Relationship between Insulin Secretion and Arterial Stiffness in Essential Hypertension

The study aims to explore the relationship between plasma insulin secretion and arterial stiffness in nondiabetic essential hypertensive patients. A total of 730 nondiabetic essential hypertensive patients registered between January 2016 and October 2020 were enrolled. A two-hour oral glucose tolerance test (OGTT) was performed to detect the levels of C-peptide and blood glucose at 0 hours and 2 hours, as well as the difference between C-peptide (Δ C-peptide) and blood glucose (Δ blood glucose) over the same period. Patients were divided into two groups: the normal glucose tolerance (NGT) group (n = 322) and the impaired glucose tolerance (IGT) group (n = 408). A multiple linear regression analysis was used to evaluate the association between brachial-ankle pulse wave velocity (baPWV) and the other factors. 0 h C-peptide, 2 h C-peptide, and Δ C-peptide were found to be higher in the IGT group. baPWV was positively linear correlated with 2 h C-peptide (r = 0.086, p = 0.020 ) and Δ C-peptide (r = 0.115, p = 0.002 ). baPWV remained independently associated with 0 h C-peptide, 2 h C-peptide, and Δ C-peptide, after adjusting by age, gender, smoking, body mass index (BMI), high-density lipoprotein (HDL), cholesterol, systolic blood pressure (SBP), and triglycerides (TG). Our data shows that higher endogenous insulin secretion might play an important role in the progression of arterial stiffness in nondiabetic essential hypertensive patients.

Download Full-text

Hypoglycemia and Islet Dysfunction Following Oral Glucose Tolerance Testing in Pancreatic-Insufficient Cystic Fibrosis

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa448 ◽

2020 ◽

Vol 105 (10) ◽

pp. 3179-3189

Author(s):

Marissa J Kilberg ◽

Clea Harris ◽

Saba Sheikh ◽

Darko Stefanovski ◽

Marina Cuchel ◽

...

Keyword(s):

Cystic Fibrosis ◽

Insulin Secretion ◽

Glucose Tolerance ◽

Early Phase ◽

Oral Glucose ◽

Oral Glucose Tolerance ◽

Insulin Effect ◽

Secretory Rate ◽

C Peptide ◽

Islet Dysfunction

Abstract Context Oral glucose tolerance test (OGTT)-related hypoglycemia is common in pancreatic-insufficient cystic fibrosis (PI-CF), but its mechanistic underpinnings are yet to be established. Objective To delineate the mechanism(s) underlying OGTT-related hypoglycemia. Design and Setting We performed 180-minute OGTTs with frequent blood sampling in adolescents and young adults with PI-CF and compared results with those from a historical healthy control group. Hypoglycemia (Hypo[+]) was defined as plasma glucose <65 mg/dL. We hypothesized that CF-Hypo[+] would demonstrate impaired early phase insulin secretion and persistent late insulin effect compared with control-Hypo[+], and explored the contextual counterregulatory response. Main Outcome Measure OGTT 1-hour and nadir glucose, insulin, C-peptide, and insulin secretory rate (ISR) incremental areas under the curve (AUC) between 0 and 30 minutes (early) and between 120 and 180 minutes (late), and Δglucagon120-180min and Δfree fatty acids (FFAs)120-180min were compared between individuals with CF and control participants with Hypo[+]. Results Hypoglycemia occurred in 15/23 (65%) patients with CF (43% female, aged 24.8 [14.6-30.6] years) and 8/15 (55%) control participants (33% female, aged 26 [21-38] years). The CF-Hypo[+] group versus the control-Hypo[+] group had higher 1-hour glucose (197 ± 49 vs 139 ± 53 mg/dL; P = 0.05) and lower nadir glucose levels (48 ± 7 vs 59 ± 4 mg/dL; P < 0.01), while insulin, C-peptide, and ISR-AUC0-30 min results were lower and insulin and C-peptide, and AUC120-180min results were higher (P < 0.05). Individuals with CF-Hypo[+] had lower Δglucagon120-180min and ΔFFA120-180min compared with the control-Hypo[+] group (P < 0.01). Conclusions OGTT-related hypoglycemia in PI-CF is associated with elevated 1-hour glucose, impaired early phase insulin secretion, higher late insulin exposure, and less increase in glucagon and FFAs. These data suggest that hypoglycemia in CF is a manifestation of islet dysfunction including an impaired counterregulatory response.

