High concentrations of nonesterified fatty acids (NEFA) are a risk factor for developing type 2 diabetes in Pima Indians. In vitro and in vivo, chronic elevation of NEFA decreases glucose-stimulated insulin secretion. We hypothesized that high fasting plasma NEFA would increase the risk of type 2 diabetes by inducing a worsening of glucose-stimulated insulin secretion in Pima Indians.
The subjects were 151 Pima - 107 with normal glucose tolerance (NGT) and 44 with impaired glucose tolerance (IGT) at the outset of the study. At the outset none of the subjects had been diagnosed with frank diabetes. These subjects were part of a study on pathogenesis of diabetes in the Pima and returned for annual visits to have various tests performed. Of note, offspring of diabetic mothers were excluded from the analysis, thus the NGT group did not include this "at risk" group.
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