title: Adding to the spectrum of insulin sensitive populations for mixed meal tolerance test glucose reliability assessment.
abstract: As a measure of insulin sensitivity, the mixed meal tolerance test (MMTT) is a simple technique that can provide robust results. The assay consists of examining plasma glucose, insulin and C-peptide prior to and following the consumption of a test meal. While this procedure has been used in clinical research for several years, there is no set standard protocol, and only until recently has the reliability of this assay been thoroughly evaluated in prediabetes and type 2 diabetes subjects. Interestingly, the results from this recent study demonstrated stronger MMTT reliability for the prediabetes and diabetes cohorts compared to obese controls. This finding suggests that the obese control group may have more inherent variability in glucose response during a meal challenge likely due to compensatory influences typically observed in non-diabetic insulin-resistant subjects. Furthermore, this study raises the question whether the MMTT assay is reliable in a non-obese cohort. Therefore, to promote the standardization of this technique and contribute to the band of insulin sensitive populations, we employed the same methodology and test meal as the reference study to evaluate the MMTT reliability in healthy and overweight men. Indeed, the interclass coefficient revealed high glucose response repeatability during the MMTT in insulin-sensitive men. Overall, the MMTT is a reliable test across a range of insulin sensitivity including healthy men. However, we propose further investigation may be required to fully define the utility of this methodology in obese non-diabetic insulin-resistant populations.
authors.affiliation: Celerion, 2420 W Baseline Road, Tempe, AZ 85283 USA.
authors.forename: Sabina
authors.initials: S
authors.lastname: Paglialunga
authors.affiliation: Celerion, 2420 W Baseline Road, Tempe, AZ 85283 USA ; Current Address: Clinical Trials of Texas, San Antonio, TX USA.
authors.forename: Angelica
authors.initials: A
authors.lastname: Guerrero
authors.affiliation: XOMA Corporation, Berkeley, CA USA.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Roessig
authors.affiliation: XOMA Corporation, Berkeley, CA USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Rubin
authors.affiliation: Celerion, 2420 W Baseline Road, Tempe, AZ 85283 USA ; Current Address: Umbrella Corporation, San Antonio, TX USA.
authors.forename: Clayton A
authors.initials: CA
authors.lastname: Dehn
keywords: MMTT; Postprandial glucose; Reliability