Assessment of postprandial glucose: relationship between a standardised continental breakfast and the oral glucose tolerance test

Abstract

Background

To determine the relationship between postprandial glucose(PPG) and insulin values after an oral glucose tolerance test (OGTT) and a standardised continental breakfast.

Methods

An open, single-centre, randomised, crossover study in 32 fasted patients with type 2 diabetes and 10 healthy volunteers. Plasma glucose and insulin concentrations following a standardised breakfast challenge and a 75 g OGTT were measured over two hours.

Results

In both groups, the standardised breakfast induced similar plasma glucose and insulin profiles to the OGTT. Mean PPG excursions at each time-point were 1—2 mmol/L greater following the OGTT than the breakfast. Two-hour OGTT glucose levels correlated highly (r ≥ 0.80) with those following the breakfast at all time-points between 0.5—2 hours.

Conclusion

Plasma glucose levels measured 0.5—2 hours following a standardised breakfast are useful for assessing postprandial hyperglycaemia for diagnostic or post-treatment evaluations.

Keywords

OGTT standardised breakfast challenge post-prandial glucose evaluation.

Get full access to this article

View all access options for this article.

References

Stolk RP , Orchard TJ , Grobbee DE

Why use the oral glucose tolerance test?

Diabetes Care 1995;18:1045-9.

Ko GT , Chan JC , Woo J. et al. The reproducibility and usefulness of the oral glucose tolerance test in screening for diabetes and other cardiovascular risk factors. Ann Clin Biochem 1998;35:62-7.

Mooy JM , Grootenhuis PA , de Vries H. et al. Intra-individual variation of glucose, specific insulin and proinsulin concentrations measured by two oral glucose tolerance tests in a general Caucasian population: the Hoorn Study. Diabetologia 1996;39:298-305.

World Medical Declaration of Helsinki : Developed by the World Medical Association, revised October 2000. Available at http://www.wma.net. Accessed June 27, 2002.

The DECODE study group on behalf of the European Diabetes Epidemiology Group. Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria. Ann Intern Med 2001;161:197-204.

The DECODE study group on behalf of the European Diabetes Epidemiology Group. Glucose tolerance and mortality: comparison of WHO and American Diabetic Association diagnostic criteria. Lancet 1999;354:617-21.

Saydah SH , Varas C. , Miret M. , Gause D. , Sung J. , Brancati FL Postchallenge hyperglycemia and mortality in a national sample of U.S. adults . Diabetes Care 2001;24:1397-402.

Shankar RR , Kirkman SM , Baron AD The adequacy of current diagnostic criteria for diabetes. Curr Opin Endocrinol Diabetes 2001;8:88-94.

Smith NL , Barzilay JI , Shaffer D. et al. Fasting and 2-hour postchallenge serum glucose measures and risk of incident cardiovascular events in the elderly: the Cardiovascular Health Study. Arch Intern Med 2002;162:209-16.

10.

Davidson J. Should postprandial glucose be measured and treated to a particular target? Yes. Diabetes Care 2003;26:1919-21.

11.

Marena S. , Montegrosso G. , De Michieli F. , Pisu E. , Pagano G. Comparison of the metabolic effects of mixed meal and standard oral glucose tolerance test on glucose, insulin and C-peptide response in healthy, impaired glucose tolerance, mild and severe non-insulin-dependent diabetic subjects . Acta Diabetol 1992;29:29-33.

12.

Wolever TM , Chiasson JL , Csima A. et al. Variation of post-prandial plasma glucose, palatability, and symptoms associated with a standardized mixed meal test versus 75 g oral glucose . Diabetes Care 1998;21:336-40.

13.

Wolever TM , Vuksan V. , Palmason C. Less variation of post-prandial blood glucose after starchy test meals than oral glucose. Nutr Res 1996;16:899-905.

14.

Gannon MC , Neil BL , Wesphal SA , Nuttal FQ The insulin and glucose responses to meals of glucose proteins in type II diabetes subjects. Diabetes 1985;36(suppl 1):12.

15.

Curry DL , Curry KP , Gomez M. Fructose potentiation of insulin secretion. Endocrinology 1972;91:1493-8.

16.

Frape DL , Williams NR , Scriven AJ , Palmer CR , O'Sullivan K. , Fletcher RJ Diurnal trends in responses of blood plasma concentrations of glucose, insulin, and C-peptide following high- and low-fat meals and their relation to fat metabolism in healthy middle-aged volunteers. Br J Nutr 1997;77:523-35.

17.

Collins PJ , Horowitz M. , Cook DJ , Harding PE , Shearman DJC. Gastric emptying in normal subjects: a reproducible technique using a single scintillation camera and computer system. Gut 1983;24:1117-25.

18.

White CM , Poxon V. , Alexander-Williams J. Effects of nutrient liquids on human gastroduodenal motor activity . Gut 1983;24:1109-16.

19.

Bijlani RL , Narain JP , Shukla K. , Kochhar KP Poor reliability of the first meal tolerance test. Indian J Physiol Pharmacol 1992;36:267-9.