Shape Of Glucose Curve Research Articles

NME7 gene is associated with the shape of glucose curves during oral glucose tolerance test

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Abstract P116: The Oral Glucose Tolerance Test is Highly Reproducible for the Diagnosis of Diabetes in Africans: The Africans in America Study

Introduction: As the diabetes epidemic spreads across Africa, the oral glucose tolerance test (OGTT) has the potential to provide important information on glucose tolerance category for the individual and across the population. However, for both patient care and the collection of prevalence statistics, there needs to be a high degree of certainty that the diagnosis made by a single OGTT is reproducible. There are no rigorous studies on the reproducibility of the OGTT in Africans. Objective: By performing two OGTT in African-born blacks living in the Washington DC area, our goal was to evaluate the reproducibility of: a) the glucose tolerance category b) time to glucose peak, c) shape of glucose curve, d) glucose concentration at 60 minutes. Methods: The participants were 90 African-born blacks (66% male (59/90), age 40±11y (mean±SD), BMI 27.6±4.6 kg/m 2 ), who self-identified as healthy and were enrolled in the Africans in America cohort. Two OGTT were performed 10±8 days apart. At each OGTT plasma samples were taken at -15, 0, 30, 60, 90 and 120 minutes. Diabetes (DM), prediabetes (pre-DM) and normal glucose tolerance (NGT)was defined by ADA guidelines for glucose. The shape of the glucose curve was characterized as monophasic, biphasic or indeterminate. During the OGTT, glucose at 60 minutes ≥ 155 mg/dL was defined as elevated. The κ-statistic was used to evaluate reproducibility (slight 0.00 to 0.20, fair 0.21 to 0.40; substantial 0.61 to 0.80, excellent 0.81 to 1.0). Results: At OGTT-1, DM, pre-DM and NGT occurred in 26% (23/90), 27% (24/90) and 48% (43/90), resp. At OGTT-2, DM, pre-DM and NGT occurred in 21% (19/90), 28% (25/90) and 51% (46/90) resp. Reproducibility for the diagnosis of glucose tolerance status (NGT, pre-DM, or DM) was just substantial (κ=0.66). However, reproducibility for the diagnosis of diabetes (DM or no DM) was excellent (κ=0.88). Furthermore, no one without DM at OGTT-1 was identified as having DM at OGTT-2. The reproducibility of time to glucose peak was only fair (κ=0.32), but 100% of participants with DM had peak glucose after 30 min. Similarly, the shape of the glucose curve had fair reproducibility (κ=0.21), but no one with DM had a biphasic curve. For elevated 60 min glucose, reproducibility was substantial (κ=0.62) and 96% (22/23) of the participants with DM had elevated glucose at 60 min. Conclusion: When duplicate OGTT were performed in Africans, the diagnosis of DM and the morphology of the glucose curves were highly reproducible.

Is there a correlation between blood glucose curve and the insulin resistance during oral glucose tolerance test in females suffering from polycystic ovary syndrome?

Background/Aim. Insulin resistance occurs in approximately 60?80% of women with polycystic ovary syndrome (PCOS) and in 95% of obese women with PCOS. Previous studies have shown that the shape of the glucose curve obtained during an oral glucose tolerance test (OGTT) may be useful as a metabolic screening parameter and could give in-sight into the future risk of diabetes mellitus type II. The aim of this study was to determine the frequency of insulin resistance according to the Homeostasis model assessment of insulin resistance (HOMA-IR) and indirect assessment method of insulin resistance based on insulinemias during the oral glucose tolerance test (OGTT) (here in after ?insulinemias during the OGTT?), as well as, frequency of glucose curve shapes (monophasic, biphasic, triphasic) in patients with PCOS. Also, the aim of research was testing the correlation between glucose curve shape and peak time of glucose during the OGTT with presence of insulin resistance in patients with PCOS. Methods. Patients were observed according to the following parameters: presence of insulin resistance, glucose curve shape and peak time of glucose and insulin during the OGTT. Results. The observed prevalence of insulin resistance in the PCOS group according to the HOMA-IR > 2.5 was 66.19% and according to insulinemias during the OGTT was 78.42%. The shape of the glucose curve was monophasic in 293 (70.26%), biphasic in 56 (13.43%) and triphasic in 68 (16.31%) of patients. There was statistically significant difference in the frequency of insulin resistance, according to glucose curve shape, only when it was defined by insulinemias during the OGTT (p = 0.005). Conclusion. According to results of the study, the most patients with PCOS have a monophasic shape of glucose curve. When we take frequency of insulin resistance in account, we notice approximately the same frequency in all types of curves, when it is defined by the HOMA-IR. On the other hand, when insulin resistance is defined by insulinemias during the OGTT, resistant patients with PCOS mostly have triphasic glucose curve shape.

