Impact of mixed meal tolerance test composition on measures of beta-cell function in type 2 diabetes

• Published in: Nutrition & metabolism Vol. 18; no. 1; p. 47
• Main Authors: Kössler, Theresa, Bobrov, Pavel, Strassburger, Klaus, Kuss, Oliver, Zaharia, Oana-Patricia, Karusheva, Yanislava, Möser, Clara, Bódis, Kálmán, Burkart, Volker, Roden, Michael, Szendroedi, Julia
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04-05-2021; BioMed Central; BMC
• Subjects: Beta cells; Beta-cell function; Body mass index; Brief Communication; Carbohydrates; Diabetes; Diabetes mellitus (non-insulin dependent); Diagnosis; Eating (Physiology); Glucose; Glucose tolerance tests; Health aspects; Insulin; Inter-individual variation; Intra-individual variation; Meals; Metabolism; Methods; Mixed meal tolerance test; Nutrition; Pancreatic beta cells; Peptides; Physiology; Proteins; Type 2 diabetes; Variation; Germany; Type 2 diabetes; Inter-individual variation; Intra-individual variation; Mixed meal tolerance test; Beta-cell function
• ISSN: 1743-7075; 1743-7075
• DOI: 10.1186/s12986-021-00556-1

Application of mixed meal tolerance tests (MMTT) to measure beta-cell function in long-term studies is limited by modification of the commercial products occurring over time. This study assessed the intra-individual reliability of MMTTs and compared the effects of liquid meals differing in macronutrient composition on the estimation of beta-cell function in type 2 diabetes (T2DM).
To test the reliability of MMTTs, 10 people with T2DM (age 58 ± 11 years, body mass index 30.0 ± 4.9 kg/m
) received Boost® high Protein 20 g protein three times. For comparing different meals, another 10 persons with T2DM (58 ± 5 years, 31.9 ± 5.3 kg/m
) ingested either Boost® high Protein 20 g protein or the isocaloric Boost® high Protein 15 g protein containing 35% less protein and 18% more carbohydrates. C-peptide, insulin and glucose release were assessed from the incremental area under the concentration time curve (iAUC) and the intra- and inter-individual variation of these parameters from the coefficients of variations (CV).
Repetitive ingestion of one meal revealed intra-individual CVs for the iAUCs of C-peptide, insulin and glucose, which were at least 3-times lower than the inter-individual variation of these parameters (18.2%, 19.7% and 18.9% vs. 74.2%, 70.5% and 207.7%) indicating a good reliability. Ingestion of two different meals resulted in comparable intra-individual CVs of the iAUCs of C-peptide and insulin (16.9%, 20.5%).
MMTTs provide reliable estimation of beta-cell function in people with T2DM. Furthermore, moderate differences in the protein and carbohydrate contents in a standardized liquid meal do not result in relevant changes of C-peptide and insulin responses.
Clinicaltrials.gov, Identifier number: NCT01055093. Registered 22 January 2010 - Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/study/NCT01055093.