1.A systematic review of the accuracy of Insulin and C-peptide secretion ratios during the oral glucose tolerance test to diagnose insulinoma
Fransiskus Mikael Chandra ; Dicky Tahapary
Journal of the ASEAN Federation of Endocrine Societies 2024;39(1):79-83
Background:
Insulinoma is one of the causes of recurrent hypoglycemia, one of the chief complaints for emergency department admission. The gold standard in diagnosing insulinoma is a 72-hour fasting test which is inconvenient and inefficient as it requires hospitalization. Research has found that measurement of insulin and C-peptide during OGTT may help diagnose insulinoma. We aimed to assess the diagnostic value of OGTT in diagnosing insulinoma.
Methodology:
The literature search was conducted on 19 August 2022 using several databases (MEDLINE, Scopus, Embase, and ScienceDirect). All studies that measured OGTT as diagnostic tools in diagnosing insulinoma and 72-hour fasting test as reference standard were included. The quality assessment of the selected studies was based on the Centre of Evidence-Based Medicine University of Oxford and the Quality Assessment of Diagnostic Accuracy-2 tool (QUADAS-2). Analysis of the included studies was performed qualitatively. This study was registered on PROSPERO (CRD42022360205).
Results:
A total of two case-control studies (106 patients) were included, which were at risk of bias and low concern of applicability. Both studies demonstrated that the combination of insulin and C-peptide levels measured during OGTT had high specificity, sensitivity, positive predictive value, and negative predictive value in diagnosing insulinoma compared to the reference standard. A logistic regression model of 8.305 – (0.441 × insulin 2-h/0-h) – (1.679 × C-peptide 1-h/0-h) > 0.351 has the highest diagnostic value in one study (AUC 0.97, Sensitivity 86.5%, Specificity 95.2%, PPV 94.1, NPV 88.9).
Conclusion
The measurement of 0-h and 2-h insulin and C-peptide levels during 2-h OGTT was found in two small case-control studies with a total of 106 patients to have good sensitivity and specificity. However, due to these limitations, future research is still needed to validate the potential use of OGTT for the diagnosis of insulinoma.
Insulinoma
;
Glucose Tolerance Test
2.To evaluate the hypoglycemic effect of smilax glabra-roxb per oral route in the mice and its influence on the glucose tolerance test
Journal of Medical Research 2003;24(4):20-24
Cryophylisat powder of ethanolic fluid extract of Smilax glabra (SG) was administered orally on mouse with a single dose of 1g/kg of body mass. Hypoglycemic effect exerted with 10.58% approximatively. Continous use of 7 days of this dose increased the hypoglycemic action. Oral SG effects manifested lately with less level than injectable SG. Apart from the increase of synthetization capacity of glycogene, SG promote the sensitivity of the tissues to insuline.
Glucose Tolerance Test
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Hypoglycemic Agents
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mice
3.Association of gestational diabetes mellitus diagnosed using the IADPSG and the POGS 75 gram Oral Glucose Tolerance Test Cut-off Values with Adverse Perinatal outcomes in the Philippine General Hospital
Hannah Urbanozo ; Iris Thiele Isip-Tan
Journal of the ASEAN Federation of Endocrine Societies 2014;29(2):157-162
Objective:
To determine the association of adverse perinatal outcomes among women with gestational diabetes mellitus (GDM) according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) and the Philippine Obstetrical and Gynecological Society (POGS) diagnostic cut-offs for 75 g oral glucose tolerance test (OGTT).
Methodology:
A review of deliveries from September to December 2013 at the charity services of the Philippine General Hospital (PGH) looking at 75 g OGTT results and perinatal outcomes was done. The association between GDM and perinatal outcomes were estimated and tested using logistic regression analysis. The diagnostic accuracy between the POGS and the IADPSG criteria was tested by comparing their areas under the curve (AUC).
