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Determining pancreatic β-cell compensation for changing insulin sensitivity using an oral glucose tolerance test
- Source :
- American journal of physiology. Endocrinology and metabolism. 307(9)
- Publication Year :
- 2014
-
Abstract
- Plasma glucose, insulin, and C-peptide responses during an OGTT are informative for both research and clinical practice in type 2 diabetes. The aim of this study was to use such information to determine insulin sensitivity and insulin secretion so as to calculate an oral glucose disposition index (DIOGTT) that is a measure of pancreatic β-cell insulin secretory compensation for changing insulin sensitivity. We conducted an observational study of n = 187 subjects, representing the entire glucose tolerance continuum from normal glucose tolerance to type 2 diabetes. OGTT-derived insulin sensitivity (SI OGTT) was calculated using a novel multiple-regression model derived from insulin sensitivity measured by hyperinsulinemic euglycemic clamp as the independent variable. We also validated the novel SI OGTT in n = 40 subjects from an independent data set. Plasma C-peptide responses during OGTT were used to determine oral glucose-stimulated insulin secretion (GSISOGTT), and DIOGTT was calculated as the product of SI OGTT and GSISOGTT. Our novel SI OGTT showed high agreement with clamp-derived insulin sensitivity (typical error = +3.6%; r = 0.69, P < 0.0001) and that insulin sensitivity was lowest in subjects with impaired glucose tolerance and type 2 diabetes. GSISOGTT demonstrated a significant inverse relationship with SI OGTT. GSISOGTT was lowest in normal glucose-tolerant subjects and greatest in those with impaired glucose tolerance. DIOGTT was sequentially lower with advancing glucose intolerance. We hereby derive and validate a novel OGTT-derived measurement of insulin sensitivity across the entire glucose tolerance continuum and demonstrate that β-cell compensation for changing insulin sensitivity can be readily calculated from clinical variables collected during OGTT.
- Subjects :
- Blood Glucose
Male
medicine.medical_specialty
endocrine system diseases
Physiology
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Denmark
Type 2 diabetes
Impaired glucose tolerance
Cohort Studies
Diagnosis, Differential
Prediabetic State
Insulin resistance
Physiology (medical)
Internal medicine
Insulin-Secreting Cells
Glucose Intolerance
Insulin Secretion
medicine
Humans
Insulin
Ohio
Glycated Hemoglobin
Glucose tolerance test
medicine.diagnostic_test
business.industry
nutritional and metabolic diseases
Insulin sensitivity
Articles
Glucose clamp technique
Glucose Tolerance Test
Middle Aged
medicine.disease
Obesity
Endocrinology
Diabetes Mellitus, Type 2
Allostasis
Disease Progression
Glucose Clamp Technique
Female
Insulin Resistance
business
hormones, hormone substitutes, and hormone antagonists
Subjects
Details
- ISSN :
- 15221555
- Volume :
- 307
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- American journal of physiology. Endocrinology and metabolism
- Accession number :
- edsair.doi.dedup.....5207ee629e64bc5fc8df9f2c4b80edbc