The Use of Areas Under Curves in Diabetes Research

Allison, David B.; Paultre, Furcy; Maggio, Carol A.; Mezzitis, N; Pi‐Sunyer, F. Xavier

doi:10.2337/diacare.18.2.245

Cited by 334 publications

(265 citation statements)

References 14 publications

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“…As recently pointed out by Allison et al, 1 interpretation of glucose and insulin data are subject to limitations of analysis depending upon which method is used to calculate the AUC. The main finding of this investigation is that following 9 months of exercise the incremental and positive incremental methods for calculating insulin AUC will result in an inter- Areas under the curve JA Potteiger et al pretation of no change in AUC, while employing the total AUC method would suggest an improvement for insulin action following 9 months of aerobic exercise.…”

Section: Discussionmentioning

confidence: 99%

“…In one method the baseline measures are subtracted from all subsequent readings before the AUC is calculated and is referred to as the 'incremental area' method. 1 A major problem exists when using this method, 'if any of the postbaseline measures are lower than the baseline value, then it is possible to obtain a negative area, and a negative value for area logically contradicts the concept of area in the physical sense.' Another method for determining the AUC is to use only those areas that are above the baseline values and ignore any value that falls below baseline.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of methods for analyzing glucose and insulin areas under the curve following nine months of exercise in overweight adults

Jacobsen

Donnelly

2002

Int J Obes

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OBJECTIVE:We examined three methods for calculating the area under the curve (AUC) following an oral glucose tolerance test (OGTT) in overweight adults prior to and after 9 months of exercise. METHOD: Subjects (n ¼ 27) were randomly assigned to a control (CON, n ¼ 9) or intervention (INT, n ¼ 18) group. INT performed supervised exercise 5 days per week, 45 min per session, at 65% of heart rate reserve. OGTTs were administered preand post-training. Blood was collected during a 75 g OGTT and analyzed for glucose (GLU) and insulin (INS) concentrations. AUCs were calculated using the incremental, positive incremental, and total AUC methods and the difference scores for pre-and post-training were determined. RESULTS: No differences were observed among the methods for glucose AUC for either group. Significant differences were observed for INT insulin AUC with total AUC (1525 AE 3291 mU=1=180 min) significantly greater than incremental AUC (1112 AE 3229 mU=1=180 min) or positive incremental AUC (1085 AE 3195 mU=I=180 min). Total insulin AUC was significantly reduced following training for INT, while incremental and positive incremental insulin AUCs showed no change. CONCLUSION: These data suggest that the method of used to calculate AUC may affect the interpretation of whether or not an intervention was effective.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A comparison of methods for analyzing glucose and insulin areas under the curve following nine months of exercise in overweight adults

Jacobsen

Donnelly

2002

Int J Obes

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“…Measured C-peptide values are non-zero and simulation studies suggested that integrals estimated from trapezoidal rule outperformed all other methods when functions are non-zero [17]. The 'minus 10' minute and 'zero' minute measure for C-peptide level was averaged to obtain the pre-meal baseline level of C-peptide and the subsequent measures were used to calculate total AUC for each participant.…”

Section: Discussionmentioning

confidence: 99%

Exercise to preserve β‐cell function in recent‐onset Type 1 diabetes mellitus (EXTOD) – a randomized controlled pilot trial

et al. 2017

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Aim Residual b-cell function is present at the time of diagnosis with Type 1 diabetes. Preserving this b-cell function reduces complications. We hypothesized that exercise preserves b-cell function in Type 1 diabetes and undertook a pilot trial to address the key uncertainties in designing a definitive trial to test this hypothesis.Methods A randomized controlled pilot trial in adults aged 16-60 years diagnosed with Type 1 diabetes within the previous 3 months was undertaken. Participants were assigned to control (usual care) or intervention (exercise consultation every month), in a 1 : 1 ratio for 12 months. The primary outcomes were recruitment rate, drop out, exercise adherence [weeks with ≥ 150 min of self-reported moderate to vigorous physical activity (MVPA)], and exercise uptake in the control group. The secondary outcomes were differences in insulin sensitivity and rate of loss of b-cell function between intervention and control at 6 and 12 months.Results Of 507 individuals who were approached, 58 (28 control, 30 intervention) entered the study and 41 completed it. Participants were largely white European males, BMI 24.8 AE 3.8 kg/m 2 , HbA 1c 75 AE 25 mmol/mol (9 AE 2%). Mean level of objectively measured MVPA increased in the intervention group (mean 243 to 273 min/week) and 61% of intervention participants reached the target of ≥ 150 min/week of self-reported MVPA on at least 42 weeks of the year. Physical activity levels fell slightly in the control group (mean 277 to 235 min of MVPA/week). There was exploratory evidence that intervention group became more insulin sensitive and required less insulin. However, the rate of loss of b-cell function appeared similar between the groups, although the change in insulin sensitivity may have affected this.Conclusion We show that it is possible to recruit and randomize people with newly diagnosed Type 1 diabetes to a trial of an exercise intervention, and increase and maintain their exercise levels for 12 months. Future trials need to incorporate measures of greater adherence to exercise training targets, and include more appropriate measures of b-cell function. (Clinical Trials

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“…The AUC was calculated according to the trapezoidal model (Bryant, 1983;Allison et al, 1995). Incremental areas of the curve from baseline (fasting) values over time were calculated up to 90, 120, and 240 min after the meal.…”

Section: Statistical Analysis Data Are Presented As Means7standard Dementioning

confidence: 99%

Glucose and insulin responses in healthy women after intake of composite meals containing cod-, milk-, and soy protein

2006

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Objective: To evaluate the metabolic effect of three different kinds of dietary proteins as part of composite meals with similar macronutrient composition in healthy subjects. Design: A randomised meal study. Setting: Metabolic ward. Subjects and methods: In total, 17 healthy women, 30-65 years old, consumed three meals in randomised order. The meals consisted of foodstuffs with similar nutrient composition but different types of protein (cod, cottage cheese, or soy protein isolate). The distribution of energy from protein, fat and carbohydrates was 33, 26, and 41 energy percent, respectively. Total amount of energy was 2300 kJ. Blood samples were drawn for assay of B-glucose, S-insulin, S-free fatty acids, S-triglycerides, and C-peptide in the fasting state and at seven times (20, 40, 60, 90, 120, 180, and 240 min) after starting to eat the test meal. Results: The blood glucose response after the cod protein meal differed from that of the soy protein meal, with a larger area under the curve (AUC) calculated up to 120 min. The serum insulin response after the milk protein meal differed from that of the cod protein meal with a larger AUC calculated up to 240 min. The insulin/C-peptide and the insulin/glucose ratios differed between the meals; the insulin/C-peptide ratio was higher after the milk protein meal compared to the cod, and soy protein meal at 120 min. The insulin/glucose ratio was lower after the cod protein meal compared to the milk, and soy protein meals at 120 min. The results showed that the metabolic responses differed after meals with similar macronutrient composition containing cod-, milk-, or soy protein.

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The Use of Areas Under Curves in Diabetes Research

Cited by 334 publications

References 14 publications

A comparison of methods for analyzing glucose and insulin areas under the curve following nine months of exercise in overweight adults

A comparison of methods for analyzing glucose and insulin areas under the curve following nine months of exercise in overweight adults

Exercise to preserve β‐cell function in recent‐onset Type 1 diabetes mellitus (EXTOD) – a randomized controlled pilot trial

Glucose and insulin responses in healthy women after intake of composite meals containing cod-, milk-, and soy protein

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