Time to Glucose Peak During an Oral Glucose Tolerance Test Identifies Prediabetes Risk

Summary

Context

Morphological characteristics of the glucose curve during an OGTT (time to peak and shape) may reflect different phenotypes of insulin secretion and action, but their ability to predict diabetes risk is uncertain.

Objective

To compare the ability of time to glucose peak and curve shape to detect prediabetes and β-cell function.

Design and participants

In a cross-sectional evaluation using an OGTT, 145 adults without diabetes (age 42±9y (mean±SD), range 24-62y, BMI 29.2±5.3 kg/m², range 19.9-45.2 kg/m²) were characterized by peak (30mins vs. >30mins) and shape (biphasic vs. monophasic).

Main Outcome Measures

Prediabetes and disposition index (DI) – a marker of β-cell function.

Results

Prediabetes was diagnosed in 36% (52/145) of participants. Peak>30mins, not monophasic curve, was associated with increased odds of prediabetes (OR: 4.0 vs. 1.1; P<0.001). Both monophasic curve and peak>30 mins were associated with lower DI (P≤0.01). Time to glucose peak and glucose AUC were independent predictors of DI (adjR²=0.45, P<0.001).

Conclusion

Glucose peak >30mins was a stronger independent indicator of prediabetes and β-cell function than the monophasic curve. Time to glucose peak may be an important tool that could enhance prediabetes risk stratification.

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