Variation of postprandial plasma glucose, palatability, and symptoms associated with a standardized mixed test meal versus 75 g oral glucose.
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.


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 x 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 x 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% less than 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.
Wolever
T M
TM
Department of Nutritional Sciences, Univeristy of Toronto, Ontario, Canada. thomas.wolever@utoronto.ca
Chiasson
J L
JL
Csima
A
A
Hunt
J A
JA
Palmason
C
C
Ross
S A
SA
Ryan
E A
EA
D000284:Administration, Oral; D000328:Adult; D001786:Blood Glucose / Q000032:analysis* / Q000187:drug effects / Q000378:metabolism; D003920:Diabetes Mellitus / Q000097:blood / Q000178:diet therapy; D003927:Diet, Diabetic; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004244:Dizziness / Q000139:chemically induced; D004305:Dose-Response Relationship, Drug; D005260:Female; D005518:Food Preferences / Q000187:drug effects; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D005947:Glucose / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D018149:Glucose Intolerance / Q000097:blood; D005951:Glucose Tolerance Test; D006261:Headache / Q000139:chemically induced; D006801:Humans; D006815:Hunger / Q000187:drug effects; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood; D015588:Observer Variation; D019518:Postprandial Period; D012016:Reference Values; D011795:Surveys and Questionnaires; D013649:Taste; D013997:Time Factors
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D007328:Insulin; D005947:Glucose