Results:
A total of 236 deliveries were included. The GDM group had a significantly increased risk for primary Caesarean section (CS) (OR=1.79, 95% CI: 1.02-3.16, p=0.041) and infant admission to the Neonatal Intensive Care Unit (NICU) (OR=2.66, 95% CI: 1.3-5.44, p=0.007). Per category of glycemia, a 1-hour OGTT value >180 mg/dL was associated with an increased risk for primary CS (OR=1.968, 95% CI: 1.08-3.55); a fasting blood sugar (FBS) >92 mg/dL with increased risk for large for gestational age (LGA) infants (OR=20.97, 95% CI 2.27-192.97); and elevated FBS, 1-hour and 2-hour OGTT blood glucose values with increased risk for infant admission to the NICU (OR=2.18, OR=2.39, OR=2.34, respectively). There was no significant difference in outcomes between women diagnosed using the IADPSG and POGS criteria (n=104) and those diagnosed with the IADPSG criteria only (n=90).
Conclusion
The currently used cut-off values in diagnosing GDM was associated with increased risk for primary CS and infant admission to NICU. No significant difference in outcomes was found between the group of women that included those diagnosed with the more stringent POGS criteria from the group that excluded them, implying adequacy of the IADPSG thresholds for local use.
Diabetes, Gestational
;
Pregnancy Outcome
;
Glucose Tolerance Test
4.Normal Glucose Tolerance with a High 1-Hour Postload Plasma Glucose Level Exhibits Decreased beta-Cell Function Similar to Impaired Glucose Tolerance.
Tae Jung OH ; Se Hee MIN ; Chang Ho AHN ; Eun Ky KIM ; Soo Heon KWAK ; Hye Seung JUNG ; Kyong Soo PARK ; Young Min CHO
Diabetes & Metabolism Journal 2015;39(2):147-153
BACKGROUND: Subjects with normal glucose tolerance (NGT) who have a high 1-hour postload plasma glucose level (> or =155 mg/dL; NGT 1 hour-high) have been shown to be at higher risk for type 2 diabetes than subjects with NGT 1 hour-low postload plasma glucose level (<155 mg/dL). We compared beta-cell function in subjects with NGT 1 hour-high, NGT 1 hour-low, and impaired glucose tolerance (IGT). METHODS: We classified subjects into NGT 1 hour-low (n=149), NGT 1 hour-high (n=43), and IGT (n=52). The beta-cell function was assessed based on insulinogenic index (IGI), oral disposition index (DI), and insulin secretion-sensitivity index-2 (ISSI-2). RESULTS: Insulin sensitivity was comparable between the subjects with NGT 1 hour-high and NGT 1 hour-low. The beta-cell function with/without adjusting insulin sensitivity was significantly different among the three groups. The IGI (pmol/mmol) was 116.8+/-107.3 vs. 64.8+/-47.8 vs. 65.8+/-80.6 (P=0.141), oral DI was 3.5+/-4.2 vs. 1.8+/-1.4 vs. 1.8+/-3.1 (P<0.001), and ISSI-2 was 301.2+/-113.7 vs. 213.2+/-67.3 vs. 172.5+/-87.5 (P<0.001) in NGT 1 hour-low, NGT 1 hour-high, and IGT, respectively. Post hoc analyses revealed that oral DI and ISSI-2 were significantly different between NGT 1 hour-low and NGT 1 hour-high but comparable between NGT 1 hour-high and IGT. CONCLUSION: Among Korean subjects with NGT, those who have a higher 1-hour postload glucose level have a compromised insulin-sensitivity adjusted beta-cell function to a similar degree as IGT subjects.
Blood Glucose*
;
Glucose Tolerance Test
;
Glucose*
;
Insulin
;
Insulin Resistance
5.Generalized Actinic Granuloma annulare with Impaired Glucose Tolerance Test.
Jai Il YOUN ; Ai Young LEE ; Yoo Shin LEE
Korean Journal of Dermatology 1984;22(4):449-453
We speculate that this is case of an intermediate state between granuloma annulare and actinic granuloma. This intermediate state would be a variant of granuloma annulare related to actinic damage. Therefore this case can be termed actinic granuloma annulare with generalized distribution.
Actins*
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Glucose Tolerance Test*
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Glucose*
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Granuloma Annulare*
;
Granuloma*
6.Two Cases of Pituitary Microadenomas Treated by Transsphenoidal Approach.
