scholarly journals Incretin responses to oral glucose and mixed meal tests and changes in fasting glucose levels during 7 years of follow-up: The Hoorn Meal Study

PLoS ONE ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. e0191114 ◽  
Author(s):  
A. D. M. Koopman ◽  
F. Rutters ◽  
S. P. Rauh ◽  
G. Nijpels ◽  
J. J. Holst ◽  
...  
Keyword(s):  
Fasting Glucose ◽  
Oral Glucose ◽  
Mixed Meal ◽  
Glucose Levels ◽  
Meal Study

scholarly journals Diabetes in Patients with Ataxia telangiectasia: A National Cohort Study

2020 ◽  
Author(s):  
Helena Donath ◽  
Ursula Hess ◽  
Matthias Kieslich ◽  
Marius Theis ◽  
Ute Ohlenschläger ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Ataxia Telangiectasia ◽  
Autosomal Recessive ◽  
Fasting Glucose ◽  
Therapy Response ◽  
Common Finding ◽  
Oral Glucose ◽  
Multisystem Disorder ◽  
National Cohort

Abstract Background: Ataxia telangiectasia (A-T) is a rare autosomal-recessive multisystem disorder characterized by pronounced cerebellar ataxia, telangiectasia, cancer predisposition and altered body composition. In addition, evidence is rising for endocrine dysfunction. Objectives: To determine the evolution of diabetes and its prevalence in a larger A-T cohort. Methods: A retrospective analysis of the patient charts of 39 subjects from the Frankfurt A-T cohort was performed between August 2002 and 2018 concerning HbA1c and oral glucose tolerance (OGTT). The median follow-up period was 4 years (1-16 years). In addition, in 31 A-T patients aged 1 to 38 years HbA1c and fasting glucose were studied prospectively from 2018-2019. Results: In the retrospective analysis, we could demonstrate a longitudinal increase of HbA1c. The prospective analysis showed a significant increase of HbA1c and fasting glucose with age (r = 0.79, p <0.0001). OGTT has a good sensitivity for IR screening, whereas HbA1c can be used to evaluate individual courses and therapy response. Seven out of 39 (17.9%) patients suffered from diabetes. Metformin did not always lead to sufficient diabetes control; one patient was treated successfully with repaglinide. Conclusion: Diabetes is a common finding in older A-T patients and often starts in puberty. Our data clearly demonstrate the need for an annual diabetes screening in patients > 12 years.

scholarly journals Identification of factors differentially associated with isolated impaired fasting glucose and isolated post-load impaired glucose tolerance: the Hong Kong Cardiovascular Risk Factor Study

2006 ◽  
Vol 155 (4) ◽  
pp. 623-632 ◽  
Author(s):  
G Neil Thomas ◽  
C Mary Schooling ◽  
Sarah M McGhee ◽  
Sai-Yin Ho ◽  
Bernard M Y Cheung ◽  
...  
Keyword(s):  
Hong Kong ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Glucose Intolerance ◽  
Impaired Fasting Glucose ◽  
Early Life ◽  
Fasting Glucose ◽  
Oral Glucose ◽  
Hip Circumference ◽  
Glucose Levels

Background: The use of fasting and post-prandial glucose levels in the classification of hyperglycaemic states often identifies distinct subjects, but the factors determining these intermediate-isolated glucose intolerant states are yet to be clearly elucidated in Chinese subjects. Methods: Representative subjects (n = 2769) were randomly recruited from the Hong Kong Chinese population and glycaemic status was determined using both fasting and 2h 75 g oral glucose tolerance test glucose levels. The relationship between the groups with isolated glucose intolerance and vascular risk factors was investigated using ANOVA and logistic regression analyses. Results: Using either criterion, diabetes was identified in 265 (9.6%) subjects and glucose intolerance in 568 (20.5%) subjects. Of those 568, isolated impaired glucose tolerance (IGT) using the post-load criterion was identified in 49.5% and isolated impaired fasting glucose (IFG) in 30.5%. Ageing and hyperinsulinaemia were common determinants of IGT and IFG; with small hip circumference a marker of poorer early life development and being born in China rather than Hong Kong, a possible low birth weight marker was also associated with IFG. Hypertension, hypertriglyceridaemia and poor education were also associated with IGT. When we looked for factors differentially associated with these glucose intolerant states, female sex, greater hip circumference, high triglyceride levels, low fasting insulin levels, and not being born in China were independently associated with isolated IGT compared with isolated IFG. Conclusion: Despite common antecedents to the glucose intolerant states, isolated IFG appeared to be particularly associated with early life development, and isolated IGT was more strongly associated with obesity-related determinants such as hypertriglyceridaemia.

