Determining a Diagnostic Algorithm for Hyperinsulinaemia

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aut.relation.issue1en_NZ
aut.relation.journalJournal of Insulin Resistanceen_NZ
aut.relation.volume4en_NZ
aut.researcherCrofts, Catherine
dc.contributor.authorCrofts, CAPen_NZ
dc.contributor.authorSchofield, Gen_NZ
dc.contributor.authorWheldon, MCen_NZ
dc.contributor.authorZinn, Cen_NZ
dc.contributor.authorKraft, JRen_NZ
dc.date.accessioned2019-08-01T00:23:07Z
dc.date.available2019-08-01T00:23:07Z
dc.description.abstractBackground: Ascertaining Kraft dynamic insulin response patterns following a 3-h 100 g oral glucose tolerance test seems to be the most reliable method for diagnosing hyperinsulinaemia. However, this test may be too resource-intensive for standard clinical use. Aim: This study aims to see if Kraft patterns can be accurately predicted using fewer blood samples with sensitivity and specificity analyses. Setting: St Joseph Hospital, Chicago, Illinois, United States and Human Potential Centre, Auckland University of technology, Auckland, New Zealand. Method: We analysed the results of 4185 men and women with a normal glucose tolerance, who had a 100 g oral glucose tolerance test with Kraft pattern analysis. Participants were dichotomised into normal–low insulin tolerance (Kraft I or V patterns) or hyperinsulinaemia (Kraft IIA–IV patterns). Sensitivity and specificity analysis was applied to available variables (including age, body mass index, fasting insulin or glucose) both individually and in combination. Results: Out of a maximal combined sensitivity and specificity score of 2.0, 2-h insulin level > 45 µU/mL attained the highest score (1.80). Two-hour insulin also attained the highest sensitivity (> 30 µU/mL, 0.98) and the highest specificity (> 50 µU/mL, 0.99) scores. Combining the 2-h insulin with other variables reduced the sensitivity and/or specificity. Dynamic measures had a better combined sensitivity and specificity compared to fasting or anthropological measures. Conclusion: People with a 2-h plasma insulin level < 30 µU/mL are unlikely to be hyperinsulinaemic. Given that first-line treatment is lifestyle modification, we recommend that a 2-h plasma insulin level > 30 µU/mL following a 100 g oral glucose tolerance test be used to identify the hyperinsulinaemic individual.
dc.identifier.citationJournal of Insulin Resistance, 4(1), 7 pages. doi:https://doi.org/10.4102/jir.v4i1.49
dc.identifier.doi10.4102/jir.v4i1.49en_NZ
dc.identifier.issn2412-2785en_NZ
dc.identifier.issn2519-7533en_NZ
dc.identifier.urihttps://hdl.handle.net/10292/12708
dc.languageenen_NZ
dc.publisherAOSISen_NZ
dc.relation.urihttps://insulinresistance.org/index.php/jir/article/view/49
dc.rightsAll articles published in this journal are licensed under the Creative Commons Attribution 4.0 International (CC BY 4.0) license, unless otherwise stated. Website design & content: ©2019 AOSIS (Pty) Ltd. All rights reserved. No unauthorised duplication allowed.
dc.rights.accessrightsOpenAccessen_NZ
dc.subjectType 2 diabetes; Insulin resistance; Hyperinsulinaemia; Kraft patterns; Insulin response patterns; Diagnosis
dc.titleDetermining a Diagnostic Algorithm for Hyperinsulinaemiaen_NZ
dc.typeJournal Article
pubs.elements-id362342
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Health & Environmental Science
pubs.organisational-data/AUT/Health & Environmental Science/Interprofessional Health
pubs.organisational-data/AUT/PBRF
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences/HI Interprofessional 2018 PBRF
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