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Original Articles

Variation of Postprandial Plasma Glucose, Palatability, and Symptoms Associated With a Standardized Mixed Test Meal Versus 75 g Oral Glucose

  1. Thomas M S Wolever, DM, PHD,
  2. Jean-Louis Chiasson, MD,
  3. Adele Csima, MSC,
  4. John A Hunt, MD,
  5. Carol Palmason, MSC,
  6. Stuart A Ross, MD and
  7. Edmond A Ryan, MD
  1. Departments of Nutritional Sciences, University of Toronto Toronto, Ontario
  2. Public Health Sciences, University of Toronto Toronto, Ontario
  3. St. Michael's Hospital, University of Toronto Toronto, Ontario
  4. Research Centre, CHUM, Hôtel-Dieu de Montreal Hospital Montreal, Quebec
  5. Lion's Gate Hospital, North Vancouver British Columbia
  6. Heritage Medical Research Centre Edmonton
  7. University of Alberta, Ceapro Inc. Edmonton
  8. Calgary Metabolic Education and Research Centre Calgary, Alberta, Canada
  1. Address correspondence and reprint requests to Dr. Thomas M.S. Wolever, Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada M5S 3E2. E-mail: thomas.wolever{at}utoronto.ca
Diabetes Care 1998 Mar; 21(3): 336-340. https://doi.org/10.2337/diacare.21.3.336
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Abstract

OBJECTIVE To compare within-subject variability of plasma glucose measured 2 h after a glucose tolerance test (GTT) with that of plasma glucose measured 2 h after administration of a standardized test meal (diabetes screening product [DSP], Ceapro, Edmonton, Alberta, Canada) and to determine the relationship between the two sets of plasma glucose measurements.

RESEARCH DESIGN AND METHODS Plasma glucose and insulin responses of 36 overnight-fasted subjects (10 lean normal, 9 obese normal, 9 with impaired glucose tolerance [IGT], and 8 with mild diabetes) were studied on eight different mornings after they consumed 75 g oral glucose or 50 g carbohydrate from the DSP. Each test meal was repeated four times by each subject. Within-subject coefficients of variation (CVs) (CV = 100 × SD/mean) of plasma glucose concentrations 2 h after administration of the GTT and DSP were compared by repeated measures ANOVA and linear regression analysis.

RESULTS Mean plasma glucose 2 h after administration of the DSP (D) was linearly related to that 2 h after the GTT (G): G = 1.5 × D − 1.6 (r = 0.97, P < 0.0001). The CV of 2-h plasma glucose was significantly lower after administration of the DSP, 10.5 ± 1.0%, than after the GTT, 12.7 ± 1.18% (P = 0.025). The effect of test meal on CV differed in different groups of subjects (P = 0.018), with the largest difference found in IGT subjects, in whom the CV after DSP administration was 47% < after the GTT (P = 0.0005). The DSP was significantly more palatable and produced fewer adverse symptoms than the GTT.

CONCLUSIONS Plasma glucose concentrations measured 2 h after DSP administration are closely related to those measured 2 h after the GTT but are more consistent than the 2-h post-GTT concentrations within the critical IGT range. This finding suggests that measurement of plasma glucose 2 h after administration of the DSP may allow more precise discrimination among normal glucose levels, IGT, and diabetes than measurement of plasma glucose 2 h after the GTT.

  • Received August 15, 1997.
  • Accepted November 3, 1997.
  • Copyright © 1998 by the American Diabetes Association

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March 1998, 21(3)
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Variation of Postprandial Plasma Glucose, Palatability, and Symptoms Associated With a Standardized Mixed Test Meal Versus 75 g Oral Glucose
Thomas M S Wolever, Jean-Louis Chiasson, Adele Csima, John A Hunt, Carol Palmason, Stuart A Ross, Edmond A Ryan
Diabetes Care Mar 1998, 21 (3) 336-340; DOI: 10.2337/diacare.21.3.336

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Variation of Postprandial Plasma Glucose, Palatability, and Symptoms Associated With a Standardized Mixed Test Meal Versus 75 g Oral Glucose
Thomas M S Wolever, Jean-Louis Chiasson, Adele Csima, John A Hunt, Carol Palmason, Stuart A Ross, Edmond A Ryan
Diabetes Care Mar 1998, 21 (3) 336-340; DOI: 10.2337/diacare.21.3.336
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