Hypothalamic obesity in female rats in absence of vagally mediated hyperinsulinemia

1980 ◽  
Vol 239 (6) ◽  
pp. E437-E441 ◽  
Author(s):  
B. M. King ◽  
G. R. Phelps ◽  
L. A. Frohman
Keyword(s):  
Fasting Glucose ◽  
Insulin Response ◽  
Female Rats ◽  
Oral Glucose ◽  
Fasting Insulin ◽  
Hypothalamic Obesity ◽  
Glucose Levels ◽  
Rapid Absorption ◽  
Intact Rats

In order to assess the role of vagally mediated hyperinsulinemia in hypothalamic obesity, plasma insulin and glucose levels were assayed in vagotomized and sham-vagotomized female rats after a 6-h fast and after a measured glucose meal both before and 10–14 days after ventromedial hypothalamic (VMH) lesions. Both groups displayed similar gains in body weight in the first 10 days after VMH lesions, but only the sham-vagotomized VMH-lesioned animals displayed elevated fasting insulin levels. Fasting glucose levels did not differ either before or after the lesion. The insulin response to oral glucose was increased in VMH rats, both in vagotomized and sham-vagotomized animals, and it is concluded that the hyperresponsiveness to oral glucose is independent of vagal mediation. Vagotomy markedly exaggerated the glucose and insulin response to oral glucose loading in both intact rats and rats with VMH lesions, probably as a result of more rapid absorption of glucose from the intestine. It is concluded that the fasting hyperinsulinemia that is characteristic of VMH animals is under vagal control and that its elimination does not prevent the development of obesity.

scholarly journals A Clinic-based Approach to Diagnosis and Management of Prediabetes in High-risk Children and Adolescents

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Chelsea Lawson ◽  
S Naseeruddin Ahmed ◽  
Cassandra Brady ◽  
Ashley H Shoemaker
Keyword(s):  
High Risk ◽  
Glucose Tolerance ◽  
Best Practice ◽  
Fasting Glucose ◽  
Retrospective Chart Review ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Oral Glucose Tolerance Testing ◽  
Normal Glucose

Abstract Background Type 2 diabetes (T2D) in youth is increasing in prevalence. Diabetes screening is recommended for at-risk youth but best-practice strategies for management of pediatric prediabetes are unknown. This study leverages a pediatric prediabetes clinic to assess identification of high-risk patients, the rate of clinic follow-up and progression to T2D in youth over time. Methods Retrospective chart review of children referred to a single center for evaluation of prediabetes over a 3-year period. Measurements included hemoglobin A1c (HbA1C) and oral glucose tolerance testing. Patients were classified as normal glucose tolerance (NGT), impaired glucose tolerance (IGT) or T2D based on 2019 American Diabetes Association criteria. Patients classified as IGT/T2D were prescribed metformin. Results Of the 254 patients included; 25.6% had IGT and 6.7% had T2D. The IGT/T2D groups were older and more obese than the NGT group. There was a moderate correlation between HbA1C and fasting glucose (r = 0.59, P &lt; 0.001); HbA1C and 2-hour glucose (r = 0.63, P &lt; 0.001). Over the 3-year study, 52 of 82 patients with IGT/T2D (63%) returned for follow-up. Four patients regained NGT; 3 of those had isolated impaired fasting glucose (100 to 102 mg/dL). Three patients (4.6%) progressed from IGT to T2D over an average of 13 ± 6.2 months. In those patients, body mass index had increased 1.7 ± 2.3 kg/m2 from baseline. Conclusions A pediatric prediabetes clinic may allow for identification of high-risk youth but lost to follow-up rates are high. Continued weight gain is a risk factor for progression to T2D and effective weight management programs are needed.

scholarly journals Salivary amylase gene copy number and its association with fasting and postprandial glucose response