Download Full-text

The relationship between fasting hyperglycemia and insulin secretion in subjects with normal or impaired glucose tolerance

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00674.2007 ◽

2008 ◽

Vol 295 (2) ◽

pp. E401-E406 ◽

Cited By ~ 43

Author(s):

Muhammad A. Abdul-Ghani ◽

Masafumi Matsuda ◽

Rucha Jani ◽

Christopher P. Jenkinson ◽

Dawn K. Coletta ◽

...

Keyword(s):

Insulin Secretion ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Plasma Glucose ◽

Early Phase ◽

Mexican Americans ◽

Late Phase ◽

Oral Glucose ◽

C Peptide ◽

The Relationship

To assess the relationship between the fasting plasma glucose (FPG) concentration and insulin secretion in normal glucose tolerance (NGT) and impaired glucose tolerance (IGT) subjects, 531 nondiabetic subjects with NGT ( n = 293) and IGT ( n = 238; 310 Japanese and 232 Mexican Americans) received an oral glucose tolerance test (OGTT) with measurement of plasma glucose, insulin, and C-peptide every 30 min. The insulin secretion rate was determined by plasma C-peptide deconvolution. Insulin sensitivity (Matsuda index) was measured from plasma insulin and glucose concentrations. The insulin secretion/insulin resistance (IS/IR) or disposition index was calculated as ΔISR/ΔG ÷ IR. As FPG increased in NGT subjects, the IS/IR index declined exponentially over the range of FPG from 70 to 125 mg/dl. The relationship between the IS/IR index and FPG was best fit with the equation: 28.8 exp(−0.036 FPG). For every 28 mg/dl increase in FPG, the IS/IR index declined by 63%. A similar relationship between IS/IR index and FPG was observed in IGT. However, the decay constant was lower than in NGT. The IS/IR index for early-phase insulin secretion (0–30 min) was correlated with the increase in FPG in both NGT and IGT ( r = −0.43, P < 0.0001 and r = −0.20, P = 0.001, respectively). However, the correlation between late-phase insulin secretion (60–120 min) and FPG was not significant. In conclusion, small increments in FPG, within the “normal” range, are associated with a marked decline in glucose-stimulated insulin secretion and the decrease in insulin secretion with increasing FPG is greater in subjects with NGT than IGT and primarily is due to a decline in early-phase insulin secretion.

Download Full-text

GLUCOSE TOLERANCE AND IMMUNOREACTIVE INSULIN IN PATIENTS WITH PHEOCHROMOCYTOMA: THE EFFECT OF α-RECEPTOR BLOCKING AGENTS

Acta Endocrinologica ◽

10.1530/acta.0.0660368 ◽

1971 ◽

Vol 66 (2) ◽

pp. 368-378 ◽

Cited By ~ 11

Author(s):

Ruth Illig ◽

W. H. Ziegler

Keyword(s):

