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Daytime variability of postprandial glucose tolerance and pancreatic B‐cell function using 12‐h profiles in persons with Type 2 diabetes
Author(s) -
Peter R.,
Dunseath G.,
Luzio S. D.,
Chudleigh R.,
Roy Choudhury S.,
Owens D. R.
Publication year - 2010
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2010.02949.x
Subject(s) - postprandial , medicine , endocrinology , meal , type 2 diabetes , area under the curve , proinsulin , diabetes mellitus , insulin
Diabet. Med. 27, 266–273 (2010) Abstract Aims To study the variation in daytime glucose tolerance and pancreatic B‐cell function at different levels of glycated haemoglobin (HbA 1c ) in subjects with Type 2 diabetes (T2DM). Methods T2DM subjects ( n = 49; 34 men) had 12‐h daytime plasma glucose (PG), insulin (PI), total (PTp) and intact proinsulin (PIp) profiles determined in response to three identical test meals at 4‐h intervals. Subjects were divided into three groups according to HbA 1c —group 1: < 7.3% ( n = 18); group 2: 7.3–8.0% ( n = 17); group 3: > 8.0% ( n = 14). Fasting and preprandial (prior to meals 2 and 3) concentrations, total area under the curve (AUC), AUC above fasting (dAUC) and maximum postprandial metabolic concentrations (C max ) were compared between the three meals and across the groups. Results Subjects in group 1 had significantly higher fasting plasma glucose (FPG) compared with preprandial PG concentrations (7.1 ± 0.2 vs. 5.9 ± 0.3 vs. 5.4 ± 0.2; P < 0.01). Subjects in groups 2 and 3 had significantly higher FPG compared with preprandial PG levels prior to meal 3. PG.dAUC was highest in response to meal 1 and lowest following meal 2 ( P < 0.05). FPI concentrations were significantly lower compared with preprandial PI concentrations. Subjects in group 1 had significantly higher PI prior to meal 2 compared with meal 3. PI.dAUC was highest in response to meal 1. Subjects in group 1 had lowest PI.dAUC following meal 2. FTp and FIp concentrations were also significantly lower compared with preprandial concentrations. PTp.dAUC and PIp.dAUC was highest in response to meal 1. Conclusions There appears to be a shift in diurnal variation in glucose homeostasis and pancreatic B‐cell function. Subjects had decreased glucose tolerance in response to the first and third meal of the day irrespective of glycaemic control. The variability in glucose tolerance was reflected by both quantitative and qualitative dysfunction of the pancreatic B‐cell.