IDF21-0684 Comparing glucose response according to the OGTT and MMT in PCOS and non-PCOS groups: 2nd-hour-value sufficient or not?

Abstract

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive aged women, that is a leading risk factor for insulin resistance syndrome and type 2 diabetes. Aim: İn this study, glucose tolerance was examined in PCOS and non-PCOS groups with 75 g of Glucose Tolerance Test (GTT) and Mixed Meal Tolerance Test (MMT) and the glucose levels change in the first two hours was evaluated comparatively. Method: MMT was applied to 69 women out of 131 patients diagnosed with PCOS, and the remaining 62 women underwent GTT. MMT was applied to 21 of the women with diagnosed non-PCOS , and GTT was applied to 19 of them .Fasting glucose levels and the first 30, 60, 90, 120, 180, 240 minutes of postprandial glucose levels were measured in these 4 groups, then finding values were compared within these 4 groups. Results: WHO-ADA consensus determines glucose intolerance when the second-hour value of the GTT is between 140 and 199 mg/dl. According this criteria, the PCOS (+) GTT applied-group and MMT applied-group was found as 9% and 9.8% respectively. In the non-PCOS group, there was no glucose intolerance case according to the results of the MMT and GTT. If WHO-ADA consensus defineds glucose intolerance as postprandial glucose levels between 140 and 199 mg/dl in the first two hours, in the PCOS (+) group GTT applied-group and MMT applied-group, the highest glucose levels was found in the first 30 min and approximately half of the cases were determined as glucose intolerance. In the non-PCOS group according to the first 30 min of the GTT 10% of cases who have glucose levels between 140 and 199 mg/dl. There was no patient was found with glucose intolerance in the non-PCOS MMT applied-group. In the PCOS (+) GTT applied group, glucose intolerance rate according to the 60th minute was found as 26.2% while 90th minute was 24.6%. In the PCOS (+) MMT applied group, the rates of 60th minute and 90th minute were found as 19.4% and 14.9%. In the non-PCOS group according to criteria of WHO-ADA, the glucose levels were not found between 140 and 199 mg/dl in any cases in other hours. Discussion: When the second-hour values were taken as criteria, the rate of glucose intolerance was found as approximately 10%. However when we evaluate the values of the first 2 h (30th, 60th, 90th, 120th minutes) approximately 50% of the cases were determined as glucose intolerance with the glucose level between 140 and 199 mg/dl. Accordingly, WHO-ADA criteria overlook almost 40% of the PCOS (+) patients with glucose intolerance.