title: Clinical characteristics of people experiencing biochemical hypoglycaemia during an oral glucose tolerance test: cross-sectional analyses from a UK multi-ethnic population.
abstract: OBJECTIVE
  People who experience biochemical hypoglycaemia during an oral glucose tolerance test (OGTT) may be insulin resistant, but this has not been investigated robustly, therefore we examined this in a population-based multi-ethnic UK study.
  
  
  METHODS
  Cross-sectional data from 6478 diabetes-free participants (849 with fasting insulin data available) who had an OGTT in the ADDITION-Leicester screening study (2005-2009) were analysed. People with biochemical hypoglycaemia (2-h glucose <3.3mmol/l) were compared with people with normal glucose tolerance (NGT) or impaired glucose regulation (IGR) using regression methods.
  
  
  RESULTS
  359 participants (5.5%) had biochemical hypoglycaemia, 1079 (16.7%) IGR and 5040 (77.8%) NGT. Biochemical hypoglycaemia was associated with younger age (P<0.01), white European ethnicity (P<0.001), higher HDL cholesterol (P<0.01), higher insulin sensitivity (P<0.05), and lower body mass index (P<0.001), blood pressure (P<0.01), fasting glucose (P<0.001), HbA1C (P<0.01), and triglycerides (P<0.01) compared with NGT and IGR separately in both unadjusted and adjusted (age, sex, ethnicity, body mass index, smoking status) models.
  
  
  CONCLUSIONS
  Biochemical hypoglycaemia during an OGTT in the absence of diabetes or IGR was not associated with insulin resistance, but instead appeared to be associated with more favourable glycaemic risk profiles than IGR and NGT. Thus, clinicians may not need to intervene due to biochemical hypoglycaemia on a 2-h OGTT.
authors.affiliation: University of Leicester, Diabetes Research Centre, UK.
authors.forename: S
authors.initials: S
authors.lastname: Parekh
authors.affiliation: University of Leicester, Diabetes Research Centre, UK; University of Leicester, Leicester Clinical Trials Unit, UK. Electronic address: dhm6@le.ac.uk.
authors.forename: D H
authors.initials: DH
authors.lastname: Bodicoat
authors.affiliation: University of Leicester, Leicester Clinical Trials Unit, UK; Department of Diabetes Research, University Hospitals of Leicester, NHS Trust, UK.
authors.forename: E
authors.initials: E
authors.lastname: Brady
authors.affiliation: University of Leicester, Diabetes Research Centre, UK; University of Leicester, Leicester Clinical Trials Unit, UK.
authors.forename: D
authors.initials: D
authors.lastname: Webb
authors.affiliation: University of Leicester, Diabetes Research Centre, UK; Department of Diabetes and Endocrinology, University Hospitals of Leicester, NHS Trust, UK.
authors.forename: H
authors.initials: H
authors.lastname: Mani
authors.affiliation: University of Leicester, Diabetes Research Centre, UK.
authors.forename: S
authors.initials: S
authors.lastname: Mostafa
authors.affiliation: Department of Diabetes Research, University Hospitals of Leicester, NHS Trust, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Levy
authors.affiliation: University of Leicester, Diabetes Research Centre, UK; University of Leicester, Leicester Clinical Trials Unit, UK.
authors.forename: K
authors.initials: K
authors.lastname: Khunti
authors.affiliation: University of Leicester, Diabetes Research Centre, UK; University of Leicester, Leicester Clinical Trials Unit, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Davies
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000208:ethnology / Q000503:physiopathology*; D005215:Fasting; D005260:Female; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006801:Humans; D006946:Hyperinsulinism; D007003:Hypoglycemia / Q000097:blood / Q000208:ethnology / Q000503:physiopathology*; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D006113:United Kingdom / Q000208:ethnology
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Diabetes screening; Hypoglycaemia; Insulin resistance; Insulin sensitivity