Strong association between insulin-mediated glucose uptake and the 2-hour, not the fasting plasma glucose concentration, in the normal glucose tolerance range

J Clin Endocrinol Metab. 2014 Sep;99(9):3444-9. doi: 10.1210/jc.2013-2886. Epub 2014 May 5.

Abstract

Aim: The aim of this study was to examine the relationship between whole-body insulin-mediated glucose disposal and the fasting plasma glucose concentration in nondiabetic individuals.

Research design and methods: Two hundred fifty-three nondiabetic subjects with normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance, and combined glucose intolerance received a 75-g oral glucose tolerance test and euglycemic hyperinsulinemic clamp. Total glucose disposal (TGD) during the insulin clamp was compared in IFG and NGT individuals and was related to fasting and 2-hour plasma glucose concentrations in each group.

Results: TGD varied considerably between NGT and IFG individuals and displayed a strong inverse relationship with the 2-hour plasma glucose (PG; r = 0.40, P < .0001) but not with the fasting PG. When IFG and NGT individuals were stratified based on their 2-hour PG concentration, the increase in 2-hour PG was associated with a progressive decrease in TGD in both groups, and the TGD was comparable among NGT and IFG individuals.

Conclusion: The present results indicate the following: 1) as in NGT, insulin-stimulated TGD varies considerably in IFG individuals; 2) the large variability in TGD in IFG and NGT individuals is related to the 2-hour PG concentration; and 3) after adjustment for the 2-hour proglucagon concentration, IFG subjects have comparable TGD with NGT individuals.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Validation Study

MeSH terms

  • Adult
  • Blood Glucose / metabolism*
  • Fasting / metabolism
  • Female
  • Glucagon / metabolism
  • Glucose Clamp Technique / methods
  • Glucose Clamp Technique / standards
  • Glucose Intolerance / metabolism
  • Glucose Tolerance Test / methods*
  • Glucose Tolerance Test / standards*
  • Humans
  • Hyperinsulinism / metabolism
  • Insulin / metabolism*
  • Linear Models
  • Male
  • Mexican Americans
  • Middle Aged
  • Muscle, Skeletal / metabolism
  • Prediabetic State / metabolism
  • Reference Values

Substances

  • Blood Glucose
  • Insulin
  • Glucagon