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The oral disposition index is a strong predictor of incident diabetes in Asian Indian prediabetic men

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Abstract

Aims

In this analysis, we sought to examine the prospective association of the disposition index (DIo) derived from oral glucose tolerance test with incident diabetes in Asian Indian men with impaired glucose tolerance (IGT).

Methods

These post hoc analyses used data from a 2-year prospective study in primary prevention of diabetes using lifestyle intervention among 517 men with IGT. All the participants received standard lifestyle advice at baseline. The surrogate insulin sensitivity and insulin secretion measures were tested for their hyperbolic relationship. Predictive associations of various surrogate measures with incident diabetes were determined using receiver operating characteristic curves.

Results

The combination of total area under the curve of insulin-to-glucose ratio (AUCinsulin/glucose) and Matsuda’s insulin sensitivity index was the best equation to depict DIo [β: −0.954 (95 % CI −1.015 to −0.893)] compared to other measures tested in this cohort. There was an inverse association between change in DIo at the final follow-up and development of incident diabetes. Among the surrogate insulin measures studied, DIo [AUC (0.717 (95 % CI 0.675–0.756))] as a composite measure was superior than other surrogate indices.

Conclusions

Among the surrogate indices studied, DIo was the best measure associated with incident diabetes.

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Abbreviations

ANOVA:

Analysis of variance

AUC:

Area under the curve

BMI:

Body mass index

HOMA-IR:

Homeostasis model assessment-estimated insulin resistance

IVGTT:

Intravenous glucose tolerance test

IGT:

Impaired glucose tolerance

NGT:

Normoglycemia

OGTT:

Oral glucose tolerance test

SMS:

Short message service

T2DM:

Type 2 diabetes

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Acknowledgments

This trial was funded by the UK India Education and Research Initiative (Grant No. IND/CONT/06-07/187E) and partly by the World Diabetes Foundation (WDF 08–406). We thank the epidemiology team of the India Diabetes Research Foundation—Mary Simon, C K Sathish Kumar, and K Tamilselvan; L Vijaya for secretarial and statistical assistance.

Conflict of interest

DGJ is supported by the UK National Institute for Health Research (NIHR). Imperial College, London, is grateful for support from the NIHR Collaboration for Leadership in Applied Health Research and Care and the Imperial NIHR Biomedical Research Centre. We declare that we have no conflicts of interest.

Ethical standard

This study was approved by the Institutional Ethics Committee of the India Diabetes Research Foundation, Chennai, India [Dated 6th July 2007].

Human and animal rights disclosure

All human rights were observed in keeping with Declaration of Helsinki 2008 (ICH GCP) and the Indian Council of Medical Research (ICMR) guidelines. There are no animal rights issues as this is a clinical study.

Informed consent disclosure

Written informed consent was obtained from all participants before being included in the study.

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Correspondence to Ambady Ramachandran.

Additional information

Managed by Massimo Federici.

Electronic supplementary material

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592_2015_718_MOESM1_ESM.tif

Estimated regression coefficient (β) and 95 % CI for β, for combinations of insulin secretion, and sensitivity measures regressed using the following model: log(secretion measure) = constant + β × log(sensitivity measure); O: NGT: Y = -0.946*X + 5.079; □: IGT: Y = -1.000*X + 5.028; ∆: DM: Y = -1.063*X + 4.868; Slopes are not statistically different between the group, whereas there was a significant difference in the intercept. Thus, there is no heterogeneity between the groups at baseline. The overall equation was Y = -0.954*X + 4.982 (TIFF 137 kb)

Supplementary material 2 (DOCX 12 kb)

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Ram, J., Snehalatha, C., Selvam, S. et al. The oral disposition index is a strong predictor of incident diabetes in Asian Indian prediabetic men. Acta Diabetol 52, 733–741 (2015). https://doi.org/10.1007/s00592-015-0718-z

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  • DOI: https://doi.org/10.1007/s00592-015-0718-z

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