Correlation of Glycosylated Hemoglobin And Oral Glucose Tolerance Test Results In Hyperinsulinemic Pre-Impaired Glucose Tolerance State Versus Normoinsulinemic-Normal OGTT
Pilar D. Torres-Salvador, Gelinemae G. Malaza, Leilani B. Mercado-Asis
Apr 2018 DOI 10.35460/2546-1621.2017-0042 Access

Abstract
Background: Prediabetes is an intermediate stage prior to development of diabetes mellitus. Pre-impaired glucose tolerance state represents an early stage in the pathogenesis of diabetes wherein the normal glucose is attained by compensated hyperinsulinemia. Glycosylated hemoglobin is used in diagnosis and monitoring of diabetes but has not been explored in pre-IGT state. The objective of this study is to compare the 2-hour blood glucose, 2-hour insulin level, and HbA1c between normoinsulinemic-normal OGTT and pre-IGT groups.
Methods: Conducted at University of Santo Tomas Hospital, this was a retrospective analytical study of high-risk individuals for evaluation of type 2 diabetes from 2000-2011 and underwent 75-gm OGTT with 2-hour blood sugar and insulin determinations. The 2-hour glucose, insulin level and HbA1c in normoinsulinemic-normal OGTT were compared with the pre-IGT group using t-test. Correlation between the 2-hour blood glucose and insulin level with the HbA1c was done using Pearson correlation analysis. Statistical significance was considered for p-value of <0.05.
Results: Second-hour blood glucose and insulin levels were significantly higher in the pre-IGT group as compared to the normoinsulinemic-normal OGTT group (128.60±18 and 89.29±68.82 vs. 90.68±26 and 17.40±8.15). The HbA1c of the pre-IGT group was significantly higher than the normoinsulinemic-normal OGTT group (6.09±0.55 vs. 5.15±0.25, p-value <0.001). There was weak positive correlation between the HbA1c and 2-hour blood glucose levels between the two groups but not with the insulin levels.
Conclusion: The pre-IGT groups have significantly higher 2nd hour blood sugar, insulin and HbA1c levels. This suggests that indeed the metabolic abnormality must be addressed as early as the pre-IGT stage.
Keywords: prediabetes; HbA1C; hyperinsulinemia; normoinsulinemic
- De Groot L, Jameson JL. Endocrinology. 6th ed. W.B. Saunders, Philadelphia, Pennsylvania. 2010. Chapter 41, Type 2 Diabetes Mellitus: Etiology, Pathogenesis and Natural History; p. 767.
- Gardner D, Shoback D. Greenspan’s Basic and Clinical Endocrinology. 9th ed. McGraw Companies, Inc, USA. 2007. Chapter 17, Pancreatic hormones and Diabetes Mellitus; p. 577.
- Matawaran B, Mercado-Asis L. Comparison of pancreatic insulin response to hyperglycemia among filipino subjects of various glycemic status. Phil J Int Med. 2009; 47: 25-30.
- American Diabetes Association. Standards of medical care in diabetes-2016. Diabetes Care 2016; 39 (Supplement 1): S13-S22.
- Gerstein HC, Santaguida P, Raina P, Morrison KM, Balion C, Hunt D, et al. Annual incidence and relative risk of diabetes in people with various categories of dysglycemia: a systematic overview and meta-analysis of prospective studies. Diabetes Res Clin Pract 2007; 78: 305–312.
- Vasic D, Walcher D. Proinflammatory effects of C-peptide in different tissues. Int J Inflam. 2012; 2012:932725.
- Marx N, Walcher D, Raichle C, Aleksic M, Bach H, Grub M, et al. C-peptide colocalizes with macrophages in early arteriosclerotic lesions of diabetic subjects and induces monocyte chemotaxis in vitro. Arterioscler Thromb Vasc Biol. 2004; 24: 540–545.
- Walcher D, Babiak C, Poletek P, Rosenkranz S, Bach H, Betz S, et al. C-peptide induces vascular smooth muscle cell proliferation: involvement of Src-kinase, phosphatidylinositol 3-kinase, and extracellular signal regulated kinase ½. Circ Res 2006; 99: 1181–1187.
- Bahar A, Makhlough A, Yousefi A, et al. Correlation between prediabetes conditions and microalbuminuria. Nephrourol Mon. 2013; 5(2): 741-744.
- Chen X, Zhao Y, Zhou Z, eZhang X, Li Q, Bai L, et al. Prevalence and risk factors of diabetic retinopathy in Chongqing pre-diabetes patients. Eye (Lond). 2012; 26(6): 816-820.
- Kernan WN, Viscoli CM, Furie KL, Young LH, Inzucchi SE, Gorman M, et al. Pioglitazone after ischemic stroke or transient ischemic attack. N Engl J Med 2016; 374(14): 1321-1331.
- Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393-403.
Conflict of Interest
There is no potential conflict of interest of authors relevant to this article.
Articles related to the one you are viewing
There are currently no results to show, please try again later
CC BY:
Open Access Creative Commons Attribution 4.0 International
License, which permits use, sharing, adaptation, distribution and
reproduction in any medium or format, as long as you give
appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if
changes were made. The images or other third party material in
this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.
If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this
license, visit http://creativecommons.org/licenses/by/4.0/