Relationship and factors responsible for regulating fasting and post‐challenge plasma glucose levels in the early stage development of type 2 diabetes mellitus

Abstract

Aims/IntroductionElevation of 2-h plasma glucose (2-h PG) levels keeps step with fasting plasma glucose (FPG) levels elevation, but some individuals show dominant elevation of 2-h PG and others FPG. We analyzed dependent and independent relationships between 2-h PG and FPG, and investigated the factors regulating 2-h PG and FPG.Materials and MethodsIn 1,657 Japanese participants who underwent a 75-g oral glucose tolerance test at the initial examination for a medical check-up, we carried out simple linear regression analysis between 2-h PG and FPG levels on the three patterns of independent variables. We divided the participants into two subgroups: the 2-h PG-side group and the FPG-side from the regression line, and examined the relationships between 2-h PG-FPG and factors responsible for elevation of plasma glucose levels.ResultsThere was a significant positive correlation between 2-h PG and FPG levels. The regression line of both 2-h PG and FPG as independent variables was in accordance with the regression line of 2-h PG as an independent variable and FPG as a dependent variable. In 2-h PG-side group, age was the independent factor affecting 2-h PG in addition to insulinogenic index and insulin sensitivity index (ISI composite). In the FPG-side group, triglyceride was the independent factor affecting FPG in addition to insulinogenic index and ISI composite.ConclusionsTwo-hour PG was an independent predictor of FPG. In addition to the importance of decreased insulin secretion and insulin sensitivity, age was the strong factor to elevate 2-h PG levels in the 2-h PG-side group and triglyceride was the strong factor to elevate FPG levels in the FPG-side group in the early stage of development of type 2 diabetes.

Insulin Secretory Defect and Insulin Resistance in Isolated Impaired Fasting Glucose and Isolated Impaired Glucose Tolerance

“…Fearch et al concluded that a progressive and age-dependent loss of insulin secretion was involved in the development of postchallenge hyperglycemia in relation to progression from NGT to isolated IGT by 5-year follow-up study [ 28 ]. There are additional studies that reported that the main factors responsible for elevation of 2 h PG levels were decreased early-phase insulin secretion linked to aging [ 8 , 29 – 31 ]. IGT subjects showed a larger decrease in insulin secretion compared with NGT subjects and early-phase was decreasing more than second-phase of insulin secretion [ 29 ].…”

Association between Triglyceride to HDL-C Ratio (TG/HDL-C) and Insulin Resistance in Chinese Patients with Newly Diagnosed Type 2 Diabetes Mellitus

“…Homeostatic model assessment of β-cell function (HOMA-β) was from this equation: 20 ×INS 0 (IU/L)/(G 0 (mmol/L)-3.5) [ 6 ]. Insulin sensitivity was evaluated by insulin sensitivity index (ISI) composite: 10,000/([G 0 × INS 0 ] × [mean G 0-120 × mean INS 0-120 ] (mean G 0-120 refers to the average plasma glucose level for the first 120 minutes calculated by the average value of G 0 , G 30 , G 60 and G 120 ) [ 28 ]. Early insulin secretion was calculated based on the formula for insulinogenic index (IGI, ΔINS 30 /ΔG 30 ): (INS 30 -INS 0 ) (IU/L)/(G 30 -G 0 ) (mmol/L) [ 29 ].…”