Abstract
Aim of this study was to formulate an index for glucose effectiveness (Sg), SgIo, based on 3-point (0, 30 and 120 min) 75 g oral glucose tolerance test (OGTT). The equation for SgIO was developed in the Chikuma cohort (n = 502). Firstly, post-loading plasma glucose without insulin action and Sg (PPG-without insulin and Sg) was calculated as follows: fasting plasma glucose (mg/dl) + [0.75 × 75,000]/[0.19 × BW(kg) × 10]. Secondly, ‘PPG-without insulin/with Sg’ was obtained from inverse correlation between log10DIO and 2-h post-glucose plasma glucose at OGTT (2hPG) in each glucose tolerance category: DIO denotes oral disposition index, a product of the Matsuda Index and δIRI0–30/δPG0–30. Thirdly, expected 2hPG (2hPGE) of a given subject was obtained from the regression, and the ratio of 2hPG to 2hPGE (2hPG/2hPGE) was determined as an adjustment factor. Lastly, SgIO ([mg/dl]/min) was calculated as \( \frac{{[{\text{PPG}} \hbox{-} {\text{without}}\;{\text{insulin}}\;{\text{and}}\;{\text{Sg}}] - [{\text{PPG}} \hbox{-} {\text{without}}\;{\text{insulin}}/{\text{with}}\;{\text{Sg}}] \times [(2{\text{hPG}})/(2{\text{hPG}}_{\text{E}})]}}{120} \). SgIO was validated against Sg obtained by frequently sampled intravenous glucose tolerance test in the Jichi cohort (n = 205). Also, the accuracy of prediction of Sg by SgIo was tested by the Bland–Altman plot. SgIO was 3.61 ± 0.73, 3.17 ± 0.74 and 2.15 ± 0.60 in subjects with normal glucose tolerance (NGT), non-diabetic hyperglycemia and diabetes, respectively, in the Chikuma cohort. In the Jichi cohort, SgIO was significantly correlated with Sg in the entire group (r = 0.322, P < 0.001) and in subjects with NGT (r = 0.286, P < 0.001), and SgIo accurately predicted Sg. In conclusion, SgIO could be a simple, quantitative index for Sg.
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Abbreviations
- BMI:
-
Body mass index
- NGT:
-
Normal glucose tolerance
- NDH:
-
Non-diabetic hyperglycemia
- IFG:
-
Impaired fasting glucose
- IGT:
-
Impaired glucose tolerance
- DM:
-
Diabetes mellitus
- T2DM:
-
Type 2 diabetes
- FSIVGTT:
-
Frequently sampled intravenous glucose tolerance test
- OGTT:
-
Oral glucose tolerance test
- IRI:
-
Immunoreactive insulin
- PPG:
-
Post-loading plasma glucose
- FPG:
-
Fasting plasma glucose
- 2hPG:
-
2-h post-glucose PG
- 2hPGE :
-
Expected 2hPG
- Sg:
-
Glucose effectiveness
- SgIO :
-
Oral Sg index
- SgIVG :
-
Sg determined by FSIVGTT or the clamp method
- SI:
-
Insulin sensitivity index
- DI:
-
Disposition index
- DIO :
-
Oral disposition index
- ISIMatsuda :
-
Insulin sensitivity determined by Matsuda Index
- SMA:
-
Standardized major axis
- SD:
-
Standard deviation
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Acknowledgments
The study was in part supported by Grants-in-Aid for Scientific Research from Japan Society for the Promotion of Science (Shoichiro Nagasaka). We thank Masayuki Yamada, Kissei Pharmaceuticals, for invaluable advice regarding statistics.
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Communicated by Renato Lauro.
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Nagasaka, S., Kusaka, I., Yamashita, K. et al. Index of glucose effectiveness derived from oral glucose tolerance test. Acta Diabetol 49 (Suppl 1), 195–204 (2012). https://doi.org/10.1007/s00592-012-0417-y
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DOI: https://doi.org/10.1007/s00592-012-0417-y