Insulin Secretion ◽

Blood Glucose ◽

Glucose Tolerance ◽

Metastatic Tumour ◽

Oral Glucose ◽

Surgical Removal ◽

Receptor Blockade ◽

Receptor Blocking ◽

Control Subjects ◽

And Control

ABSTRACT Blood glucose, plasma insulin, free fatty acids and urinary noradrenaline were investigated in 5 patients with noradrenaline producing pheochromocytoma (4 adenomas, 1 metastatic tumour) and in 3 control subjects. Oral glucose tolerance tests were performed before therapy, during treatment with the α-receptor blocking agent phenoxybenzamine, and in 4 patients after surgical removal of the tumour. In the untreated pheochromocytoma patients, glucose curves were pathologically high; insulin secretion was low in relation to blood glucose levels or almost completely suppressed depending on the plasma noradrenaline concentrations. During phenoxybenzamine treatment glucose curves remained abnormal; insulin concentrations increased both in patients and control subjects. Six to 26 days after operation, glucose curves and insulin secretion became normal. Fractionated urine collections revealed a fall in noradrenaline excretion after oral glucose load. The urinary excretion of noradrenaline increased when α-receptor blockade was effective. The increased release of insulin under α-receptor blockade in patients and control subjects suggests that noradrenaline plays a role in the regulation of insulin secretion in normal conditions as well as in patients with pheochromocytoma.

Download Full-text

Effect modification by ferritin on the relationship between inflammation and arterial stiffness in hypertensive patients with different glucose tolerance

10.21203/rs.3.rs-23328/v1 ◽

2020 ◽

Author(s):

Angela Sciacqua ◽

Ettore Ventura ◽

Giovanni Tripepi ◽

Velia Cassano ◽

Graziella D'Arrigo ◽

...

Keyword(s):

Arterial Stiffness ◽

Glucose Tolerance ◽

Iron Homeostasis ◽

High Sensitivity ◽

Oral Glucose ◽

Effect Modifier ◽

Hypertensive Patients ◽

Matsuda Index ◽

Hs Crp ◽

The Relationship

Abstract Backgroud: Ferritin, a crucial element for iron homeostasis, is associated with chronic diseases characterized by subclinical inflammation such as essential arterial hypertension and type 2 diabetes mellitus (T2DM), showing a prognostic value in different clinical settings. We investigated whether ferritin is associated with arterial stiffness (AS), an early indicator of atherosclerosis, and if it could act as effect modifier on the relationship between inflammation and AS in hypertensive patients with different glucose tolerance.Methods: We enrolled 462 newly diagnosed untreated hypertensive (HT) patients. All subjects underwent an oral glucose tolerance test. Insulin sensitivity was assessed by MATSUDA index and ferritin levels were estimated by immunoradiometric assay. AS was definied by carotid-femoral pulse wave velocity (PWV).Results: Out of 462 patients, 271 showed normal glucose tolerance (HT/NGT), 146 impaired glucose tolerance (HT/IGT) and 45 were diabetic (HT/T2DM). Iron levels significantly decreased and transferrin and ferritin significantly increased from the first to the third group. PWV values were significantly higher in HT/IGT and HT/T2DM patients. PWV was related directly with ferritin, high sensitivity C reactive protein (hs-CRP), transferrin, and inversely with MATSUDA index. Ferritin resulted the strongest determinant of PWV explaining a 14.9% of its variation; moreover it was a strong modifier of the relationship between hs-CRP and PWV. The estimated augmentation in PWV portended by a fixed increase in hs-CRP, was higher across increasing values of ferritin.Conclusion: Ferritin represents an independent predictor of AS in our study population and a strong effect modifier on the relationship between inflammation and PWV.

Download Full-text

AMPK subunits harbor largely non-overlapping genetic determinants for body fat mass, glucose- and cholesterol metabolism

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem/dgz020 ◽

2019 ◽

Cited By ~ 1

Author(s):

Elko Randrianarisoa ◽

Angela Lehn-Stefan ◽

Johannes Krier ◽

Anja Böhm ◽

Martin Heni ◽

...

