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%.