Evaluation of second phase insulin secretion with simple surrogates derived from the mixed meal tolerance test in patients with type 2 diabetes

Endocrine Journal

Chun-Hsien Hsu⁵  Wei-Cheng Lian⁸  Jiunn-Diann Lin⁷  Chung-Ze Wu⁷  Dee Pei¹  Chun Pei³  Chang-Hsun Hsieh⁶  Jin-Biou Chang²  Yen-Lin Chen⁴ 

[1] Division of Endocrinology and Metabolism, Department of Internal Medicine, Cardinal Tien Hospital, Medical School, Fu Jen Catholic University, New Taipei City, Taiwan, R.O.C.;Department of Pathology, National Defense Medical Center, Division of Clinical Pathology, Tri-Service General Hospital, Taipei, Taiwan, R.O.C.;Graduate School of Gerontic Technology and Service Management, Nan Kai University of Technology, Nan Tou County, Taiwan, R.O.C.;Department of Pathology, Cardinal Tien Hospital, Medical School, Fu Jen Catholic University, New Taipei City, Taiwan, R.O.C.;Department of Family Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan, R.O.C.;Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.;Division of Endocrinology, Department of Internal Medicine, Shuang Ho Hospital, School of Medicine, School of College, Taipei Medical University, Taipei, Taiwan, R.O.C.;Division of Endocrinology and Metabolism, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital and College of Medicine, Tzu Chi University, Taiwan, R.O.C.

关键词: Type 2 diabetes;    Second phase insulin secretion;    Mixed meal tolerance test;    Modified low dose graded glucose infusion test;   

DOI  :  10.1507/endocrj.EJ13-0042

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(21)Cited-By(1)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.

【 授权许可】

Unknown