THE COMPARISON OF THE SECOND PHASE INSULIN SECRETION DERIVED FROM ORAL GLUCOSE TOLERANCE TEST AND LOW DOSE GRADED GLUCOSE INFUSION TEST

Mapping Intimacies ◽

10.36106/gjra/5813942 ◽

2021 ◽

pp. 243-246

Author(s):

Tsung-Ju Chuang ◽

Te-Lin Hsia

Keyword(s):

Insulin Secretion ◽

Glucose Tolerance ◽

Gold Standard ◽

Low Dose ◽

Glucose Tolerance Test ◽

Tolerance Test ◽

Oral Glucose ◽

Second Phase ◽

Oral Glucose Tolerance ◽

Glucose Infusion Test

Background: the pathogeneses of type 2 diabetes (T2DM) are impaired insulin action and secretion, including the second phase insulin secretion (SPIS). However, SPIS is difcult to be measured. The study aimed to validate the SPIS derived from the simpler oral glucose tolerance test (OGTT) against the SPIS derived from the more complicated gold standard test, i.e. low dose graded glucose infusion test (LDGGI). Methods: Fourteen participants (3 with normal glucose tolerance, 8 with pre-diabetes and 3 with T2DM) were enrolled. They received both a standard LDGGI and an OGTT. The mathematical method which is called deconvolution was applied in both tests. The slope of the insulin secretion rate (ISR) against glucose levels during the LDGGI was obtained and regarded as the gold standard (SPIS-L). At the same time, the SPIS calculated from OGTT with minimal model was also obtained (SPIS-O). Results: Pearson correlation was used to assess the correlation between SPIS-L and SPIS-O. There was a signicant correlation between SPIS-L and SPIS-O (r = 0.843, p = 0.000). At the same time, a good agreement between the SPIS-L and SPIS-O was also found from the Bland-Altman plot. Conclusion: SPIS-O is highly correlated with the gold standard, i.e., the SPIS-L. Since it is easier to be performed, future researches focusing on SPIS by using OGTT might be expedited.

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Age-Related Reduction in Glucose Elimination Is Accompanied by Reduced Glucose Effectiveness and Increased Hepatic Insulin Extraction in Man1

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.83.9.5107 ◽

1998 ◽

Vol 83 (9) ◽

pp. 3350-3356 ◽

Cited By ~ 1

Author(s):

Bo Ahrén ◽

Giovanni Pacini

Keyword(s):

Insulin Secretion ◽

Glucose Tolerance ◽

Glucose Tolerance Test ◽

Tolerance Test ◽

Oral Glucose ◽

Tolerance Index ◽

Second Phase ◽

Oral Glucose Tolerance ◽

Glucose Effectiveness ◽

First Phase Insulin Secretion

This study examined whether insulin secretion, insulin sensitivity, glucose effectiveness (SG), and hepatic extraction (HE) of insulin are altered by age when glucose tolerance is normal. A frequently sampled iv glucose tolerance test was performed in 20 elderly (E, 10/10 male/female, all 63 yr old) and in 20 young subjects (Y, 10/10 male/female, all 27 yr old), who were similar in body mass index and 2-h blood glucose during oral glucose tolerance test. E exhibited impaired glucose elimination (iv tolerance index, 1.31 ± 0.10 vs. 1.70 ± 0.12% min−1; P = 0.019). First-phase insulin secretion and SI did not differ between the groups, whereas E had lower glucose sensitivity of second-phase insulin secretion (0.40 ± 0.07 vs. 0.70 ± 0.08 (pmol/L)min−2/(mmol/L), P = 0.026), lower SG, 0.017 ± 0.002 vs. 0.025± 0.002 min−1, P = 0.004), and higher HE (81.3 ± 2.4 vs. 73.2 ± 2.1%, P = 0.013). Across both groups, SG correlated positively with glucose tolerance index (r = 0.58, P < 0.001) and negatively with HE (r =− 0.54, P < 0.001). Plasma leptin and glucagon did not change by age, whereas plasma pancreatic polypeptide (PP) was higher in E (122 ± 18 vs.66 ± 6 pg/mL, P = 0.004). PP did not, however, correlate to any other parameter. We conclude that E subjects with normal oral glucose tolerance have reduced SG, impaired second-phase insulin secretion, and increased HE, whereas SI and first-phase insulin secretion seem normal. SG seems most related to age-dependent impairment of glucose elimination, whereas leptin, glucagon, and PP do not seem to contribute.

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