Assessment of insulin sensitivity (SI) and glucose effectiveness (SG) from a standardized hyperglucidic breakfast test in type 2 diabetics exhibiting various levels of insulin resistance
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Jean-Fre´de´ric Brun Edouard Ghanassia Christine Fe´dou Sylvain Bordenave Eric Raynaud de Mauverger Jacques Mercier
- چاپ و سال / کشور: 2010
Description
We investigated the measurement of insulin sensitivity (SI) with a standardized hyperglucidic breakfast (SHB) compared to minimal model analysis of an intravenous glucose tolerance test (SI-IVGTT) in 17 patients clinically referred as type 2 diabetics, not yet treated by insulin, and representing a wide range of body mass index and SI. To classify the patients, ten meal-tolerance testbased calculations of SI (MTT-SI) were compared to SIIVGTT, and their reference values and distribution were measured on a separate sample of 200 control SHBs and 209 control IVGTTs. Eight MTT-SI indices exhibit significant correlations with SI-IVGTT: Mari’s OGIS index, BIGTT-SI|0–30–120, BIGTT-SI|0–60–120, 1/GbIm, Caumo’s oral minimal model (OMM), Sluiter’s index ‘‘A’’ = 104/ (IpGp), Matsuda’s composite index given by the formula ISIcomp = 104/(IbGbImGm)0.5, SI = 1/IbGbImGm with r2 ranging between 0,53 and 0,28. SI-IVGTT and SI-MTT exhibited in the lower range a very different (non-normal) pattern of distribution and thus the cutoff value for defining insulin resistance varied among indices. With such cutoffs, SI-MTT\6.3 min-1/(lU/ml) 10-4 with Caumo’s OMM was the best predictor of insulin resistance defined as SI-IVGTT\2 min-1/(lU/ml) 10-4. Other indices, including OGIS and BIGTT, resulted in more misclassifications of patients. HOMA-IR and QUICKI were poor predictors. The formula SG ¼ 2:921 e0:185ًG60G0ق satisfactorily predicts IVGTT-derived glucose effectiveness in type 2 diabetics. Thus, SHB appears suitable for the measurement of SI and SG in type 2 diabetics, and the OMM seems to provide the most accurate SHB-derived index in this population.
Acta Diabetol DOI 10.1007/s00592-010-0232-2 Received: 22 January 2008 / Accepted: 11 October 2010 Springer-Verlag 2010