Keyword(s):

Insulin Secretion ◽

Blood Glucose ◽

Insulin Sensitivity ◽

Body Fat ◽

Ldl Cholesterol ◽

Cholesterol Metabolism ◽

Hdl Cholesterol ◽

Oral Glucose ◽

Genetic Determinants ◽

The Impact

Abstract Context AMP-activated protein kinase (AMPK) is a heterotrimeric enzyme and central regulator of cellular energy metabolism. The impact of single nucleotide polymorphisms (SNPs) in all seven subunit genes on adiposity, glucose- and lipid metabolism has not been systematically studied yet. Objective To analyze the associations of common SNPs in all AMPK genes, and of different scores thereof, with adiposity, insulin sensitivity, insulin secretion, blood glucose, total-, LDL- and HDL-cholesterol and triglycerides. Study Design and Methods A cohort of 2789 non-diabetic subjects from the Tübingen Family study of type-2 diabetes, metabolically characterized by oral glucose tolerance test and genotyped by genome-wide SNP array was analyzed. Results We identified largely non-overlapping SNP sets across four AMPK genes (PRKAA1, PRKAA2, PRKAG2, PRKAG3) associated with adiposity, insulin sensitivity, insulin secretion, blood glucose, total-/LDL-cholesterol or HDL-cholesterol, respectively. A genetic score of body-fat-increasing alleles revealed per-allele effect sizes on BMI of +0.22 kg/m² (p=2.3·10-7), insulin sensitivity of -0.12·1019 L²/mol² (p=9.9·10-6) and 2-h blood glucose of +0.02 mmol/L (p=0.0048). Similar effects on blood glucose were observed with scores of insulin-sensitivity-reducing, insulin-secretion-reducing and glucose-raising alleles, respectively. A genetic cholesterol score increased total- and LDL-cholesterol by 1.17 mg/dL per allele (p=0.0002 and p=3.2·10-5, respectively), and a genetic HDL score decreased HDL-cholesterol by 0.32 mg/dL per allele (p=9.1·10-6). Conclusions We describe largely non-overlapping genetic determinants in AMPK genes for diabetes-/atherosclerosis-related traits which reflect the metabolic pathways controlled by the enzyme. Formation of trait-specific genetic scores revealed additivity of allele effects, with body-fat-raising alleles reaching a marked effect size.

Download Full-text

Spontaneous hypoglycemia in patients with cystic fibrosis

Acta Endocrinologica ◽

10.1530/eje.1.02344 ◽

2007 ◽

Vol 156 (3) ◽

pp. 369-376 ◽

Cited By ~ 33

Author(s):

A Battezzati ◽

P M Battezzati ◽

D Costantini ◽

M Seia ◽

L Zazzeron ◽

...

Keyword(s):

Cystic Fibrosis ◽

Insulin Secretion ◽

Glucose Tolerance ◽

Clinical Status ◽

Class I ◽

Oral Glucose ◽

Anthropometric Parameters ◽

C Peptide ◽

Mutation Carriers ◽

Reactive Hypoglycemia

Objective: Diabetes frequently complicates cystic fibrosis (CF) without fasting hyperglycemia or despite spontaneous hypoglycemia (anecdotally ascribed to malnutrition), whose prevalence, clinical meaning, and relationship with glucose tolerance and clinical/nutritional status were not previously investigated. The relationship of CF genotype with insulin secretion control is also unclear. Design and methods: A total of 129 CF patients without stable diabetes received 188 oral glucose tolerance tests. Distribution of fasting plasma glucose (FPG), glucose, insulin and C-peptide responses, clinical/nutritional variables, and their relationships were analyzed. Results: FPG < 60 mg/dl (3.3 mmo/l) was detected in 14% of studies and reactive hypoglycemia (PG < 50 mg/dl (2.8 mmo/l)) in 15%. OGTT-based diabetes frequency was similar in the lowest quartile (Q1) and Q2–3 for FPG (10 and 8%), with higher glucose increment and area under the curve in Q1. Insulin and C-peptide levels were similar among FPG quartiles. Class I cystic fibrosis transmembrane conductance regulator mutation carriers had higher insulin concentrations than class II, especially in Q1 for FPG. Age, sex, nutritional, and anthropometric parameters including fat and lean body mass were unrelated to FPG. Lower FPG was associated with more frequent hospitalization rates (P = 0.002) and lower Shwachman scores (P = 0.041). Steroids weaning was accurately evaluated but then excluded as a possible cause of hypoglycemia. Conclusions/interpretation: Fasting asymptomatic hypoglycemia is frequent and possibly related to inappropriate insulin secretion control in class I mutation carriers. Low FPG does not exclude impaired glucose tolerance (IGT) and diabetes in CF and reflects worse clinical status.

