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Diabetes Care 29:2708-2713, 2006
DOI: 10.2337/dc06-1118
© 2006 by the American Diabetes Association
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Cardiovascular and Metabolic Risk
Original Article

Prediction of Postprandial Glycemic Exposure

Utility of fasting and 2-h glucose measurements alone and in combination with assessment of body composition, fitness, and strength

Ohad Cohen, MD1, Rita Basu, MD1, Gerlies Bock, MD1, Chiara Dalla Man, PHD2, Marco Campioni, PHD2, Ananda Basu, MD1, Gianna Toffolo, PHD2, Claudio Cobelli, PHD2 and Robert A. Rizza, MD1

1 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic College of Medicine, Rochester, Minnesota
2 Department of Information Engineering, University of Padua, Padua, Italy

Address correspondence and reprint requests to Robert A. Rizza, MD, Mayo Clinic Rochester, 200 First St. SW, Rm. 5-194 Joseph, Rochester, MN 55905. E-mail: rizza.robert{at}mayo.edu

OBJECTIVE—To determine the best predictors of total postprandial glycemic exposure and peak glucose concentrations in nondiabetic humans.

RESEARCH DESIGN AND METHODS—Data from 203 nondiabetic volunteers who ingested a carbohydrate-containing mixed meal were analyzed.

RESULTS—Fasting glucose and insulin concentrations were poor predictors of postprandial glucose area above basal (R2 = ~0.07, P < 0.001). The correlation was stronger for 2-h glucose concentration (R2 = 0.55, P < 0.001) and improved slightly but significantly (P < 0.001) with the addition of fasting glucose, insulin, age, sex, and body weight to the model (r2 = 0.58). The 2-h glucose concentration also predicted the peak glucose concentration (R2 = 0.37, P < 0.001) with strength of the prediction increasing (P < 0.001) modestly with the addition of fasting glucose, insulin, age, sex, and body weight to the model (R2 = 0.48, P < 0.001). On the other hand, addition of measures of body function and composition did not improve prediction of total glycemic exposure or peak glucose concentration.

CONCLUSIONS—Isolated measures of fasting or 2-h glucose concentrations alone or in combination with more complex measures of body composition and function are poor predictors of postprandial glycemic exposure or peak glucose concentration. This may explain, at least in part, the weak and at times inconsistent relationship between these parameters and cardiovascular risk.

Abbreviations: AUC, area under the curve • HOMA, homeostasis model assessment • HOMA-B%, HOMA of ß-cell function • HOMA-S%, HOMA of insulin sensitivity • OGTT, oral glucose tolerance test


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Copyright © 2006 by the American Diabetes Association.