Tae Young KIM ; Young Woo KANG ; Tae Sung KIM ; Won LEEM ; Ok Hee KIM ; Jin Woo KIM ; Sun Woo KIM ; Young Gil CHOI
Journal of Korean Neurosurgical Society 1981;10(1):315-322
Two endocrine active pituitary microadenomas were treated by transsphenoidal microsurgery and evaluated endocrinologically by radioimmunoassay of hormones. They showed significant rise of serum human growth hormone(HGH) after thyrotrophine releasing hormone(TRH) administration and no suppression by oral glucose tolerance test(GTT) before operation. Pathologic findings are acidophilic adenomas.
Adenoma, Acidophil
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Glucose Tolerance Test
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Humans
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Microsurgery
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Radioimmunoassay
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Thyrotropin
7.Comparative Analysis of Limited Resection and Conventional Resection for Pancreatic Benign Lesions Focused on Perioperative Diabetes and Pancreatic Fistula.
Min Young CHOI ; Dong Do YOU ; Hyung Geun LEE ; Jin Seok HEO ; Seong Ho CHOI ; Dong Wook CHOI
Korean Journal of Hepato-Biliary-Pancreatic Surgery 2009;13(3):179-183
PURPOSE: Pancreaticoduodenectomy (PD) or distal pancreatectomy (DP) are treatments used for pancreatic benign neoplasms even though both of these treatments result in significant loss of normal pancreatic parenchyma; this leads to subsequent impairment of exocrine and endocrine pancreatic function. The purpose of this study is to provide short-and long-term result of limited resection (LR) in a single center. METHODS: Two-hundred thirty patients who had undergone pancreatic resection between April 1998 and September 2008 for benign neoplasms were reviewed retrospectively. DP was performed in 102 patients, LR in 77, PD in 51 patients. The definitions of the International Study Group of Pancreatic Fistula (ISGPF) were applied to postoperative pancreatic fistulas (POPF), perioperative endocrine function was evaluated through oral glucose tolerance test. RESULTS: LR includes 42 enucleation, 24 central pancreatectomy, and 11 uncinate process resection. No deaths occurred to patients during the study review period; POPF was detected in 50 patients (65%), 37 patients with grade A and 13 patients with grade B or C. POPF occurred 65% of the time after LR, more frequently compared to the occurrance after PD or DP (58%), but this was not statistically significant (P =.322). After LR, there were 2 patients with new onset diabetes (3%), while 26 (17%) patients developed diabetes after DP or PD (P = .002). CONCLUSION: LR may preserve endocrine and exocrine function. While mortality is low with the use of LR, it is associated with a higher pancreatic-leakage rate. The precise management of benign pancreatic lesions remains in evolution.
Glucose Tolerance Test
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Humans
;
Pancreatectomy
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Pancreatic Fistula
;
Pancreaticoduodenectomy
;
Retrospective Studies
8.Effect of Low Frequency Neuromuscular Electrical Stimulation on Glucose Profile of Persons with Type 2 Diabetes: A Pilot Study.
Georges JABBOUR ; Lise BELLIVEAU ; David PROBIZANSKI ; Ian NEWHOUSE ; Jim MCAULIFFE ; Jennifer JAKOBI ; Michel JOHNSON
Diabetes & Metabolism Journal 2015;39(3):264-267
The purpose of this study was to examine the effect of low-frequency neuromuscular electrical stimulation (NMES) on glucose profile in persons with type 2 diabetes mellitus (T2DM). Eight persons with T2DM (41 to 65 years) completed a glucose tolerance test with and without NMES delivered to the knee extensors for a 1-hour period at 8 Hz. Three blood samples were collected: at rest, and then 60 and 120 minutes after consumption of a glucose load on the NMES and control days. In NMES groups glucose concentrations were significantly lower (P<0.01) than in the control conditions. Moreover, a significant positive correlation (r=0.9, P<0.01) was obtained between the intensity of stimulation and changes in blood glucose. Our results suggest that low-frequency stimulation seem suitable to induce enhance glucose uptake in persons with T2DM. Moreover, the intensity of stimulation reflecting the motor contraction should be considered during NMES procedure.