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Mary Farrell ◽  
Emily Sonestedt ◽  
Anne Raben ◽  
Juscelino Tovar ◽  
Stina Ramne ◽  
...  
Keyword(s):  
Observational Study ◽  
Copy Number ◽  
Fasting Glucose ◽  
Postprandial Glucose ◽  
Gene Copy ◽  
Amylase Gene ◽  
Salivary Amylase ◽  
Glucose Levels ◽  
Copy Numbers ◽  
Meal Study

AbstractIntroductionWhen compared to other primates, humans elicit a large variation in the copy number for the salivary amylase gene, AMY1. This variation can range from 2 to 17 copies. The AMY1 gene is responsible for coding for salivary amylase, an enzyme needed to catalyze the hydrolysis of starch molecules into smaller sugars. AMY1 copy number correlates with the amount and activity of salivary amylase. Few studies have investigated the effect of amylase copy number on fasting and postprandial glucose levels. The aim was first to investigate the association between AMY1 copy numbers and fasting glucose in an observational study, and secondly to investigate the difference in postprandial effect of high-starch meals in individuals with either high or low AMY1 copy numbers.Materials and methodsFor the observational study, we used data from 436 participants from the Malmö Offspring Study (MOS) cohort whom have been genotyped for AMY1. For the meal study (conducted during May 2019), we used genotype-based-recall to recruit 24 participants from the observational study of the MOS cohort: 12 with low AMY1 copy number (from the lowest 20%) and 12 with high AMY1 copy numbers (from the highest 20%). Each subject will be served a breakfast meal of white wheat bread on two separate test days: one containing 40 g and the other containing 80 g of carbohydrates (mainly starch). Blood samples will then be taken at various time points to investigate postprandial glucose and insulin responses.ResultsWhen using linear regression analyses adjusting for age and sex, no significant association between AMY1 copy number and fasting glucose was observed (p = 0.23). However, there was a difference (p = 0.05) in fasting glucose levels between the lowest (2–4 copy numbers: 5.31 mmol/L; 95% CI: 5.13–5.50) and highest (10–16 copy numbers: 5.57 mmol/L; 95% CI: 5.39–5.75) copy number groups. The results for the meal study will be obtained in June 2019 and be presented at the conference.DiscussionOur findings of higher fasting glucose among the group with more than 10 AMY1 copy numbers is the first study to find this and needs to be replicated in other populations.

A CROSS-SECTIONAL STUDY OF THE ASSOCIATION BETWEEN THE 1-HOUR ORAL GLUCOSE TOLERANCE TEST AND THE METABOLIC SYNDROME IN A HIGH-RISK SAMPLE WITH IMPAIRED FASTING GLUCOSE

2020 ◽  
Vol 26 (5) ◽  
pp. 529-534
Author(s):  
Juan Carlos Lizarzaburu-Robles ◽  
Lizardo Torres-Aparcana ◽  
Raúl Mansilla ◽  
José Valera ◽  
Gabriela Vargas ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Impaired Fasting Glucose ◽  
Glucose Tolerance Test ◽  
Fasting Glucose ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Glucose Levels

Objective: The aim of this study was to evaluate the association between the 1-hour oral glucose tolerance test (OGTT) (≥155 mg/dL) and metabolic syndrome (MS) in a sample with previous impaired fasting glucose (IFG). Methods: Three hundred and twenty four Peruvian subjects with a history of IFG ≥100 mg/dL were selected for a cross-sectional study. They underwent a 75 g OGTT and were assigned to different groups according to the result. We evaluated the association between 1-hour OGTT and MS. Results: The mean age was 56.5 ± 12.6 years and 191 (61.5%) were female. During the OGTT, we found 28 (8.6%) subjects with diabetes, 74 (22.8%) with IGT, and 222 (68.5%) with a normal glucose tolerance test with a 2-hour glucose <140 mg/dL (NGT). In the NGT group, 124 (38.3%) had 1-hour glucose levels <155 mg/dL, while 98 (30.2%) had 1-hour glucose levels ≥155 mg/dL. Evaluating the association between the 1-hour value in the OGTT and MS, we found that subjects with a 1-hour glucose ≥155 mg/dL were more than twice as likely to have MS as those with a 1-hour glucose <155 mg/dL (odds ratio = 2.64, 95% confidence interval: 1.52 to 4.57). In addition, body mass index, fasting glycemia, triglycerides, and waist circumferences were significantly higher in subjects with 1-hour glucose levels ≥155 mg/dL compared to those with 1-hour glucose levels <155 mg/dL ( P<.05). Conclusion: Among subjects with IFG, performing an OGTT was helpful to identify subjects with 1-hour glucose levels ≥155 mg/dL and NGT who were significantly more likely to have MS and a worse cardiometabolic risk profile. Abbreviations: AST = aspartate aminotransferase; BMI = body mass index; CI = confidence interval; IFG = impaired fasting glucose; IGT = impaired glucose tolerance; LDL = low-density lipoprotein; MS = metabolic syndrome; NGT = normal glucose tolerance; OGTT = oral glucose tolerance test; OR = odds ratio; T2DM = type 2 diabetes; TG = triglycerides

