Development of cookie test for the simultaneous determination of glucose intolerance, hyperinsulinemia, insulin resistance and postprandial dyslipidemia.
A new cookie test was developed for the simultaneous evaluation of multiple risk factors such as glucose intolerance, hyperinsulinemia, insulin resistance and postprandial dyslipidemia. The cookie consisting of 75 g carbohydrate and 25 g fat is ingested and the blood samples are obtained at 0, 1 and 2 hours later. When the two carbohydrate sources, liquid glucose and test cookie, were compared as a glucose load within 3 months, the 2 hr plasma glucose levels were not statistically different, proposing the use of the same criteria at 2 hour glucose level for the diagnosis of diabetes and impaired glucose tolerance (IGT) in subjects without exocrine pancreatic dysfunction. In addition, hyperinsulinemia, insulin resistance (AUC insulin, and/or AUC insulin X AUC glucose), and postprandial hyperlipidemia (DeltaTG, Triglyceride; DeltaRLP, remnant like particles) have been simultaneously uncovered. Reactive hypoglycemia with adverse epigastric discomfort was observed in 26.3% of the control subjects with liquid glucose, while it was observed in only 1 case (5.3%) without any symptom with cookie tests. In fact, one reactive hypoglycemia out of 5 with liquid glucose turned out to be IGT with cookie test. In 64 subjects with lifestyle-related diseases, cookie test revealed hyperinsulinemia and insulin resistance in 56% respectively, postprandial hyperlipidemia in 39%, diabetes and IGT in 22-23% of each of the subjects and all showed at least one abnormal value. In contrast, in university students with exercise habit, all showed normal results with cookie test. In addition, improved insulin sensitivity over non-exercise group was obverved. In summary, the cookie test provided more informations compared with OGTT using liquid glucose and with fewer side effects. Simultaneous evaluation of glucose intolerance, hyperinsulinemia, insulin resistance, and postprandial hyperlipidemia was also possible.
Harano
Yutaka
Y
Niseikai Center for Lifestyle-Related Diseases, Mino City, Osaka, Japan.
Miyawaki
Takeshi
T
Nabiki
Junko
J
Shibachi
Miki
M
Adachi
Tomomi
T
Ikeda
Michiko
M
Ueda
Fukuhiro
F
Nakano
Takamitsu
T
D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000175:diagnosis; D050171:Dyslipidemias / Q000097:blood*; D015444:Exercise; D005260:Female; D018149:Glucose Intolerance / Q000097:blood*; D044882:Glucose Metabolism Disorders / Q000175:diagnosis; D005951:Glucose Tolerance Test / Q000379:methods*; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008019:Life Style; D008297:Male; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D019518:Postprandial Period; D013223:Statistics as Topic
D001786:Blood Glucose; D007328:Insulin; D004364:Pharmaceutical Preparations