Blood Glucose
;
Diabetes Mellitus, Type 2
;
Electric Stimulation*
;
Glucose Tolerance Test
;
Glucose*
;
Humans
;
Knee
;
Pilot Projects*
9.Effect of varying levels of xylobiose in sugar on glycemic index and blood glucose response in healthy adults.
Jung Sug LEE ; A Reum KIM ; Hyekyoung NAM ; Myungok KYUNG ; Sheungwoo SEO ; Moon Jeong CHANG
Journal of Nutrition and Health 2016;49(5):295-303
PURPOSE: The objective of this study was to compare the effects of three different levels of xylobiose containing sucrose on glycemic indices based on oral glucose tolerance test (OGTT) and blood glucose response in healthy adults. METHODS: Healthy adults (six male and five female participants, n = 11) underwent 14~16 hr of fasting. Subsequently, all participants took 50 g of available carbohydrates from glucose, sucrose containing 7% xylobiose (XB 7), sucrose containing 10% xylobiose (XB 10), or sucrose containing 14% xylobiose (XB 14) every week on the same day for 8 weeks. Finger prick blood was taken before and 15, 30, 45, 60, 90, and 120 min after starting to eat. RESULTS: We observed reduction of the glycemic response to sucrose containing xylobiose. The glycemic indices of XB 7, XB 10, and XB 14 were 57.0, 53.6, and 49.7, respectively. The GI values of XB 7 were similar to those of foods with medium GI, and the GI values of XB 10 and XB 14 were similar to those of foods with low GI. The postprandial maximum blood glucose rise (Cmax) of XB 14 was the lowest among the test foods. XB 7, XB 10, and XB 14 showed significantly lower areas under the glucose curve (AUC) for 0~30 min, 0~60 min, 0~90 min and 0~120 min compared to glucose. CONCLUSION: The results of this study suggest that sucrose containing xylobiose has an acute suppressive effect on GI and postprandial maximum blood glucose rise. In addition, levels of xylobiose in sugar may allow more precise assessment of carbohydrate tolerance despite lower glycemic responses in a dose-dependent manner.
Adult*
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Blood Glucose*
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Carbohydrates
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Fasting
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Female
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Fingers
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Glucose
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Glucose Tolerance Test
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Glycemic Index*
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Humans
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Male
;
Sucrose
10.Intervention of electroacupuncture for patients with impaired glucose tolerance.
Hong MENG ; Xu ZHAI ; Jin-dong HAO ; Hong-cai WANG
Chinese Acupuncture & Moxibustion 2011;31(11):971-973
OBJECTIVETo explore the regulation on 2-hour postprandial blood glucose (2h PBG) for patients with impaired glucose tolerance (IGT) in the intervention with electroacupuncture.
METHODSSixty cases of IGT were divided randomly into an electroacupuncture group and a blank control group, 30 cases in each one. In electroacupuncture group, electroacupuncture was applied to Shenshu (BL 23), Pishu (BL 20), Zusanli (ST 36) and Sanyinjiao (SP 6) in the intervention, lasting for 6 sessions. In blank control group, no any intervention was adopted. The levels of fasting blood-glucose (FBG), 2 h PBG with 75 g glucose and hemoglobin Alc (HbAlc) were observed before and after the intervention for the patients in electroacupuncture group, as well as in blank con trol group.
RESULTSThe total effective rate was 76.7% (23/30) in electroacupuncture group, which was superior to that of 16.7% (5/30) in blank control group (P < 0.01). 2h PBG [(7.08 +/- 0.74) mmol/L] and HbAlc [(5.74 +/- 0.35)%] were down-regulated significantly after the intervention with electroacupuncture of 6 sessions in electroacupuncture group. The therapeutic effects of it were superior remarkably to those [(8.93 +/- 1.87) mmol/L, (5.97 +/- 0.591)%] in blank control group, indicating statistical significant difference (P < 0.01, P < 0.05). But, there was no any impact for the patients with normal FBG.
CONCLUSIONElectroacupuncture may be the means to achieve the clinical effective intervention for the people with IGT and the approach in the prevention and treatment of diabetes at the early stage.
Adult ; Blood Glucose ; Electroacupuncture ; Female ; Glucose Intolerance ; metabolism ; therapy ; Glucose Tolerance Test ; Humans ; Male ; Middle Aged