Download Full-text

Patterns of Insulin Secretion During First-Phase Insulin Secretion in Normal Chinese Adults

Frontiers in Endocrinology ◽

10.3389/fendo.2021.738427 ◽

2021 ◽

Vol 12 ◽

Author(s):

Tao Yuan ◽

Shuoning Song ◽

Tianyi Zhao ◽

Yanbei Duo ◽

Shihan Wang ◽

...

Keyword(s):

Insulin Secretion ◽

Glucose Tolerance ◽

Linear Trend ◽

Insulin Response ◽

Density Lipoprotein ◽

Intravenous Glucose Tolerance Test ◽

Intravenous Glucose ◽

C Peptide ◽

Significant Difference ◽

First Phase Insulin Secretion

BackgroundThe increase in diabetes worldwide is alarming. Decreased acute insulin response to intravenous glucose tolerance test (IVGTT) during first-phase insulin secretion (FPIS) is a characteristic of diabetes. However, knowledge of the insulin secretion characteristics identified by different time to glucose peak in subjects with different metabolic state is sparse.AimsThis study aimed to find different patterns of FPIS in subjects with normal glucose tolerance (NGT) and analyzed the relationship between insulin secretion patterns and the risk for development of type 2 diabetes mellitus (T2DM).MethodsA total of 126 subjects were divided into three groups during a 10-min IVGTT, including NGT with time to glucose peak after 3 min (G1, n = 21), NGT with time to glucose peak at 3 min (G2, n = 95), and prediabetes or diabetes with time to glucose peak at 3 min (G3, n = 10). Glucose, insulin, and C-peptide concentrations at 0, 3, 5, 7, and 10 min during the IVGTT were tested. IVGTT-based indices were calculated to evaluate the insulin secretion and insulin sensitivity.ResultsAge, body mass index (BMI), waist-to-hip ratio, triglyceride (TG), and hemoglobin A1c (HbA1c) of subjects were gradually higher, while high-density lipoprotein cholesterol (HDL-C) was gradually lower from G1 to G3 (p for linear trend <0.05), and the differences between G1 and G2 were also statistically significant (p < 0.05). Glucose peak of most participants in G1 converged at 5 min, and the curves shape of insulin and C-peptide in G2 were the sharpest among three groups. There was no significant difference in all IVGTT-based indices between G1 and G2, but AUCIns, AUCIns/AUCGlu, and △Ins3/△Glu3 in G2 were the highest, and the p-value for linear trend of those indices among three groups were statistically significant (p < 0.05).ConclusionsTwo patterns of FPIS were in subjects with NGT, while subjects with later time to glucose peak during FPIS might be less likely to develop T2DM in the future.

Download Full-text

Caffeine ingestion elevates plasma insulin response in humans during an oral glucose tolerance test

Canadian Journal of Physiology and Pharmacology ◽

10.1139/y01-026 ◽

2001 ◽

Vol 79 (7) ◽

pp. 559-565 ◽

Cited By ~ 81

Author(s):

Terry E Graham ◽

Premila Sathasivam ◽

Mary Rowland ◽

Natasha Marko ◽

Felicia Greer ◽

...

