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Multicenter Study
. 2017 Apr:126:192-197.
doi: 10.1016/j.diabres.2017.01.009. Epub 2017 Feb 17.

Glucose patterns during the OGTT and risk of future diabetes in an urban Indian population: The CARRS study

Adam Hulman  1 , Unjali P Gujral  2 , K M Venkat Narayan  3 , Rajendra Pradeepa  4 , Deepa Mohan  5 , Ranjit Mohan Anjana  6 , Viswanathan Mohan  7 , Kristine Færch  8 , Daniel R Witte  9
Affiliations
Multicenter Study

Glucose patterns during the OGTT and risk of future diabetes in an urban Indian population: The CARRS study

Adam Hulman et al. Diabetes Res Clin Pract. 2017 Apr.

Abstract

Aims: Traditionally, fasting and 2-hour post challenge plasma glucose have been used to diagnose diabetes. However, evidence indicates that clinically relevant pathophysiological information can be obtained by adding intermediate time-points to a standard oral glucose tolerance test (OGTT).

Methods: We studied a population-based sample of 3666 Asian Indians without diabetes from the CARRS-Chennai Study, India. Participants underwent a three-point (fasting, 30-min, and 2-h) OGTT at baseline. Patterns of glycemic response during OGTT were identified using latent class mixed-effects models. After a median follow-up of two years, participants had a second OGTT. Logistic regression adjusted for diabetes risk factors was used to compare risk of incident diabetes among participants in different latent classes.

Results: We identified four latent classes with different glucose patterns (Classes 1-4). Glucose values for Classes 1, 2, and 4 ranked consistently at all three time-points, but at gradually higher levels. However, Class 3 represented a distinct pattern, characterized by high 30-min (30minPG), normal fasting (FPG) and 2-h (2hPG) plasma glucose, moderately high insulin sensitivity, and low acute insulin response. Approximately 22% of participants were categorized as Class 3, and had a 10-fold risk of diabetes compared to the group with the most favorable glucose response, despite 92.5% of Class 3 participants having normal glucose tolerance (NGT) at baseline.

Conclusions: Elevated 30minPG is associated with high risk of incident diabetes, even in individuals classified as NGT by a traditional OGTT. Assessing 30minPG may identify a subgroup of high-risk individuals who remained unidentified by traditional measures.

Keywords: Asian Indian; Diabetes physiology; Oral glucose tolerance test; Type 2 diabetes.

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Conflict of interest statement

Conflict of interest statement

The authors disclose no conflict of interest relevant to this manuscript.

Figures

Fig 1
Fig 1
Heterogeneous plasma glucose patterns during the OGTT identified by latent class trajectory analysis
See this image and copyright information in PMC

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