Diagnosis of Hyperglycemia in a Cohort of Brazilian Subjects
Fasting plasma glucose–and oral glucose tolerance test–based glycemic status are associated with different profiles of insulin sensitivity and insulin secretion
- Carolina S.V. Oliveira, MD1,
- José Gilberto H. Vieira, MD, PHD12,
- Maria Teresa Ghiringhello2,
- Omar M. Hauache, MD, PHD12,
- Cláudia Helena M. Oliveira, MD, PHD2,
- Cristina Khawali, MD12,
- Claúdia Ferrer2,
- Teresinha T. Tachibana2,
- Rui M.B. Maciel, MD, PHD2,
- Gilberto Velho, MD, PHD3 and
- André F. Reis, MD, PHD12
- 1Laboratory of Molecular Endocrinology, Federal University of São Paulo, Escola Paulista de Medicina, São Paulo, Brazil
- 2Diabetes Center, Fleury Institute, São Paulo, Brazil
- 3Institut National de la Santé et de la Recherche Médicale (INSERM), U695, Paris, France
- Address correspondence and reprint requests to Dr. André F. Reis, Diabetes Center, Fleury Institute, Av. Gal. Waldomiro de Lima, 508, 04344-070 São Paulo-SP, Brasil. E-mail: andre.reis{at}fleury.com.br
- FPG, fasting plasma glucose
- HOMA%S, homeostasis model of insulin sensitivity
- IFG, impaired fasting glucose
- IFGnc, IFG new criteria
- IFGoc, IFG old criteria
- IGT, impaired glucose tolerance
- NFG, normal fasting glucose
- NGT, normal glucose tolerance
- OGTT, oral glucose tolerance test
Impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) represent intermediate states between normal fasting glucose (NFG) or normal glucose tolerance (NGT), respectively, and diabetes (1). The regulation of fasting and glucose concentrations after an oral glucose load is dependent on different physiological mechanisms (2), and current evidence suggests that IFG and IGT have different pathophysiologies (3,4). Measurement of fasting plasma glucose (FPG) is the most frequently used screening test for diabetes. However, the oral glucose tolerance test (OGTT) might be a preferable test because FPG underestimates the severity of glucose intolerance (5,6) and because IFG and IGT define two distinct populations with only partial overlap (5,7,8). The present study was undertaken to compare insulin sensitivity and insulin secretion profiles associated with different stages of hyperglycemia as assessed by FPG only or by FPG and 2-h plasma glucose during an OGTT.
RESEARCH DESIGN AND METHODS
We analyzed data from 900 subjects without previously known diabetes who underwent an OGTT for diagnostic purposes at Fleury Institute, São Paulo, Brazil. A double-glycemic status was determined for each subject. A first set was based on FPG only as follows: NFG (FPG …
