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

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Solomon, Thomas P. J. Malin, Steven K. Karstoft, Kristian Knudsen, Sine H. Haus, Jacob M. Laye, Matthew J. Pedersen, Maria Pedersen, Bente K. Kirwan, John P.
Spatial Coverage	Denmark Ohio
Description	Author Affiliation: Solomon TP ( Department of Biomedical Sciences, Panum Institute, University of Copenhagen, Copenhagen, Denmark); Malin SK ( Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio); Karstoft K ( Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark); Knudsen SH ( Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark); Haus JM ( Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois); Laye MJ ( Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark); Pedersen M ( Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark); Pedersen BK ( Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark); Kirwan JP ( Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio)
Abstract	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 (DI(OGTT)) that is a measure of pancreatic ß-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 (S(I 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 S(I 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 (GSIS(OGTT)), and DI(OGTT) was calculated as the product of S(I OGTT) and GSIS(OGTT). Our novel S(I 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. GSIS(OGTT) demonstrated a significant inverse relationship with S(I OGTT). GSIS(OGTT) was lowest in normal glucose-tolerant subjects and greatest in those with impaired glucose tolerance. DI(OGTT) 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 ß-cell compensation for changing insulin sensitivity can be readily calculated from clinical variables collected during OGTT.
File Format	HTM / HTML
ISSN	01931849
e-ISSN	15221555
DOI	10.1152/ajpendo.00269.2014
Journal	AJP: Endocrinology and Metabolism
Issue Number	9
Volume Number	307
Language	English
Publisher	American Physiological Society
Publisher Date	2014-11-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Physiology Discipline Metabolism Discipline Endocrinology Allostasis Diabetes Mellitus, Type 2 Diagnosis Glucose Intolerance Insulin Resistance Insulin-secreting Cells Secretion Insulin Prediabetic State Blood Glucose Cohort Studies Blood Metabolism Physiopathology Diagnosis, Differential Disease Progression Glucose Clamp Technique Glucose Tolerance Test Hemoglobin A, Glycosylated Multicenter Study Observational Study Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't Validation Studies
Content Type	Text
Resource Type	Article
Subject	Physiology Endocrinology, Diabetes and Metabolism Physiology (medical)

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