Abstract P337: Association of Glucose Intolerance and Insulin Resistance with Incident Cardiovascular Disease in a Japanese Urban Cohort: The Suita Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Yoshihiro Kokubo ◽  
Makoto Watanabe ◽  
Aya Higashiyama ◽  
Yoko M Nakao ◽  
Takashi Kobayashi ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Glucose Tolerance ◽  
Cerebral Infarction ◽  
Glucose Intolerance ◽  
Fasting Glucose ◽  
Tolerance Test ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Glucose Levels

Introduction: Glucose intolerance and insulin resistance are known risk factors for cardiovascular disease (CVD). However, few prospective studies were reported the association between combinations of these two factors and incident CVD. We assessed the hypothesis that insulin resistance increased the association between glucose intolerance and CVD in Japanese general population. Methods: We studied 4,638 Japanese individuals (mean age 56.1 years, without CVD) who completed a baseline medical examination and a 75g oral glucose tolerance test in the Suita Study. Glucose categories were defined as follows: diabetes mellitus (DM; fasting plasma glucose levels [FPG] ≥126 mg/dL, 2 hours post-loaded glucose levels [2h-PG] ≥ 200 mg/dL, and/or DM medication); impaired glucose tolerance (IGT; FPG <126 mg/dL and 2h-PG =140-199 mg/dL); impaired fasting glucose (IFG; FPG =100-125 mg/dL and 2h-PG <140 mg/dL); and normal glucose tolerance [NGT]. Insulin resistance was the following formula: HOMA-IR = [FPG] x [fasting insulin] / 405. Insulin resistance was defined as HOMA-IR ≥2.5. Multivariable-adjusted Cox proportional hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated after adjusting for age, sex, body mass index, blood pressure category, hyperlipidemia, smoking, and drinking at the baseline. Results: During the 11.7-year follow-up, we documented 127 cerebral infarctions, 63 hemorrhagic stroke, 12 unclassified strokes, and 143 coronary heart disease events. The adjusted HRs (95% CIs) of subjects with FPG =100-125 mg/dL and ≥126 mg/dL were 1.38 (1.01-1.89) and 2.00 (1.12-3.58) for stroke and 1.47 (0.99-2.19) and 2.73 (1.43-5.22) for cerebral infarction, respectively, compared with the fasting NGT group. On the basis of the subjects with 2h-PG <140 mg/dL group, the adjusted HRs (95% CIs) of subjects with 2h-PG ≥200 mg/dL were 1.71 (1.07-2.72) for stroke and 2.06 (1.20-3.54) for cerebral infarction. Compared to the NGT group, the adjusted HRs (95% CIs) of the subjects with IFG, IGT, and DM were 1.59 (1.10-2.30), 1.34 (0.89-2.00), and 1.86 (1.16-3.00) for stroke and 1.82 (1.13-2.90), 1.55 (0.93-2.56), and 2.43 (1.39-4.26) for cerebral infarction, respectively. Compared to the subjects with HOMA-IR <1.5, the adjusted HRs (95% CIs) of CVD and stroke with HOMA-IR ≥2.5 were 1.45 (1.07-1.96) and 1.61 (1.07-2.42), respectively. Compared to the NGT group without insulin resistance, the IFG and DM groups with insulin resistance were observed the increased risks of stroke (HRs [95% CIs]; 2.05 [1.17-3.57] and 2.11 [1.17-3.83]) and cerebral infarction (HRs [95% CIs]; 2.45 [1.20-5.00] and 3.56 [1.84-6.88]), respectively. Conclusions: Fasting glucose intolerance and insulin resistance are predictive factors for the incidence of stroke and cerebral infarction. Insulin resistance increased the risks of incident stroke and cerebral infarction in general inhabitants with IFG and DM.

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