Impaired glucose balance and seven diabetes mellitus subtypes detected by intravenous glucose tolerance test

Abstract

A new clinically suitable method has been developed to calculate the rate of blood glucose elimination and hepatic glucose production (HGP) by the results of intravenous glucose tolerance test (IGTT). A subpopulation of non-diabetic persons was identified in whom substantially increased HGP is compensated for high blood glucose elimination, which prevents the development of hyperglycemia in them. This abnormality is designated impaired glucose balance and may be referred to as an early prehyperglycemic stage of diabetes (prediabetes). The results of IGTT analysis correlate with the types of diabetes mellitus and the degree of carbohydrate metabolic disturbance, which allows one to recommend the proposed method for diagnosing diabetes and its types and assessing the degree of metabolic disturbances in diabetes. Four types of glucose imbalance may be identified from the ratio of the degree of impaired HGP to glucose elimination. As a result, a combination of 2 types of diabetes mellitus and 4 types of glucose imbalance makes it possible to divide the population of diabetes mellitus into 7 subgroups (subtypes), which may be subsequently of importance in optimizing sugar-reducing therapy. A computer program has been developed, which automatically calculates the glucose kinetics in IGTT according to the tatter's results and which is free available in the Internet at www.diabet.ru/Dreval/ivgtt_eng.exe .