PATHOPHYSIOLOGIC FEATURES OF MATURITY-ONSET, OBESE TYPE DIABETES MELLITUS

Abstract

It is generally believed that enviromental factors including obesity may contribute to the predominance of certain features of the diabetic syndromes. An attempt was made, therefore, to determine some characteristics of maturity-onset, obese type diabetes in our diabetes clinic.The thirty two cases (33.7%) of randomly selected 98 patients with diabetes mellitus were obese type (more than + 20% overweight). The incidence of obese type which was designed as more than + 10% overweight was approximately 60%. The relative rates of abnormal findings on the electrocardiogram, hyperternsion and hyperlipemia were greater in obese type than in non-obese type, while no significant differences between two groups were observed in the incidence of diabetic retinopathy, albuminuria and abnormal knee jerk. The patients with diabetes showed a significantly low serum insulin levels 30 minutes after the oral glucose loading but similar levels of total insulin response in both obese and non-obese type compared to the normal controls, in despite of impaired glucose tolerance.These observations suggest that the duration of diabetes or control of blood glucose may be more important determinant in inducing diabetic microangiopathy rather than the degree of obesity. In contrast, the incidence of macroangiopathy and hyperlipemia appeared to be related, at least in part, to the degree of obesity which might lead to the peripheral insulin resistance.