Excess glycaemic excursions after an oral glucose tolerance test compared with a mixed meal challenge and self‐measured home glucose profiles: is the OGTT a valid predictor of postprandial hyperglycaemia and vice versa?

Meier, Juris J.; Baller, Birgit; Menge, Bjoern A.; Gallwitz, Baptist; Schmidt, Wolfgang E.; Nauck, Michael A.

doi:10.1111/j.1463-1326.2008.00922.x

Cited by 49 publications

(51 citation statements)

References 36 publications

(46 reference statements)

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“…Thirdly, it is uncertain whether the inverse relationship of lean mass and plasma glucose levels could be demonstrated with mixed meal challenge. Although plasma glucose excursion after oral glucose load and after mixed meal have been shown to be closely correlated in non-diabetic and diabetic subjects, the peak levels of plasma glucose and plasma insulin are lower by the latter test [29,30]. Fourthly, the findings of this study may not be applied to advanced type 2 diabetic subjects who have The presence of muscle insulin resistance together with the insufficient insulin secretion can cause postprandial hyperglycemia in glucose intolerance subjects.…”

Section: Discussionmentioning

confidence: 61%

Lean mass inversely predicts plasma glucose levels after oral glucose load independent of insulin secretion or insulin sensitivity in glucose intolerance subjects

et al. 2014

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The epidemiologic sTudies in several populations indicate that 2 hours plasma glucose levels after an oral glucose tolerance test (OGTT) and prevalence of impaired glucose tolerance were higher in non-diabetic women than non-diabetic men [1][2][3]. Our previous study in lean, non-diabetic Thai subjects also supported those findings [4]. The mechanism by which the 2 hours plasma glucose levels after OGTT are higher in women is unclear. Lower height and/or lesser fat-free Lean mass inversely predicts plasma glucose levels after oral glucose load independent of insulin secretion or insulin sensitivity in glucose intolerance subjects Abstract. Muscle mass inversely relates to 2 hours glucose levels after oral glucose load in non-diabetic subjects. A study in glucose intolerance subjects has never been performed. We conducted this study to determine the relationship between muscle mass and glucose level after oral glucose load in glucose intolerance subjects. Sixty Thai subjects, 44 drug-naïve, newly diagnosed type 2 diabetes mellitus and 16 impaired glucose tolerance were studied. The 180 min 75 g oral glucose tolerance test was performed. Total body fat and lean mass were measured by dual-energy x-ray absorptiometry. Insulin sensitivity was determined by insulin sensitivity index using model of Matsuda & DeFronzo. The 1st-phase and total insulin secretion were determined from glucose tolerance data. Pearson correlation and linear regression were used for the analysis. Lean mass was inversely correlated with area-under-curves of glucose 0-180 min (r =-0.320; p=0.013). The relationship was significant after adjustment with age and body-mass-index (r =-0.350; p=0.007). Area-under-curves of glucose 0-180 min was correlated with height (r =-0.282; p=0.029), fasting glucose (r =0.742; p<0.0001), log area-undercurves of insulin 0-180 min (r =-0.258; p=0.047) and log 1st-phase insulin secretion (r =-0.518; p<0.0001). By multivariate analysis, fasting glucose (standardized β=4.54; p<0.001), log 1st-phase insulin secretion (standardized β=-43.09; p=0.005) and lean mass (standardized β=-0.003; p=0.011) were the significant parameters predicting area-under-curves of glucose 0-180 min. In conclusion, lean mass inversely predicted glucose levels after oral glucose load independent of insulin secretion and insulin sensitivity in glucose intolerance subjects.

