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Glucose Effectiveness from Short Insulin-Modified IVGTT and Its Application to the Study of Women with Previous Gestational Diabetes Mellitus.

Abstract：

BACKGROUND:This study aimed to design a simple surrogate marker (i.e., predictor) of the minimal model glucose effectiveness (SG), namely calculated SG (CSG), from a short insulin-modified intravenous glucose tolerance test (IM-IVGTT), and then to apply it to study women with previous gestational diabetes mellitus (pGDM). METHODS:CSG was designed using the stepwise model selection approach on a population of subjects (n=181) ranging from normal tolerance to type 2 diabetes mellitus (T2DM). CSG was then tested on a population of women with pGDM (n=57). Each subject underwent a 3-hour IM-IVGTT; women with pGDM were observed early postpartum and after a follow-up period of up to 7 years and classified as progressors (PROG) or non-progressors (NONPROG) to T2DM. The minimal model analysis provided a reference SG. RESULTS:CSG was described as CSG=1.06×10⁻²+5.71×10⁻²×KG/Gpeak, KG being the mean slope (absolute value) of loge glucose in 10-25- and 25-50-minute intervals, and Gpeak being the maximum of the glucose curve. Good agreement between CSG and SG in the general population and in the pGDM group, both at baseline and follow-up (even in PROG and NONPROG subgroups), was shown by the Bland-Altman plots (<5% observations outside limits of agreement), and by the test for equivalence (equivalence margin not higher than one standard deviation). At baseline, the PROG subgroup showed significantly lower SG and CSG values compared to the NONPROG subgroup (P<0.03). CONCLUSION:CSG is a valid SG predictor. In the pGDM group, glucose effectiveness appeared to be impaired in women progressing to T2DM.

journal_name

Diabetes Metab J

journal_title

Diabetes & metabolism journal

authors

Morettini M,Castriota C,Göbl C,Kautzky-Willer A,Pacini G,Burattini L,Tura A

doi

10.4093/dmj.2019.0016

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

286-294

issue

2

eissn

2233-6079

issn

2233-6087

pii

44.e2

journal_volume

44

pub_type

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