Morettini M, Di Nardo F, Burattini L, Fioretti S, Göbl C, Kautzky-Willer A, Pacini G, Tura A. Assessment of glucose effectiveness from short IVGTT in individuals with different degrees of glucose tolerance.
Acta Diabetol 2018;
55:1011-1018. [PMID:
29931422 DOI:
10.1007/s00592-018-1182-3]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 06/12/2018] [Indexed: 02/06/2023]
Abstract
AIMS
Minimal model analysis of intravenous glucose tolerance test (IVGTT) data represents the reference method to assess insulin sensitivity (SI) and glucose effectiveness (SG) that quantify the insulin-dependent and insulin-independent processes of glucose disappearance, respectively. However, test duration (3 h) and need for modeling expertise limit the applicability of this method. Aim of this study was providing a simple predictor of SG applicable to short test (1 h), as previously done with SI.
METHODS
Three groups of subjects reflecting different glucose tolerance degrees underwent a 3 h IVGTT: subjects with normal glucose tolerance (NGT, n = 164), with defective glucose regulation (DGR, n = 191), and with type 2 diabetes (T2D, n = 39). Minimal model analysis provided reference SG and its components at zero (GEZI) and basal (BIE) insulin. The simple predictor CSG (calculated SG) was described by the formula CSG = α0 + α1 × KG/Gpeak, being KG the glucose disappearance rate (between 10 and 50 min) and Gpeak the maximum of the glucose curve during the test; α0 and α1 coefficients were provided by linear regression analysis.
RESULTS
CSG and SG showed a markedly significant relationship in the whole dataset (r = 0.72, p < 0.0001) and in the single groups (r = 0.70 in NGT, r = 0.71 in DGR and r = 0.70 in T2D, p < 0.0001 for all); α1 × KG/Gpeak was significantly related to GEZI (r ≥ 0.60).
CONCLUSIONS
The interest for insulin-independent glucose disappearance is increasing, due to the recent availability of SGLT2 pharmacological agents, lowering glycemic levels without requiring insulin action. This study proposes a reliable predictor of SG based on IVGTT lasting 1 h only, and not requiring mathematical modeling skills.
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