Vnitr Lek 1994, 40(5):320-324

[Recent findings on type II non-insulin-dependent diabetes (epidemiologic data, etiopathogenesis)].

J Rybka: Interní klinika Institu postgraduálního vzdĕlání ve zdravotnictví, Zlin.

Although NIDDM is by far the most frequent form of diabetes, the pathogenesis is less clear and even more controversial than in IDDM. There is a heterogeneity of IDDM and NIDDM and there are reasons why the two types should be considered different diseases although we do not know exactly why. NIDDM is the result of a disbalance between insulin sensitivity and insulin secretion. Fully developed NIDDM syndrome calls for the concurrent existence of both main defects, i.e. insulin resistance and deteriorated B-cell function. It is important that the two defects must occur simultaneously, only then marked glucose intolerance develops. Concurrent hyperglycaemia and hyperinsulinaemia on fasting suggest severe insulin resistance. Investigations provide evidence that hyperinsulinaemia is a predictor of the final development of IGT and IDDM and it was demonstrated that hyperglycaemia is a predictor of development of NIDDM in Caucasians.