In:
Journal of Diabetes Science and Technology, SAGE Publications, Vol. 12, No. 3 ( 2018-05), p. 665-672
Abstract:
Physiological models that are used with dynamic test data to assess insulin sensitivity (SI) assume that the metabolic target glucose concentration ( G TARGET ) is equal to fasting glucose concentration ( G 0 ). However, recent research has implied that irregularities in G 0 in diabetes may cause erroneous SI values. This study quantifies the magnitude of these errors. Methods: A clinically validated insulin/glucose model was used to calculate SI with the standard fasting assumption (SFA) G 0 = G TARGET . Then G TARGET was treated as a variable in a second analysis (VGT). The outcomes were contrasted across twelve participants with established type 2 diabetes mellitus that were recruited to take part in a 24-week dietary intervention. Participants underwent three insulin-modified intravenous glucose tolerance tests (IM-IVGTT) at 0, 12, and 24 weeks. Results: SI VGT had a median value of 3.36×10 −4 L·mU −1 ·min −1 (IQR: 2.30 – 4.95×10 −4 ) and were significantly lower ( P 〈 .05) than the median SI SFA (6.38×10 −4 L·mU −1 ·min −1 , IQR: 4.87 – 9.39×10 −4 ). The VGT approach generally yielded lower SI values in line with expected participant physiology and more effectively tracked changes in participant state over the 24-week trial. Calculated G TARGET values were significantly lower than G 0 values (median G TARGET = 5.48 vs G 0 = 7.16 mmol·L −1 P 〈 .001) and were notably higher in individuals with longer term diabetes. Conclusions: Typical modeling approaches can overestimate SI when G TARGET does not equal G 0 . Hence, calculating G TARGET may enable more precise SI measurements in individuals with type 2 diabetes, and could imply a dysfunction in diabetic metabolism.
Type of Medium:
Online Resource
ISSN:
1932-2968
,
1932-2968
DOI:
10.1177/1932296817750402
Language:
English
Publisher:
SAGE Publications
Publication Date:
2018
detail.hit.zdb_id:
2467312-2
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