Insulin secretion based on the late oral glucose tolerance test period and incident diabetes: The San Antonio Heart Study

C. Lorenzo, K. Williams, S. M. Haffner

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8 Scopus citations

Abstract

Aims The Insulinogenic Index from 0 to 30min (ΔI 0-30/ΔG 0-30), a measure of insulin secretion derived from the early period of the oral glucose tolerance test, predicts future diabetes. However, there are few data on secretory measures from the late oral glucose tolerance test period. We therefore investigated the association of the ratio of the area under the insulin curve to the area under the glucose curve from 60 to 120min (I/G AUC60-120) with incident diabetes. Methods Participants were 1540 Mexican Americans and non-Hispanic whites in the San Antonio Heart Study who were free of diabetes at baseline. We analysed indices of sensitivity (Matsuda index) and secretion from the early (ΔI 0-30/ΔG 0-30) and late oral glucose tolerance test periods (I/G AUC60-120). Results A total of 179 participants developed diabetes after 7.5years. I/G AUC60-120 was an independent predictor of diabetes [odds ratio×1SD unit increase, 0.37 (0.26-0.54)] in a model that also included age, sex, ethnicity, body mass index, family history of diabetes, Matsuda index and (ΔI 0-30/ΔG 0-30) as covariates. I/G AUC60-120 increased the C statistic (a test of discrimination) of the model (0.882 vs. 0.875, P=0.044). I/G AUC60-120 correctly reclassified one-fifth of individuals with moderate and strong risks of future diabetes. The net reclassification improvement was 0.13 (P<0.001) and the integrated discrimination improvement was 0.033 (P<0.001). Conclusions An insulin secretory measure derived from the late oral glucose tolerance test period is useful for classifying individuals at risk of future diabetes independently of other risk factors, including insulin sensitivity and a secretory measure from the early oral glucose tolerance test period.

Original languageEnglish (US)
Pages (from-to)e151-e158
JournalDiabetic Medicine
Volume29
Issue number8
DOIs
Publication statusPublished - Aug 1 2012

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Keywords

  • Epidemiology
  • Insulin resistance
  • Insulin secretion
  • Oral glucose tolerance test
  • Prediction of Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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