Shape of the OGTT glucose response curve: relationship with β-cell function and differences by sex, race, and BMI in adults with early type 2 diabetes treated with metformin
Open Access
- 16 September 2021
- journal article
- research article
- Published by BMJ in BMJ Open Diabetes Research & Care
- Vol. 9 (1), e002264
- https://doi.org/10.1136/bmjdrc-2021-002264
Abstract
Introduction The shape of the glucose curve during an oral glucose tolerance test (OGTT) reflects β-cell function in populations without diabetes but has not been as well studied in those with diabetes. A monophasic shape has been associated with higher risk of diabetes, while a biphasic pattern has been associated with lower risk. We sought to determine if phenotypic or metabolic characteristics were associated with glucose response curve shape in adults with type 2 diabetes treated with metformin alone. Research design and methods This is a cross-sectional analysis of 3108 metformin-treated adults with type 2 diabetes diagnosed Results The monophasic profile was the most common (67.8% monophasic, 5.5% biphasic, 26.7% continuous rise). The monophasic subgroup was younger, more likely male and white, and had higher body mass index (BMI), while the continuous rise subgroup was more likely female and African American/black. HOMA2-S and fasting glucose did not differ among the subgroups. The biphasic subgroup had the highest early, late, and total insulin and C peptide responses (all pConclusions Based on the large multiethnic GRADE cohort, sex, race, age, and BMI were found to be important determinants of the shape of the glucose response curve. A pattern of a continuously rising glucose at 2 hours reflected reduced β-cell function and may portend increased glycemic failure rates. Trial registration number NCT01794143.Keywords
Funding Information
- Centers for Disease Control and Prevention (N/A)
- American Diabetes Association (N/A)
- National Institute of Diabetes and Digestive and Kidney Diseases (U01 DK098246, U34 DK088043)
- National Heart, Lung, and Blood Institute (N/A)
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