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Insulin concentrations duing development of IGT and NIDDM in Pima Indians
Sequential changes in insulin concentration during the development of Type 2 diabetes are shown. The line and arrows represent the mean insulin levels in groups of individuals who went from NGT to IGT, and from IGT to Type 2 diabetes. The orange line represents the insulin levels among individuals who went from NGT, then IGT and finally to Type 2 diabetes. Insulin levels increase considerably during the development of IGT, whereas during the transition from IGT to Type 2 diabetes, insulin concentrations remain the same or decrease. Among those with Type 2 diabetes, increasing hyperglycemia is associated with further decreases in insulin concentration. These findings suggest that insulin resistance increases progressively up to the point when IGT occurs. With development of further degrees of hyperglycemia, insulin levels diminish.

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