这种空腹血糖偏高、但OGTT正常的血象,显示胰岛素抵抗主要是在肝脏(脂肪肝)。A1c,空腹血糖,OGTT三个指标显示的是血糖代谢的不同角度,当中有一个偏高就说明有问题。既然想预防糖尿病,就不要等到其他两个指标都坏了才开始行动。治未病,有时间窗口。早意识到了早做调整,效果才好。
"impairments in glucose metabolism occur many years before it is possible to classify individuals as abnormally hyperglycemic either in the fasting or postchallenge state. Hyperglycemia in the fasting state (i-IFG) seems primarily to be caused by an inherent insulin secretory dysfunction followed by a decline in hepatic insulin sensitivity. In contrast, the development of postchallenge hyperglycemia (i-IGT) mainly seems to be caused by low whole-body insulin sensitivity followed by a progressive decline in β-cell function, indicating a loss of β-cell compensation. This study supports the notion that the pre-diabetic states of i-IFG and i-IGT may have different etiological and pathophysiological origins"
http://care.diabetesjournals.org/content/32/3/439?