system
Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Asian Americans, Diabetes Mellitus, Type 2, Female, Glucose Tolerance Test, Humans, Insulin, Male, Middle Aged, Odds Ratio.
user
Do patterns of insulin concentration during the OGTT predict the risk of type 2 diabetes in Japanese Americans? Context: To examine whether the patterns of insulin concentration during the oral glucose tolerance test (OGTT) predict type 2 diabetes. We followed 400 nondiabetic Japanese Americans for 10-11 years. Insulin concentrations at 30, 60, and 120 min during a 2-h 75-g OGTT at baseline were used to derive the following possible patterns of insulin: pattern 1 (30-min peak, higher insulin level at 60 than at 120 min), pattern 2 (30-min peak, lower or equal level at 60 vs. 120 min), pattern 3 (60-min peak); pattern 4 (120-min peak, lower level at 30 than at 60 min), and pattern 5 (120-min peak, equal or higher level at 30 vs. 60 min). Insulin sensitivity was estimated by homeostasis model assessment of insulin resistance (HOMA-IR) and Matsuda index. Insulin secretion was estimated by the insulinogenic index (IGI) [Δinsulin/Δglucose (30-0 min)] and disposition index (IGI/HOMA-IR). There were 86 incident cases of type 2 diabetes. The cumulative incidence was 3.2, 9.8, 15.4, 47.8, and 37.5% for patterns 1, 2, 3, 4, and 5, respectively. Compared with pattern 1, patterns 4 and 5, characterized by a lasting late insulin response, were associated with significantly less insulin sensitivity as measured by the Matsuda index and lower early insulin response by the disposition index. The multiple-adjusted odds ratios of type 2 diabetes were 12.55 (95% CI 4.79-32.89) for pattern 4 and 8.34 (2.38-29.27) for pattern 5 compared with patterns 1 and 2. This association was independent of insulin secretion and sensitivity.
assistant
The patterns of insulin concentration during an OGTT strongly predict the development of type 2 diabetes. Final Decision: yes