Abstract
Objective: To compare insulin resistance and beta-cell function in nondiabetic, prediabetic, and diabetic subjects in a subset of obese Pakistani population.
 Materials and Methods: Two hundred and ten obese subjects underwent anthropometric measurements. After overnight fasting for 8 hours, 6 cc blood was drawn for fasting blood glucose level, fasting insulin level. Blood glucose samples were taken after drinking 75 gm glucose in 260 ml water. HOMA IR and HOMA BETA% were calculated by the formula. Subjects were divided into obese nondiabetic, obese prediabetic and obese diabetic according to WHO criteria.
 Results: Out of 210 obese subjects, 53 (25.2%) were males and 157 (74.8%) were females. The mean BMI was 32.39±5.21. Mean abdominal circumference was 102.78±10.16. There were 101(48%) obese nondiabetic, 51(24%) were found to be obese prediabetic, 58(28%) were found to be obese diabetic. Mean insulin resistance in obese nondiabetic subjects was 2.8 ±3.7, in prediabetic 8.5± 12.3, in diabetic was 17.7±24.6. Mean HOMA beta was 245.3±267.4 in obese nondiabetic subjects, 290.5±298.4 in prediabetic, and 16.6±57 in diabetic.
 Conclusion: There was a significantly increased incidence of prediabetes and diabetes in obese subjects. Prediabetic and diabetic subjects were found to have marked insulin resistance. Beta-cell function was markedly reduced in diabetic subjects having a family history of diabetes, emphasizing the genetic predisposition to develop beta-cell exhaustion.
Highlights
There is an increasing prevalence of diabetes in Pakistan over the past twenty years
Glucose carries the main drive on beta cells and persistent hyperglycemia can exhaust the beta cells resulting in diabetes [4]
Different studies in young [7] and adults [8] are present in literature discussing the beta-cell function and insulin resistance in diabetes but in this study, only obese subjects have been selected
Summary
There is an increasing prevalence of diabetes in Pakistan over the past twenty years. Different studies in young [7] and adults [8] are present in literature discussing the beta-cell function and insulin resistance in diabetes but in this study, only obese subjects have been selected. The objective is to investigate obese subjects in a subgroup of Pakistani subjects, for insulin resistance and beta-cell function in obese nondiabetic, prediabetic, and diabetic subjects, to see the influence of both of these mechanisms in prediabetes and diabetes in the presence of obesity. Their anthropometric measurements, weight in kg, height in m2, abdominal girth in cm were taken. Subjects were divided into obese nondiabetic, obese prediabetic and obese diabetic on the results of glucose tolerance test according to WHO criteria. HOMA IR and HOMA BETA% were calculated by the formula ( fasting insulin x fasting glucose / 22.5) and ( 20x fasting insulin/ fasting glucose – 3.5) respectively
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