Publication
Title
The ¹³C glucose breath test accurately identifies insulin resistance in people with type 1 diabetes
Author
Abstract
Objective This study investigated whether the delta-over-baseline of exhaled (CO2)-C-13 (Delta(CO2)-C-13), generated from a C-13 glucose breath test (13C-GBT), measured insulin resistance (IR) in people with type 1 diabetes, using the hyperinsulinemic-euglycemic clamp (HEC) as a reference method. The secondary objective was to compare the 13C-GBT with the estimated glucose disposal rate (eGDR). Methods A 40 mU/m(2)/min HEC and 2 separate 13C-GBTs (euglycemic with insulin bolus and hyperglycemic without bolus) were consecutively performed in 44 adults with type 1 diabetes with varying body compositions. eGDR was calculated based on hemoglobin A1c (HbA1c), presence of hypertension, and waist circumference. Results The mean glucose disposal rate (M-value) was 5.9 +/- 3.1 mg/kg/min and mean euglycemic Delta(CO2)-C-13 was 6.4 +/- 2.1 delta parts per thousand, while median eGDR was 5.9 [4.3-9.8] mg/kg/min. The hyperglycemic Delta(CO2)-C-13 did not correlate with the M-value, while the euglycemic Delta(CO2)-C-13 and the M-value correlated strongly (r = 0.74, P < .001). The correlation between M-value and eGDR was more moderate (Spearman's rho = 0.63, P < .001). Linear regression showed an association between Delta(CO2)-C-13 and M-value, adjusted for age, sex, and HbA1c ]adjusted R-2 = 0.52, B = 1.16, 95% confidence interval (CI) .80-1.52, P < .001]. The area under the receiver-operator characteristics curve for Delta(CO2)-C-13 to identify subjects with IR (M-value < 4.9 mg/kg/min) was 0.81 (95% CI .68-.94, P < .001). The optimal cut-off for Delta(CO2)-C-13 to identify subjects with IR was <= 5.8 delta parts per thousand. Conclusion Under euglycemic conditions, the 13C-GBT accurately identified individuals with type 1 diabetes and concurrent IR, suggesting its potential as a valuable noninvasive index.
Language
English
Source (journal)
The journal of clinical endocrinology and metabolism. - Baltimore, Md
Publication
Washington : Endocrine soc , 2024
ISSN
0021-972X
DOI
10.1210/CLINEM/DGAE175
Volume/pages
(2024) , p. 1-11
ISI
001193732200001
Pubmed ID
38487831
Full text (Publisher's DOI)
Full text (publisher's version - intranet only)
UAntwerpen
Faculty/Department
Research group
Project info
Elucidating the contribution of NAFLD (non-alcoholic fatty liver disease) and insulin resistance in the development of cardiovascular complications in people with type 1 diabetes.
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identifier
Creation 02.05.2024
Last edited 16.05.2024
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