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November 8, 1995

Insulin Resistance and Non—insulin-dependent Diabetes-Reply

Author Affiliations

University of Rochester Rochester, NY

JAMA. 1995;274(18):1426. doi:10.1001/jama.1995.03530180020017

In Reply.  —Dr de Neeling's first concern was that we might have matched for the insulin-resistant genotype when we matched our subjects for obesity. To the extent that obesity is genetic, this may be true. If that were the case, obesity would be the genetic cause of insulin resistance, and there would be no intrinsic insulin-resistance gene as is commonly thought. The latter is the point of the article.The second concern was that by including subjects older than 50 years we had selected people who, having normal glucose tolerance at that age, may have lacked an insulin-resistance gene. First of all, of the 50 individuals studied, only 13 were older than 50 years. Second, the median age of our subjects was 41 years; the median age of diagnosis of NIDDM in the large United Kingdom prospective Diabetes Study Group was 52 years.1 Third and most importantly, even if

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