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Section: Discussionmentioning

confidence: 61%

Lean mass inversely predicts plasma glucose levels after oral glucose load independent of insulin secretion or insulin sensitivity in glucose intolerance subjects

et al. 2014

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“…In contrast, the integrated insulin response above fasting was 44% greater (p < 0.001) in the IFG group compared with the NFG group. and colleagues, 11 it seems reasonable to question the notion that dramatic increases in postprandial hyperglycaemia, per se, account for the increased CVD risk in prediabetes.…”

Section: Discussionmentioning

confidence: 99%

Plasma glucose and insulin responses to mixed meals: Impaired fasting glucose re-visited

Bhat

Blasey

et al. 2011

Diabetes and Vascular Disease Research

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The experimental population consisted of 182 women and 107 men who had responded to newspaper advertisements describing our studies of glucose and insulin metabolism. Volunteers had a normal medical history, physical examination, and laboratory values. Stanford University's Human Subjects committee approved the study protocols, and Plasma glucose and insulin responses to mixed meals: Impaired fasting glucose re-visited SL Bhat, F Abbasi, C Blasey, GM Reaven and SH Kim Abstract Background: In individuals with varying glucose tolerance, glucose and insulin comparisons are usually made based on response to oral glucose challenge. However, an oral glucose tolerance test may not reflect daylong glucose and insulin excursions in response to meals. To better understand individuals with impaired fasting glucose (IFG), we compared insulin action as well as plasma glucose and insulin responses to mixed meals in individuals with normal fasting glucose (NFG; n = 141) and IFG (n = 148) concentrations. Methods: Insulin action was quantified by determining steady-state plasma glucose (SSPG) concentrations during the insulin suppression test. Plasma glucose and insulin concentrations were measured before and hourly after two mixed meals. Results: SSPG concentrations were significantly higher in the IFG group (11.8 ± 3.6 vs. 9.1 ± 3.8 mmol/l). Mean hourly daylong glucose (6.4 ± 0.07 vs. 5.5 ± 0.04 mmol/l) and insulin (390 ± 20 vs. 279 ± 15 pmol/l) concentrations were also higher in those with IFG (p < 0.001). Daylong incremental meal-stimulated glucose response, however, was comparable (p = 0.77) in the two groups, whereas the incremental insulin response was 44% higher in the IFG group. Conclusion: Although individuals are currently defined as having IFG based on fasting plasma glucose concentration, our data show that these individuals with IFG also are insulin resistant and have higher daylong insulin concentrations.

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“…Previously, the OGTT was regarded as the diagnostic gold standard with high sensitivity [16]; however more recent evidence indicates that many patients experience large glycaemic excursions at 30, 60 and 90 minutes after oral glucose, which may be clinically significant, but have normal blood glucose levels at baseline and 2 hours [17]. While there is a relationship between the 2 hour OGTT blood glucose value and glycaemic excursions following a mixed meal in healthy subjects, and those with impaired glucose tolerance or overt diabetes [18], the absolute blood glucose concentrations vary substantially between the two tests. The OGTT tends to elicit greater glycaemic excursions, while a mixed meal more accurately represents the glycaemic variations occurring in everyday life.…”

Section: Cfrd Diagnosismentioning

confidence: 99%

Cystic fibrosis related diabetes—a new perspective on the optimal management of postprandial glycemia

Perano

Rayner

Couper

et al. 2014

Journal of Diabetes and its Complications

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In all cases accepted manuscripts should: link to the formal publication via its DOI  bear a CC-BY-NC-ND license -this is easy to do, click here to find out how  if aggregated with other manuscripts, for example in a repository or other site, be shared in alignment with our hosting policy  not be added to or enhanced in any way to appear more like, or to substitute for, the published journal article

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Excess glycaemic excursions after an oral glucose tolerance test compared with a mixed meal challenge and self‐measured home glucose profiles: is the OGTT a valid predictor of postprandial hyperglycaemia and vice versa?

Cited by 49 publications

References 36 publications

Lean mass inversely predicts plasma glucose levels after oral glucose load independent of insulin secretion or insulin sensitivity in glucose intolerance subjects

Lean mass inversely predicts plasma glucose levels after oral glucose load independent of insulin secretion or insulin sensitivity in glucose intolerance subjects

Plasma glucose and insulin responses to mixed meals: Impaired fasting glucose re-visited

Cystic fibrosis related diabetes—a new perspective on the optimal management of postprandial glycemia

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