Abstract

LOPEZ, José Enrique  and  URBANEJA, Hermaliz. Tolerancia a la glucosa e insulinemia en hermanos asintomáticos de pacientes diabéticos tipo 2. Gac Méd Caracas [online]. 2006, vol.114, n.4, pp.305-317. ISSN 0367-4762.

SUMMARY In diabetes mel1itus the metabolism of glucids, lipids and proteins is affected. As the time elapsed the quality of life and labor productivity diminished. The symptoms, the clinic- epidemiological characters of the il1ness and, the family history help the physician confirm the diagnosis. We studied asymptomatic consanguine group of brothers and sisters of patients with the diagnosis of diabetes mel1itus type 2 and a control group of adults, age above 18 years old, asymptomatic who were hospitalized in the University Hospital Dr. Enrique Tejera in Valencia, Carabobo state, between January 2003 to January 2005. There were 152 patients in two groups: the first consanguine brothers of diabetic type 2 patients (n = 91) and the second asymptomatic, with no family history of diabetes mel1itus type 2 who were the control group (n = 61). The selection of subjects was intentional with no probabilistic or aleatory sampling. The research team knew the universe object of the study. It was a transversal, analytic and comparative, non experimental field study. The asymptomatic group of brothers and sisters of patients with diabetes type 2 had alteration of the glucidic metabolism in routine laboratory examinations as fasting glicemia, who was altered 21 %, which fulfill the criteria of diabetes 9 %: With oral feeding with 75 g of glucose (glucose tolerance test) 17 patients had intolerance to glucose similar to the fasting glicemia. But elevation to 42 % was observed fulfilling the criteria for the diagnosis of diabetes. In other words the glucose tolerance test (GTT) made the diagnosis of 36 individuals who had not these criteria with the fasten glicemia. It was statistically significant (P< 0.001). The fasting plasmatic insulin levels reported six patients with hyperinsulinemia, same as the glucose tole-rance test showed increase of 32 % of the patients with hyperinsulinism. In the control group no patient had insulin above 60 µUl/mL glucose tolerance test (P< 0.0001). The glycoside hemoglobin fraction A 1C showed values 17 % above that considered normal and l0 % for the control group. The difference was statistically significative (P< 0.001) a fact that permits to infer that there are asymptomatic metabolic changes. The study of corporal mass index showed as stated in the literature, that there is a significative relation of diabetic brothers and obesity as twenty six individuals had a corporal mass index above 30 kg/m2 (P< 0.001). The data obtained were submitted to statistical analysis:1. -Student "t". 2.- Square chi (c2) 3.- Kolmogorov-Smirnoff test. It was used because the fasting glicemic test has variations up to 10 % and with the test the distribution was near normal. That gave statistical significance of P< 0.001. 4. Wilcoxon test. The rest of the values. were not normally distributed and the coefficients of variation are above 20 %. For these fact the contrast between the central values (medium rank), were done with these test for independent samples. All the differences were statistically significative.

Keywords : Diabetes detection in asintomatic brothers of type 2 diabetic patients..