Elevated Insulin Clearance Contributes to the Reduced Peripheral Insulin Concentration Observed in Obese Young Asian with Type 2 Diabetes

Introduction: The importance of insulin clearance (CLins) on insulin dynamics and the role exerted in controlling glucose in type 2 subjects has recently been appreciated. Moreover, evidence in mice showed that CLins is reduced by incretin hormones at physiological levels. Aim: To evaluate in 29 young (19±1 years) multi-ethnic Asian type 2 subjects (T2D) the contribution of CLins to insulin dynamics and if an association exists with GLP-1. Methods: T2D (15F/14M; BMI=30.2±0.9 kg/m2; HbA1c=8.8±0.4% [73±4.4 mmol/mol]; mean duration of disease 2.5 years) had fasting glucose Gb=192±14 mg/mL and insulin Ib=19±3 µU/mL. They were compared to 17 (8F/9M) age-matched nondiabetic overweight (BMI=27.8±1.0, p=0.1) control subjects (CT, Gb=82±1, p