Keyword(s):

Blood Glucose ◽

Glucose Tolerance ◽

Oral Glucose Tolerance Test ◽

Glucose Tolerance Test ◽

Serum Insulin ◽

Tolerance Test ◽

Oral Glucose ◽

Oral Glucose Tolerance ◽

Caffeine Ingestion ◽

C Peptide

We tested the hypothesis that caffeine ingestion results in an exaggerated response in blood glucose and (or) insulin during an oral glucose tolerance test (OGTT). Young, fit adult males (n = 18) underwent 2 OGTT. The subjects ingested caffeine (5 mg/kg) or placebo (double blind) and 1 h later ingested 75 g of dextrose. There were no differences between the fasted levels of serum insulin, C peptide, blood glucose, or lactate and there were no differences within or between trials in these measures prior to the OGTT. Following the OGTT, all of these parameters increased (P [Formula: see text] 0.05) for the duration of the OGTT. Caffeine ingestion resulted in an increase (P [Formula: see text] 0.05) in serum fatty acids, glycerol, and plasma epinephrine prior to the OGTT. During the OGTT, these parameters decreased to match those of the placebo trial. In the caffeine trial the serum insulin and C peptide concentrations were significantly greater (P [Formula: see text] 0.001) than for placebo for the last 90 min of the OGTT and the area under the curve (AUC) for both measures were 60 and 37% greater (P [Formula: see text] 0.001), respectively. This prolonged, increased elevation in insulin did not result in a lower blood glucose level; in fact, the AUC for blood glucose was 24% greater (P = 0.20) in the caffeine treatment group. The data support our hypothesis that caffeine ingestion results in a greater increase in insulin concentration during an OGTT. This, together with a trend towards a greater rather than a more modest response in blood glucose, suggests that caffeine ingestion may have resulted in insulin resistance.Key words: adenosine, skeletal muscle, methylxanthines, glucose uptake, diabetes.

Download Full-text

Antidiabetic Activity of Picris japonica Thunb Aqueous Extract in Diabetic KK-Ay Mice

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2018/1298030 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Yanmei Jia ◽

Lirong Chen

Keyword(s):

Blood Glucose ◽

Glucose Tolerance ◽

Aqueous Extract ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Hypoglycemic Effect ◽

Oral Glucose ◽

Oral Glucose Tolerance ◽

Ay Mice

Objective. To evaluate the hypoglycemic effect of Picris japonica Thunb (Asteraceae) on KK-Ay mice. Methods. The hypoglycemic effect of Picris japonica aqueous extract (PJE) in a spontaneous type 2 diabetic model (KK-Ay mice) was studied in the present research. PJE was administrated at doses of 700 mg/kg and 350 mg/kg (calculated as crude herb) for 14 days and blood glucose, oral glucose tolerance test, plasma insulin level, and blood lipid were evaluated. Meanwhile, Rosiglitazone was used for the positive control. Results. It was found the PJE treatment significantly reduced blood glucose level and improved oral glucose tolerance ability (p < 0.01 or p < 0.05) in a dose-dependent manner compared to the control diabetic mice. The blood insulin levels were significantly reduced in PJE-treated mice (700 mg/kg) and Rosiglitazone compared with the diabetic control (p < 0.01). Compared with the control diabetic group, the serum total cholesterol, triglyceride, and low density lipoprotein cholesterol were reduced by PJE (700 mg/kg) and Rosiglitazone (p < 0.05), and the serum high density lipoprotein cholesterol was significantly increased only by Rosiglitazone (p < 0.01). Conclusions. The findings demonstrate that Picris japonica has remarkable antidiabetic effect in diabetic KK-Ay mice, which suggests that Picris japonica may be beneficial to the treatment of type 2 diabetes mellitus.

Download Full-text

Determining pancreatic β-cell compensation for changing insulin sensitivity using an oral glucose tolerance test

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00269.2014 ◽

2014 ◽

Vol 307 (9) ◽

pp. E822-E829 ◽

Cited By ~ 14

Author(s):

Thomas P. J. Solomon ◽

Steven K. Malin ◽

Kristian Karstoft ◽

Sine H. Knudsen ◽

Jacob M. Haus ◽

...

Keyword(s):

Type 2 Diabetes ◽

Insulin Secretion ◽

Insulin Sensitivity ◽

Glucose Tolerance ◽

Oral Glucose ◽

Pancreatic Β Cell ◽

Β Cell ◽

C Peptide ◽

Normal Glucose

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.

Download Full-text