July 28, 2025Diabetology & Metabolic Syndrome1 citationsOpen Access

Relationship between glucose response curve shape during the oral glucose tolerance test and macrovascular complications in type 2 diabetes mellitus

RORong OuyangNantong University HZHan ZhangZhengzhou University XZXiaoqin ZhaoPeople’s Hospital of Wenshan Prefecture

Structured PICO

Does a monophasic glucose response curve during OGTT predict macrovascular complications in patients with T2DM?

Population

571 subjects, including 75 with normal glucose tolerance (NGT) and 496 patients with type 2 diabetes mellitus (T2DM).

Intervention

Monophasic glucose response curve during a 3-hour oral glucose tolerance test (OGTT)

Comparator

Multiphasic glucose response curve during a 3-hour OGTT

Outcome

Macrovascular complications (assessed via common carotid artery diameter, intima-media thickness, and carotid atherosclerosis)surrogate

A monophasic glucose response curve during an oral glucose tolerance test is independently associated with an increased risk of carotid atherosclerosis and macrovascular complications in patients with type 2 diabetes.

Abstract

INTRODUCTION: This study evaluated the predictive value of glucose response curve shape during the oral glucose tolerance test (OGTT) for macrovascular complications in patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS: A retrospective observational analysis was conducted involving 75 subjects with normal glucose tolerance (NGT) and 496 patients with T2DM, all of whom underwent a 3-hour OGTT, along with insulin and C-peptide release tests. Multivariate linear regression models assessed the cross-sectional associations between glucose response curve shapes and common carotid artery (CCA) diameter and intima-media thickness (IMT) in T2DM patients. Risk factors for carotid atherosclerosis analyzed using multivariate logistic regression. RESULTS: Among patients with type 2 diabetes who underwent OGTT, the group with monophasic curves (n = 282) showed higher blood glucose levels, increased insulin resistance, and poorer pancreatic β-cell function compared to the multiphasic curve group (n = 214). Larger CCA diameters were independently associated with monophasic curves compared to multiphasic curves (regression coefficient: 0.134 0.016, 0.252, P = 0.026). Increased IMT was independently associated with monophasic curves compared to multiphase curves (regression coefficient: 0.038 0.001, 0.075, P = 0.045). Independent risk factors for carotid atherosclerosis in T2DM patients included monophasic curve (odds ratio OR 2.014, 95% confidence interval CI 1.300-3.121, P = 0.002), age (OR 1.040, 95% CI 1.020-1.059, P < 0.001), male sex (OR 2.107, 95% CI 1.364-3.256, P = 0.001), and duration of diabetes (OR 1.043, 95% CI 1.009-1.078, P = 0.012). CONCLUSION: The shape of the glucose response curve during OGTT was significantly linked to the risk of macrovascular complications in T2DM patients. Those with monophasic glucose curves were at an elevated risk of developing such complications.

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