Diabetes in African Americans: Unique pathophysiologic features

被引：23

作者：

Banerji M.A. ^{[1
]}

机构：

[1] SUNY Health Science Center, Brooklyn, NY 11203

来源：

Current Diabetes Reports | 2004年 / 4卷 / 3期

关键词：

Metabolic Syndrome; Visceral Adipose Tissue; Repaglinide; Diabetic Ketoacidosis; Glipizide;

D O I：

10.1007/s11892-004-0027-3

中图分类号：

学科分类号：

摘要：

Type 2 diabetes is an increasing public health problem among African Americans, especially children. Several features make type 2 diabetes among African Americans unique. First, African-American adults with type 2 diabetes, or Flatbush diabetes, present with diabetic ketoacidosis. Patients are insulin resistant with acute, severe defects in insulin secretion and no islet cell autoantibodies. Following treatment, some insulin secretory capacity is recovered and ketoacidosis generally does not recur. The second is remission in African Americans with type 2 diabetes. Recovery of glucose homeostasis, accompanied by recovery of β-cell function, follows intensive glycemic regulation. Finally, among African Americans with diabetes who are not obese, normal insulin sensitivity is not uncommon. Such individuals do not have the increased cardiovascular risk of insulin-resistant individuals. Differences in visceral, not subcutaneous, adipose tissue volume appear to determine insulin sensitivity. Understanding the unique physiologic and clinical features of African Americans is critical in designing appropriate treatment strategies. Copyright © 2004 by Current Science Inc.

引用

页码：219 / 223

页数：4

共 55 条

[1] Harris M.I., Flegal K.M., Cowie C.C., Et al., Prevalence of diabetes, impaired fasting glucose and impaired glucose tolerance in US adults, Diabetes Care, 21, pp. 518-524, (1998)
[2] Brancati F.L., Kao W.H., Folsom A.R., Et al., Incident type 2 diabetes mellitus in African American and white adults: The Atherosclerosis Risk in Communities Study, JAMA, 283, pp. 2253-2259, (2000)
[3] Smedley B.D., Stith A.Y., Nelson A.R., The healthcare environment and its relation to disparities, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, pp. 80-124, (2003)
[4] Banerji M.A., Chaiken R.L., Huey H., Et al., GAD antibody negative NIDDM in black subjects with diabetic ketoacidosis and increased frequency of human leukocyte antigen DR3 and DR4. Flatbush diabetes, Diabetes, 43, pp. 741-745, (1994)
[5] Banerji M.A., Lebovitz H.E., Remission in non-insulin-dependent diabetes mellitus: Clinical characteristics of remission and relapse in black patients, Medicine, 69, pp. 176-185, (1990)
[6] Chaiken R.L., Banerji M.A., Pasmantier R.M., Et al., Patterns of glucose and lipid abnormalities in black NIDDM subjects, Diabetes Care, 14, pp. 1036-1042, (1991)
[7] Banerji M.A., Lebovitz H.E., Insulin sensitive and insulin resistant variants in NIDDM, Diabetes, 38, pp. 784-801, (1989)
[8] Reaven G.M., The role of insulin resistance in human disease, Diabetes, 37, pp. 1595-1607, (1988)
[9] McFarlane S.I., Banerji M.A., Sowers J.R., Insulin resistance and cardiovascular risk, J. Clin. Endocrinol. Metab., 86, pp. 713-718, (2001)
[10] Morrison E.Y., Ragoobirsingh D., Thompson H., Et al., Phasic insulin dependent diabetes: Manifestations and cellular mechanisms, J. Clin. Endocrinol. Metab., 80, pp. 1996-2001, (1995)

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