUCOSE LOAD.  THIS CAN BE BEST SEEN AS THE SUMMATION-I VALUE IN THE FOURTH COLUMN FROM THE RIGHT.  INSULIN REQUIRING DIABETICS HAVE A SUMMATION I VALUE LESS THAN 70 AND ARE UNABLE TO REACH THE NORMAL FASTING 10, 1-HR 40, 2-HR 20 VALUES FROM SERUM INSULIN.

2.    THERE IS A GROUP OF INDIVIDUALS WHOM ARE HYPER-INSULIN SECRETORS WITH SUMMATION OF INSULIN VALUES GREATER THAN 150 SUCH AS DOUGLAS AND RAYMOND1.  THESE ARE INDIVIDUALS WITH EARLIER DIABETES WHOM ARE TRYING TO COMPENSATE.  IN TIME, THEY WILL BURN OUT TOO AND REQUIRE INSULIN.

3.    NOTE THAT THESE OVERWEIGHT MEN ALSO HAVE LOW FREE ANDROGEN INDICES. THEY HAVE HIGHER RATIOS OVERALL THEN THE INSULIN REQUIRING MEN, ALBEIT, 10%.