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Войти в исследования Diabetes research and clinical practice · 2026
A novel disposition index without insulin is an earlier and sensitive predictor of type 2 diabetes than current diagnostic criteria.
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Ryang Soree, Kim Jinmi, Kim Minsoo, Im Myungsoo, Kim Doohwa, Kim Yeong Jin, Kang Hyuk, Kim Young Jin, Kim In Joo, Chung Stephane T, Bergman Michael, Sherman Arthur, Kim Sang Soo, Ha Joon
Аннотация
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 without measuring 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.
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 without measuring 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.