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Oral glucose tolerance: relationship with hemoglobin A1c
H S Starkman1, J S Soeldner, R E Gleason
1Elliot P. Joslin Research Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Diabetes Research and Clinical Practice
|November 1, 1987
Summary
This study investigated discordance between oral glucose tolerance tests (OGTT) and hemoglobin A1c (HbA1c) in males. Group 3, with abnormal OGTT and normal HbA1c, exhibited significant hyperinsulinism, suggesting a distinct metabolic profile.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Diabetes Research
Background:
- Discordance between oral glucose tolerance test (OGTT) and hemoglobin A1c (HbA1c) can complicate diabetes diagnosis.
- Understanding the physiological basis for this discordance is crucial for accurate patient assessment.
Purpose of the Study:
- To investigate the reasons for discordance between OGTT and HbA1c in males.
- To analyze glucose and insulin responses in individuals with varying OGTT and HbA1c results.
Main Methods:
- Studied 52 normal males and 77 male offspring of diabetic parents (aged 15-72).
- Classified subjects into four groups based on OGTT and HbA1c results.
- Analyzed glucose and insulin response patterns during OGTT for each group.
Main Results:
- Group 2 (normal OGTT, abnormal HbA1c) showed slightly higher early glucose areas than Group 1.
- Group 3 (abnormal OGTT, normal HbA1c) exhibited significantly higher blood glucose levels and marked absolute hyperinsulinism compared to other groups.
- Group 3 also showed evidence of relative hyperinsulinism, indicated by an elevated insulin/glucose regression coefficient.
Conclusions:
- The findings highlight distinct metabolic characteristics in individuals with discordant OGTT and HbA1c results.
- Hyperinsulinism appears to be a key feature in subjects with an abnormal OGTT but normal HbA1c.
- Further research is warranted to elucidate the long-term implications of these discordant profiles.