Ethnic Differences in Insulin Secretion and Diabetes Risk

New research highlights significant differences in insulin secretion, sensitivity, and clearance between normoglycemic Black and White adults with a parental history of type 2 diabetes. These factors are key predictors of future dysglycemia and diabetes risk, shedding light on the varying diabetes risks across ethnic groups.

The study, derived from the Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC), followed 268 participants (145 African American and 123 European American) for over 5.5 years. All participants were initially normoglycemic, with assessments conducted for insulin secretion via intravenous glucose tolerance tests (IVGT), insulin sensitivity through hyperinsulinemic-euglycemic clamps (HEC), and insulin clearance measured using C-peptide to insulin ratios.

Findings revealed notable disparities: African American participants exhibited higher insulin secretion and disposition index (DI) but lower insulin sensitivity and insulin clearance compared to European Americans. These differences suggest varying physiological responses to glucose metabolism across ethnic groups, impacting the likelihood of developing dysglycemia.

Over the study period, 91 participants developed dysglycemia, while 177 maintained normoglycemia. Statistical models revealed that insulin secretion (HR 0.997), insulin sensitivity (HR 0.948), disposition index (HR 0.945), and basal insulin clearance (HR 1.030) significantly predicted incident dysglycemia. Lower insulin sensitivity and reduced insulin clearance were more closely associated with a higher risk of transitioning from normoglycemia to dysglycemia.

These findings underscore the importance of considering ethnic disparities in insulin dynamics when assessing diabetes risk. Differences in how insulin is secreted, cleared, and utilized could guide personalized prevention strategies for at-risk populations.

Actionable Insights:

• Tailored Screening Programs: Early detection focusing on insulin clearance and sensitivity disparities.
• Personalized Interventions: Ethnicity-specific dietary and lifestyle strategies.
• Enhanced Awareness: Medical education about how parental diabetes history impacts future risk.

Understanding the complex relationship between insulin sensitivity, secretion, and clearance can revolutionize strategies for predicting and preventing type 2 diabetes in diverse populations.

More Information: Chimaroke Edeoga, Peace Asuzu, Jim Wan, Samuel Dagogo-Jack – Insulin secretion, sensitivity, and clearance in normoglycemic Black and White adults with parental type 2 diabetes: association with incident dysglycemia: BMJ Open Diabetes Research & Care 2024;12:e004545.