Glucose/Insulin Relationships in a Population Sample

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Abstract
In the course of a population survey 300 subjects underwent oral glucose tolerance tests which included estimations of plasma glucose and IRI at 0,10, 20, 30, 60, 90, and 120 min. Diabetics had significantly higher mean IRI levels than matched controls, but lower IRI/glucose ratios. Subjects who screened positive but had normal GTT had higher IRI levels than controls, and subjects with borderline GTT had the highest IRI levels of all groups and the highest IRI/glucose ratios. In all groups the IRI levels were positively correlated with weight. All groups showed a significant response of IRI at 10 min, with approximately a 100-percent rise over fasting level. Thus, although the peak level was often delayed in the diabetics, they showed no initial delay. We conclude that the earliest carbohydrate abnormality is an excessive response of insulin to glucose, while diabetes occurs with a moderate fall from this abnormally high level. Analysis of individual IRI curves showed that all types of response occurred in all groups–we could not say that any response was ‘typical’ of diabetes. In general the pattern of IRI response followed that of the glucose curve closely. We present evidence that ‘lag storage curves’ should include only those with glucose peaks at 30 min or earl·’er, and are to be distinguished from ‘borderline’ curves, with 60 or 90-min peak levels.

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