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Horm Metab Res 2006; 38(8): 536-542
DOI: 10.1055/s-2006-949526
Original Clinical

© Georg Thieme Verlag KG Stuttgart · New York

Reproducibility of a Glycemic Response to Mixed Meals in Type 2 Diabetes Mellitus

D. J. Brillon 1 , C. P. Sison 2 , A. D. Salbe 1 , 3 , L. Poretsky 1 , 4
  • 1Division of Endocrinology, Department of Medicine, The New York Presbyterian Hospital and Weill Medical College of Cornell University, New York, New York 10021, USA
  • 2North Shore-Long Island Jewish Institute for Medical Research, Biostatistics Unit, Manhasset, New York 11030, USA
  • 3National Institutes of Health/National Institute of Diabetes, Digestive and Kidney Disease, Clinical Diabetes and Nutrition Section, Phoenix, Arizona 85016, USA
  • 4Division of Endocrinology and Metabolism, Department of Medicine, Beth Israel Medical Center and Albert Einstein College of Medicine, New York, New York 10003, USA
Further Information

Publication History

Received 17 October 2005

Accepted after revision 17 January 2006

Publication Date:
29 August 2006 (online)

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Abstract

Objective: To evaluate the inter-patient and intra-patient reproducibility of the glycemic response to a mixed meal in individuals with type 2 diabetes mellitus (DM). Subjects/Setting: Six individuals with DM were admitted to the General Clinical Research Center for 6 days. Intervention: Subjects consumed 3 different meal plans consisting of 4 meals daily (breakfast, lunch, dinner and snack) on 2 separate occasions. Serum insulin and glucose levels were sampled at 19 time points every day. The glycemic response (GR) to a meal was calculated as the area under the glucose response curve after consumption of a given meal. In addition, the incremental area under the curve (IGR) was calculated assuming a pre-prandial (baseline) glucose value before each meal as zero. Results: Intra-patient correlation coefficients (R) of GR for meals in subjects with DM were quite good, ranging 0.69-0.94. The range of the inter-patient coefficients of variation (CV) for the same meals was 21.5-30.4%. For IGR, the R values ranged from 0.64 to 0.91 for 8 out of 12 meals, confirming good intra-patient reproducibility for these meals. CV for IGR ranged from 31% to 113%. Conclusions: For patients with DM, the GR of individual meals exhibits excellent intra-patient reproducibility, allowing prediction of the glycemic response to a given meal in an individual subject. However, significant inter-patient variability of the GR precludes its use for the prediction of post-prandial glucose concentrations in groups of patients with diabetes.

Key words

Diabetes - mixed meal - glycemic response - glycemic index - glucose levels

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Correspondence

Leonid PoretskyM.D. 

Beth Israel Medical Center

317 East 17th Street·Fierman Hall, 7th Floor·New York·NY 10003·USA

Phone: +1/212 420 46 66

Fax: +1/212 420 22 24

Email: lporetsk@bethisraelny.org

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