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Early insulin response and insulin sensitivity are equally important as predictors of glucose tolerance after
Lars Berglund1, Christian Berne, Kurt Svärdsudd
1Department of Public Health/Geriatrics, Uppsala University, Uppsala, Sweden. lars.berglund@ucr.uu.se
Aims:
We estimated measurement error (ME) corrected effects of insulin sensitivity (M/I), from euglycaemic insulin clamp, and insulin secretion, measured as early insulin response (EIR) from oral glucose tolerance test (OGTT), on fasting plasma glucose, HbA1c and type 2 diabetes longitudinally and cross-sectional.
Methods:
In a population-based study (n=1128 men) 17 men made replicate measurements to estimate ME at age 71 years. Effect of 1 SD decrease of predictors M/I and EIR on longitudinal response variables fasting plasma glucose (FPG) and HbA1c at follow-ups up to 11 years, were estimated using uncorrected and ME-corrected (with the regression calibration method) regression models.
Results:
Uncorrected effect on FPG at age 77 years was larger for M/I than for EIR (effect difference 0.10mmol/l, 95% CI 0.00;0.21), while ME-corrected effects were similar (0.02mmol/l, 95% CI -0.13;0.15mmol/l). EIR had greater ME-corrected impact than M/I on HbA1c at age 82 years (-0.11%, -0.28; -0.01%).
Conclusions:
Due to higher ME effect of EIR on glycaemia is underestimated as compared with M/I. By correcting for ME valid estimates of relative contributions of insulin secretion and insulin sensitivity on glycaemia are obtained.
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