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Reproducibility of the blood glucose and plasma insulin response to identical oral glucose load performed 1 year apart



Reproducibility of the blood glucose and plasma insulin response to identical oral glucose load performed 1 year apart



Diabete and Metabolisme 4(2): 95-102



Reproducibility of the blood glucose and plasma insulin response to oral glucose load was studied in 16 borderline diabetics submitted to identical oral glucose tolerance tests (OGTT) performed 1 yr apart. Several parameters of the OGTT were analyzed, including plasma insulin, blood glucose, insulin/glucose (I/G) ratio, the slope (a) and the y intercept (b) of the regression line of plasma insulin on blood glucose. The ratio of inter- to intra-individual variance was chosen as the index of reproducibility (R index) because: it provides a quantitative definition of reproducibility by reference to ability to discriminate between individuals and it makes possible the comparison of the reproducibility of parameters exhibiting great differences of physiological range. The R index indicated better reproducibility for plasma insulin, I/G and (a) than for blood glucose. The (a) coefficient summarized in one value the information contained in the plasma insulin response curves. Comparison of insulin values predicted from both glucose values and regression of plasma insulin on blood glucose, with observed insulin values, showed that insulin response to OGTT depended not only on the plasma glucose stimulus, but also on another factor (F) which was estimated. The existence of F resulted in a bias in the estimation of various insulinogenic indexes, and increased the number of abnormal insulin-glucose relationships in subjects with borderline OGTT. Corrected insulinogenic indexes were obtained by subtracting this factor F from the experimental insulin values. The reproducibility of insulinogenic indexes indicated the ability of this measurement to serve as a biological constant to evaluate the individual .beta. cell function in clinical field. In order to be valid, comparisons using insulinogenic indexes, if not corrected, must be done in groups paired on glucose value.

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