Does a novel model-derived disposition index without insulin (mDI-woI) improve and provide earlier prediction of incident type 2 diabetes compared to current diagnostic criteria in healthy individuals?
A novel disposition index requiring only three glucose measurements without insulin (mDI-woI) predicts incident type 2 diabetes significantly earlier and more accurately than current standard biomarkers.
AIMS Early identification of individuals at risk for type 2 diabetes (T2D) is essential for prevention. We evaluated a novel model-derived disposition index without insulin (mDI-woI), which requires only glucose values from a three time-point oral glucose tolerance test (OGTT: 0, 60, 120 min). METHODS Among 5,742 healthy Koreans (age 51.2 ± 8.6 years, BMI 24.5 ± 3.1 kg/m2) followed biennially for up to 14 years with repeated OGTTs, we compared baseline mDI-woI with current diabetes biomarkers and the oral disposition index (oDI) using AUC-ROC analyses. RESULTS mDI-woI and mean OGTT glucose (mean G) showed the strongest prediction for incident T2D (AUC = 0.79 each), outperforming fasting plasma glucose (0.67), 1 h-PG (0.77), 2 h-PG (0.72), HbA1c (0.71), and oDI (0.68; all P < 0.001). In individuals who progressed to T2D, baseline mDI-woI, mean G, and 1-PG exceeded their thresholds while fasting and 2 h glucose were still below prediabetes cutoffs, indicating earlier risk detection. Moreover, the novel marker mDI-woI is the earliest one, 4 years earlier than mean G and 4.5 years earlier than 1 h-PG, the next two earliest. CONCLUSIONS Using only three glucose measurements and no insulin, mDI-woI provides a simple, sensitive, and clinically practical early marker that outperforms current diabetes criteria for predicting T2D progression, with strong potential for large-scale studies.
Ryang et al. (Thu,) studied this question.