AI Article Synopsis
- The study investigated a glucose fraction that operates independently of insulin secretion in individuals positive for diabetes-related autoantibodies.
- It utilized data from two major trials, analyzing the relationship between the glucose response and insulin levels through linear regression.
- Findings revealed that this independent glucose fraction (iAUCGLU) significantly contributes to the rise in blood sugar levels in impaired glucose tolerance and is a stronger predictor for this condition than for type 1 diabetes (T1D).
Article Abstract
We assessed whether there is an impactful glucose fraction independent of insulin secretion in autoantibody-positive individuals. Baseline 2-h oral glucose tolerance test data from the TrialNet Pathway to Prevention (TNPTP; = 6190) and Diabetes Prevention Trial-Type 1 (DPT-1; = 705) studies were used. Linear regression of area under the curve (AUC) glucose versus Index60 was performed to identify two fractions: dependent (dAUCGLU) or independent (iAUCGLU) of insulin secretion. The lack of correlation ( = 0.06) of iAUCGLU and the inverse correlation of dAUCGLU ( = -0.59) with the first-phase insulin response from DPT-1 were consistent with the independent and dependent designations of the glucose fractions. Correlations of AUC C-peptide were inverse with dAUCGLU and positive with iAUCGLU (TNPTP: = -0.72, = 0.57; DPT-1: = -0.56, = 0.60). The explained variance of AUC C-peptide increased markedly after separating AUC glucose into its fractions (from 4% to 85% in TNPTP; from 1% to 67% in DPT-1). The independent fraction contributed more to the increased glycemia of impaired glucose tolerance (IGT) than did the dependent fraction. Both dAUCGLU and iAUCGLU predicted IGT and type 1 diabetes (T1D) ( < 0.0001 for all). However, whereas dAUCGLU was more predictive of T1D (chi-square: 849 vs. 249), iAUCGLU was more predictive of IGT (chi-square: 451 vs. 176). A glucose fraction independent of insulin secretion was identified that was appreciable in autoantibody-positive individuals. It provides insight into the relation between glucose and C-peptide, contributes substantially to the glycemia of IGT, and predicts both T1D and IGT, particularly the latter.
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| http://dx.doi.org/10.1089/dia.2024.0422 | DOI Listing |
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