Classical and model-based estimates of beta-cell function during a mixed meal vs. an OGTT in a population-based cohort

Diabetes Res Clin Pract. 2009 Feb;83(2):280-8. doi: 10.1016/j.diabres.2008.11.017. Epub 2008 Dec 20.

Abstract

This study compared classical and model-based beta-cell responses during an oral glucose tolerance test (OGTT) and a meal tolerance test (MTT) in a population-based cohort. Individuals with normal glucose metabolism (NGM, n=161), impaired glucose metabolism (IGM, n=19) and type 2 diabetes mellitus (DM, n=20) underwent a 75 g-OGTT and an MTT (75 g carbohydrates, 50 g fat, 24 g proteins). Classical estimates of beta-cell function (insulinogenic index and the ratio of areas under insulin and glucose curves) were calculated. Mathematical modelling was used to determine beta-cell glucose sensitivity, rate sensitivity and potentiation. Insulin sensitivity was characterized by three surrogate estimates. Both classical and model-based estimates of beta-cell function were higher during MTT than during OGTT (P<0.05). Regarding the model-based parameters, especially beta-cell sensitivity was increased following MTT as compared with OGTT (P<0.05). Both during OGTT and MTT, across most parameters describing beta-cell function, the largest reduction in beta-cell response occurred between IGM and DM, while the largest reduction in insulin sensitivity occurred between NGM and IGM. We conclude that beta-cell response is stronger after a mixed meal than after an OGTT with equal carbohydrate quantity, both for classical and model-based parameters. The higher response was mostly explained by higher beta-cell sensitivity during the meal.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / metabolism
  • Cohort Studies
  • Complex Mixtures / pharmacology*
  • Female
  • Food*
  • Glucose / administration & dosage
  • Glucose / pharmacology*
  • Glucose Tolerance Test
  • Humans
  • Insulin / blood
  • Insulin Resistance / physiology
  • Insulin-Secreting Cells / drug effects
  • Insulin-Secreting Cells / physiology*
  • Male
  • Middle Aged
  • Models, Biological*
  • Population

Substances

  • Blood Glucose
  • Complex Mixtures
  • Insulin
  • Glucose