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Authors
Fujioka, Youhei Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine, Tottori University Researchers DB KAKEN
Okura, Tsuyoshi Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine, Tottori University Researchers DB KAKEN
Sumi, Keisuke Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine, Tottori University Researchers DB
Matsumoto, Kazuhisa Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine, Tottori University
Shoji, Kyoko Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine, Tottori University
Nakamura, Risa Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine, Tottori University
Matsuzawa, Kazuhiko Department of Regional Medicine, Faculty of Medicine, Tottori University Researchers DB
Izawa, Shoichiro Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine, Tottori University Researchers DB KAKEN
Kato, Masahiko Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine, Tottori University Researchers DB KAKEN
Taniguchi, Shinichi Department of Regional Medicine, Faculty of Medicine, Tottori University Researchers DB KAKEN
Yamamoto, Kazuhiro Division of Molecular Medicine and Therapeutics, Department of Multidisciplinary Internal Medicine, Tottori University Researchers DB KAKEN
Keywords
C-peptide
Glucagon stimulation test
Meal tolerance test
Abstract
Aims/Introduction: The aim of the present study was to evaluate the properties of the glucagon stimulation test (GST) and the normal meal tolerance test (NMTT) in patients with type 2 diabetes. Materials and Methods: We enrolled 142 patients with type 2 diabetes, and carried out a GST and a NMTT. We carried out the NMTT using a calorie-controlled meal based on an intake of 30 kcal/kg ideal bodyweight/day. We calculated the change in C-peptide immunoreactivity (ΔCPR) by subtracting fasting CPR from the CPR 6 min after the 1-mg glucagon injection (GST) or 120 min after the meal (NMTT). Results: Mean ΔCPR for the GST was 2.0 ng/mL, and for the NMTT was 3.1 ng/mL. A total of 104 patients had greater ΔCPR in the NMTT than the GST, and the mean ΔCPR was significantly greater in the NMTT than the GST (P < 0.05). To exclude any influence of antidiabetic drugs, we examined 42 individuals not taking antidiabetic agents, and found the mean ΔCPR was significantly greater in the NMTT than the GST (GST 2.4 ng/mL, NMTT 4.3 ng/mL; P < 0.05). To consider the influence of glucose toxicity, we carried out receiver operating characteristic analyses with fasting plasma glucose and glycated hemoglobin. The optimal cut-off levels predicting GST ΔCPR to be larger than NMTT ΔCPR were fasting plasma glucose 147 mg/dL and glycated hemoglobin 9.0% (fasting plasma glucose: sensitivity 0.64, specificity 0.76, area under the curve 0.73; glycated hemoglobin: sensitivity 0.56, specificity 0.71, area under the curve 0.66). Conclusions: The NMTT is a reliable insulin secretion test in patients with type 2 diabetes, except for those in a hyperglycemic state.
Publisher
WILEY
Content Type
Journal Article
Link
ISSN
20401116
EISSN
20401124
Journal Title
JOURNAL OF DIABETES INVESTIGATION
Current Journal Title
JOURNAL OF DIABETES INVESTIGATION
Volume
9
Issue
2
Start Page
274
End Page
278
Published Date
2018-03
Publisher-DOI
Text Version
Publisher
Rights
(C) 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd J Diabetes Investig Vol. No 2017 This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Citation
Fujioka Youhei, Okura Tsuyoshi, Sumi Keisuke, et al. Normal meal tolerance test is preferable to the glucagon stimulation test in patients with type 2 diabetes that are not in a hyperglycemic state: Comparison with the change of C-peptide immunoreactivity. JOURNAL OF DIABETES INVESTIGATION. 2018. 9(2). 274-278. doi:10.1111/jdi.12692
Department
Faculty of Medicine/Graduate School of Medical Sciences/University Hospital
Language
English
Web of Science Key ut
WOS:000426626900008