Blood Glucose Area Under the Curve: Methodological Aspects

Abstract

To specify the influence of methods used in estimating area under the curve (AUC) and the meaning of total and incremental AUC, 75 glycemic responses to a mixed meal were studied in 75 diabetic patients, 39 with insulin-dependent diabetes mellitus and 36 with non-insulin-dependent diabetes mellitus. AUC was integrated with five computerized methods: polynomial interpolation of third and fourth degree, trapezoidal rule, Simpson's integration, and cubic interpolatory splines. Although these methods gave significantly different results (P less than 0.001), a strong correlation was found between estimations of AUC with different methods (r greater than 0.99, P less than 0.001). In addition, variation between methods was less than or equal to 2%, whereas the coefficient of variation between subjects was 38%. Total AUC was strongly correlated with basal blood glucose value (r = 0.90, P less than 0.001), whereas incremental and positive AUC were not (r = 0.12 and 0.07, respectively, NS). Incremental and positive AUC were strongly correlated with glycemic rise (r = 0.89 and 0.93, respectively, P less than 0.001), whereas total AUC was only slightly so (r = 0.31, P less than 0.01). Incremental and positive AUC gave slightly but significantly different information on glucose response. These results suggest that variations related to the method used in estimating AUC are not clinically relevant and that a simple method such as trapezoidal rule can be used. Total AUC is a descriptive factor related to basal blood glucose value, whereas incremental and positive AUC more accurately describe glycemic response to foods.

Effect of the amino acid alanine on glucagon secretion in non-diabetic and type 1 diabetic subjects during hyperinsulinaemic euglycaemia, hypoglycaemia and post-hypoglycaemic hyperglycaemia

“…Post hoc comparisons (Tukey's test) were performed to pinpoint specific differences in significant interaction means. The AUC and the incremental AUC (iAUC) was calculated for hormones and substrates at the clamped initial euglycaemia (0-30 min), hypoglycaemia (90-130 min), post-hypoglycaemic euglycaemia (150-190 min) and hyperglycaemia (210-250 min) according to the trapezoidal rule (with subtraction of the basal values for iAUC) [19] and analysed by paired or unpaired Student's t-test as appropriate. Data in the text are given as mean±SE and were considered to be significantly different at p<0.05.…”

Impact of insulins glulisine and aspart on postprandial glycemia after a high-glycemic index meal in children with type 1 diabetes

“…Both of these metabolic alterations contribute to the complications of diabetes. Therefore, fluctuations in blood glucose levels should be taken into consideration while assessing the risk of late complications of diabetes (14,24). In the present study, we observed postprandial glucose fluctuations in both groups, using GLU and ASP, although without any statistical difference in variation in glucose levels.…”

Nonfat milk attenuates acute hyperglycemia in individuals with android obesity: A randomized control trial

“…A commercially available radioimmunoassay kit was used to assess glucagon (EMD Millipore, Darmstadt, Germany) (Clevenger, Parker Jones, Tanaka, Seals, & DeSouza, 2002). The net incremental area under the curve (iAUC) for plasma glucose and insulin was calculated using the trapezoidal method (Clevenger et al., 2002) as it was shown to be more strongly correlated with glycemic rise than total AUC (Le Floch, Escuyer, Baudin, Baudon, & Perlemuter, 1990). …”