Why Isn't Postprandial Insulin Assay Being Used to Predict Diabetes Onset?
While promising, there is no way to know whether introducing lifestyle changes to patients who are diagnosed earlier will positively effect their outcomes.
With James DiNicolantonio, PharmD; Elena Christofides, MD, FACE, and Robert Lustig, MD
The current strategy for screening patients for prediabetes and diabetes—using fasting glucose, oral glucose tolerance testing (OGTT), and hemoglobin A1C—still may be missing millions of individuals with these conditions,1 according findings published in BMJ Open Heart.
Focusing only on glucose levels is too little, too late, said study author, James DiNicolantonio, PharmD, a cardiovascular research scientist at St. Luke's MidAmerica Heart Institute in Kansas City. He and three colleagues made a case for employing the postprandial insulin assay as a more efficient tool to diagnose prediabetes and diabetes sooner than the current standards.1
By the time people are diagnosed using standard glucose testing, ''these individuals likely will have lost up to 50% of their beta cells,'' Dr. DiNicolantonio told EndocrineWeb, ''When a person is diagnosed with prediabetes [using standard glucose testing], the patient will have likely lost 25% of their beta cells."
He added, ''the reason for this outcome is that we have been relying on the wrong surrogate marker: glucose. A patient can be severely ill and still have glucose levels in the normal range; by the time the patient becomes hyperglycemic, the disease had progressed significantly."
Building a Case for the Insulin Assay
Using the postprandial insulin assay, Dr. DiNicolantonio believes th Continue reading