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Direct evidence that insulin resistance precedes the development
of Type 2 diabetes comes from prospective studies among
the Pima Indian population. This graph shows the
cumulative incidence of diabetes over a five-year period
in individuals with NGTat the begining. Those with the
highest fasting insulin levels had the highest risk of
developing diabetes over the period. In people with NGT
the fasting insulin level is a reflection of the extent
of insulin resistance. Similar patterns have now been
seen in many other ethnic groups.
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