Abstract
The major contributors to the pathogenesis of type 2 diabetes are impaired insulin action and insulin secretion, including second phase insulin secretion (2nd ISEC). This study aimed to compare surrogates derived from the mixed meal tolerance test (MTT) with 2nd ISEC derived from modified low-dose graded glucose infusion (M-LDGGI) in patients with type 2 diabetes. We were subsequently able to decide which surrogate would be performed easily and accurately. Twenty type 2 diabetes patients were enrolled. They received both MTT and M-LDGGI. The standardized MTT meals were provided at 8:00 A.M. and 12:00 P.M. The M-LDGGI was a simplified version of the Polonsky method; only two 80-min stages of glucose infusion (2 and 6 mg/kg/min) were given. The slopes of the insulin to glucose curve during the test were regarded as the 2nd ISEC. First, we used the area under the insulin curve (AUCIN) during MTT to quantify the 2nd ISEC. The best correlated AUCIN was from 60-240 min. Second, the slopes between any two time points of the plasma insulin to glucose level (SLOPEI/G) were also assessed. The time period best correlated with 2nd ISEC was from 0-120 min (SLOPE0-120). Finally, the insulin-to-glucose ratio (IGr) of each time point was used to estimate the 2nd ISEC, and the best correlation was observed at 180 min. In conclusion, estimating 2nd ISEC surrogates derived from MTT proved to be possible. The most accurate surrogate is the SLOPE0-120, while IGr180 is another less precise but more convenient method.
| Original language | English |
|---|---|
| Pages (from-to) | 1077-1084 |
| Number of pages | 8 |
| Journal | Endocrine Journal |
| Volume | 60 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 2013 |
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Keywords
- Mixed meal tolerance test
- Modified low dose graded glucose infusion test
- Second phase insulin secretion
- Type 2 diabetes
ASJC Scopus subject areas
- Endocrinology
- Endocrinology, Diabetes and Metabolism
Cite this
Evaluation of second phase insulin secretion with simple surrogates derived from the mixed meal tolerance test in patients with type 2 diabetes. / Lian, Wei Cheng; Lin, Jiunn Diann; Chang, Jin Biou; Hsu, Chun Hsien; Pei, Chun; Wu, Chung Ze; Hsieh, Chang Hsun; Pei, Dee; Chen, Yen Lin.
In: Endocrine Journal, Vol. 60, No. 9, 2013, p. 1077-1084.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Evaluation of second phase insulin secretion with simple surrogates derived from the mixed meal tolerance test in patients with type 2 diabetes
AU - Lian, Wei Cheng
AU - Lin, Jiunn Diann
AU - Chang, Jin Biou
AU - Hsu, Chun Hsien
AU - Pei, Chun
AU - Wu, Chung Ze
AU - Hsieh, Chang Hsun
AU - Pei, Dee
AU - Chen, Yen Lin
PY - 2013
Y1 - 2013
N2 - The major contributors to the pathogenesis of type 2 diabetes are impaired insulin action and insulin secretion, including second phase insulin secretion (2nd ISEC). This study aimed to compare surrogates derived from the mixed meal tolerance test (MTT) with 2nd ISEC derived from modified low-dose graded glucose infusion (M-LDGGI) in patients with type 2 diabetes. We were subsequently able to decide which surrogate would be performed easily and accurately. Twenty type 2 diabetes patients were enrolled. They received both MTT and M-LDGGI. The standardized MTT meals were provided at 8:00 A.M. and 12:00 P.M. The M-LDGGI was a simplified version of the Polonsky method; only two 80-min stages of glucose infusion (2 and 6 mg/kg/min) were given. The slopes of the insulin to glucose curve during the test were regarded as the 2nd ISEC. First, we used the area under the insulin curve (AUCIN) during MTT to quantify the 2nd ISEC. The best correlated AUCIN was from 60-240 min. Second, the slopes between any two time points of the plasma insulin to glucose level (SLOPEI/G) were also assessed. The time period best correlated with 2nd ISEC was from 0-120 min (SLOPE0-120). Finally, the insulin-to-glucose ratio (IGr) of each time point was used to estimate the 2nd ISEC, and the best correlation was observed at 180 min. In conclusion, estimating 2nd ISEC surrogates derived from MTT proved to be possible. The most accurate surrogate is the SLOPE0-120, while IGr180 is another less precise but more convenient method.
AB - The major contributors to the pathogenesis of type 2 diabetes are impaired insulin action and insulin secretion, including second phase insulin secretion (2nd ISEC). This study aimed to compare surrogates derived from the mixed meal tolerance test (MTT) with 2nd ISEC derived from modified low-dose graded glucose infusion (M-LDGGI) in patients with type 2 diabetes. We were subsequently able to decide which surrogate would be performed easily and accurately. Twenty type 2 diabetes patients were enrolled. They received both MTT and M-LDGGI. The standardized MTT meals were provided at 8:00 A.M. and 12:00 P.M. The M-LDGGI was a simplified version of the Polonsky method; only two 80-min stages of glucose infusion (2 and 6 mg/kg/min) were given. The slopes of the insulin to glucose curve during the test were regarded as the 2nd ISEC. First, we used the area under the insulin curve (AUCIN) during MTT to quantify the 2nd ISEC. The best correlated AUCIN was from 60-240 min. Second, the slopes between any two time points of the plasma insulin to glucose level (SLOPEI/G) were also assessed. The time period best correlated with 2nd ISEC was from 0-120 min (SLOPE0-120). Finally, the insulin-to-glucose ratio (IGr) of each time point was used to estimate the 2nd ISEC, and the best correlation was observed at 180 min. In conclusion, estimating 2nd ISEC surrogates derived from MTT proved to be possible. The most accurate surrogate is the SLOPE0-120, while IGr180 is another less precise but more convenient method.
KW - Mixed meal tolerance test
KW - Modified low dose graded glucose infusion test
KW - Second phase insulin secretion
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=84884912067&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84884912067&partnerID=8YFLogxK
U2 - 10.1507/endocrj.EJ13-0042
DO - 10.1507/endocrj.EJ13-0042
M3 - Article
VL - 60
SP - 1077
EP - 1084
JO - Endocrine Journal
JF - Endocrine Journal
SN - 0918-8959
IS - 9
ER -