Does the Shape of the OGTT Glucose Curve Reflect Metabolic Function in Individuals with Type 2 Diabetes? Baseline Data from the GRADE Cohort

In nondiabetic subjects a biphasic (rise, fall, rise) vs. monophasic (rise then fall) glucose pattern on OGTTs has been associated with better metabolic parameters, but data in T2DM are limited. We categorized the shape of the glucose curve from baseline OGTTs performed in the Glycemia Reduction Approaches in Diabetes Study (GRADE) into monophasic, biphasic or continuous rise and analyzed their relationship with metabolic parameters. GRADE eligibility included T2DM <10 y, HbA1c 6.8-8.5% with metformin treatment alone. OGTT glucose and insulin were measured at 0, 15, 30, 60, 90 and 120 minutes (n=5047 adults: age 57.2±10 y, 63.6% male, HbA1c 7.5±0.5%, duration T2DM 4.2±2.8 y). Most glucose profiles were monophasic. HbA1c did not differ between groups. Those with a monophasic shape were more likely to be men, had higher BMI, fasting glucose and incAUC glucose, and lower HOMA-S and disposition index (Table). Compared to the monophasic group, those with a continuous rise shape had lower fasting glucose and higher HOMA-S, but the highest 2 h glucose. Those with a biphasic pattern had intermediate insulin sensitivity, but the highest disposition index. Thus, a biphasic glucose pattern reflects better β-cell function, similar to that observed in nondiabetic subjects. Whether glucose patterns predict response to GRADE interventions will be determined on study completion.Table. Phenotypic and metabolic characteristics by OGTT glucose curve shapeMonophasicBiphasicContinuousP valueN (%)3212 (64.0)283 (5.6)1523 (30.4)Sex (%male)70.359.750.2<0.001Age (years)56.5±9.958.0±10.558.5±9.9<0.001BMI (kg/m2)35±732±633±7<0.001HbA1c (%)7.5±0.57.5±0.57.5±0.50.6Fasting glucose (mmol/L)8.5±1.78.4±1.68.3±1.7<0.0012 hour glucose (mmol/L)15.4±2.915.8±3.117.1±3.0<0.001incrementalAUC0-120 glucose (mmol/L)6.4±1.55.3±1.75.7±1.5<0.001HOMA-S (mU.mmol/L-2)0.22±0.230.25±0.210.28±0.41<0.001δInsulin/δGlucose0-30 (mU/mmol)5.3±4.46.5±5.65.1±6.10.002Disposition index (mmol/L-1)0.34±0.640.46±0.430.38±0.370.005Mean±SD. 23 had missing data and 6 were excluded with a triphasic pattern. Disposition index = δI/δG0-30 x HOMA-S. Disclosure K. Utzschneider: Consultant; Self; Novo Nordisk Inc. M. Banerji: Speaker's Bureau; Self; Merck & Co., Inc. J.I. Barzilay: Stock/Shareholder; Self; AbbVie Inc., AstraZeneca, Celgene Corporation, DuPont, Merck & Co., Inc., Teva Pharmaceutical Industries Ltd.. E.V. Gonzalez: None. F. Ismail-Beigi: None. K.J. Mather: Research Support; Self; Merck & Co., Inc., Sanofi-Aventis, Novo Nordisk A/S, Abbott. Advisory Panel; Self; Merck & Co., Inc. P. Raskin: Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Intarcia Therapeutics, Inc.. Consultant; Self; Intarcia Therapeutics, Inc., GlaxoSmithKline plc.. N. Younes: None. S.E. Kahn: Advisory Panel; Self; Boehringer Ingelheim GmbH, Elcelyx Therapeutics, Inc., Eli Lilly and Company, Intarcia Therapeutics, Inc., Janssen Research & Development, Merck & Co., Inc., Novo Nordisk A/S. G. Research Group: Research Support; Self; National Institute of Diabetes and Digestive and Kidney Diseases, National Heart, Lung, and Blood Institute. Other Relationship; Self; Bristol-Myers Squibb Company, Merck & Co., Inc., Novo Nordisk Inc., Sanofi-Aventis, Roche Diagnostics Corporation, Becton, Dickinson and Company, Centers for Disease Control and Prevention, National Diabetes Education Program.

Shape of glucose curve can be used as a predictor for screening prediabetes in obese children

We attempted to classify obese children with glucose abnormalities into different categories based on the plasma glucose (PG) at 0, 60, 120 and 180 min and extract the metabolic information from the shape of the PG curve. We recruited 1205 obese children and 325 nonobese children. Their body weight, blood pressure, waist and hip circumferences were measured. An oral glucose tolerance test (OGTT) was carried out, and glucose, insulin and glucagon levels were tested. There were six forms of abnormal glucose tolerance (AGT) curves in obese children in addition to normal glucose tolerance (NGT). 58.3% of obese children had AGT. BMI, waist circumference, waist-to-hip ratio and systolic blood pressure of each obese group were much higher than in nonobese children (p < 0.05). HOMA-IR increased significantly in obese children with high fasting PG and obese children with high fasting and 3-h PG (p < 0.05), and HOMA-β cell increased significantly in obese children with high 1- and 2-h but low 3-h PG (p < 0.05). Abnormal glucose tolerance was highly prevalent when concerning with glucose values at 60 and 180 min. The shape of PG which contains a net of metabolic information can be a predictor for screening prediabetes.

The shape of plasma glucose concentration curve during OGTT predicts future risk of type 2 diabetes

The aim of the study is to assess the relationship between the shape of plasma glucose concentration during the OGTT and future risk for T2DM. 2445 non-diabetic subjects from the Botnia study received an OGTT at baseline and after 7-8 years of follow-up. NGT and IFG subjects who returned their plasma glucose concentration following an ingested glucose load below FPG within 60 min had increased insulin sensitivity, greater insulin secretion and lower risk for future T2DM compared to NGT and IFG subjects whose post-load plasma glucose concentration required 120 min or longer to return their plasma glucose level to FPG level. IGT subjects who had a lower plasma glucose concentration at 1-h compared to 2-h during OGTT had greater insulin sensitivity, better beta cell function and lower risk for future T2DM. These data suggest that the shape of glucose curve can be utilized to assess future risk for T2DM.