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Reference Glycaemic and Beta-Cell Profiles in Response to a Standardised Meal Challenge in Adults Across the Glycaemic Spectrum

Gareth Dunseath Orcid Logo, David Owens Orcid Logo, Steve Luzio Orcid Logo

Diabetology, Volume: 7, Issue: 2, Start page: 30

Swansea University Authors: Gareth Dunseath Orcid Logo, David Owens Orcid Logo, Steve Luzio Orcid Logo

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DOI (Published version): 10.3390/diabetology7020030

Abstract

Background: The pancreatic beta-cell hormone insulin regulates the metabolism of carbohydrates, as well as fats and protein. While the insulin response to a carbohydrate challenge is well defined in normoglycaemic as well as dysglycaemic (prediabetes and type 2 diabetes (T2DM)) individuals, the resp...

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Published in: Diabetology
ISSN: 2673-4540
Published: MDPI AG 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa71417
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While the insulin response to a carbohydrate challenge is well defined in normoglycaemic as well as dysglycaemic (prediabetes and type 2 diabetes (T2DM)) individuals, the response of co-secreted beta-cell products (C-peptide, proinsulin and proinsulin intermediates) is less well defined. This analysis aimed to establish the expected glycaemic and pancreatic beta-cell responses to a standardised mixed meal in individuals with impaired glucose tolerance (IGT) and T2DM alongside reference ranges established in normoglycaemic individuals (NGT). Methods: A total of 743 adults (104 NGT, 85 IGT and 554 T2DM) were included, none of whom were on any anti-diabetic medication at the time of initial testing. All attended following a 10 h fast, before consuming a 500 kcal solid mixed meal (calorie contribution: 58% carbohydrates, 22% fat and 20% protein). Blood samples were collected every 30 min for the 4.5 h duration of the test for the determination of plasma glucose, insulin, C-peptide and intact and total proinsulin. Median profiles with corresponding 2.5th and 97.5th percentile lines to display the expected range were calculated and plotted for the three participant groups. Results: Median profiles with ranges over a 4.5 h meal period have been created for glucose, insulin, C-peptide and intact and total proinsulin, along with respective fasting and post-meal intervals in the three participant groups with differing glycaemic status. 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spelling 2026-03-16T12:09:28.9183466 v2 71417 2026-02-13 Reference Glycaemic and Beta-Cell Profiles in Response to a Standardised Meal Challenge in Adults Across the Glycaemic Spectrum fccbba9edcaee08a839a3c5cff8cbe19 0000-0001-6022-862X Gareth Dunseath Gareth Dunseath true false 2fd4b7c3f82c6d3bd546eff61ff944e9 0000-0003-1002-1238 David Owens David Owens true false 01491e1cd582746a654fad9addf0de16 0000-0002-7206-6530 Steve Luzio Steve Luzio true false 2026-02-13 MEDS Background: The pancreatic beta-cell hormone insulin regulates the metabolism of carbohydrates, as well as fats and protein. While the insulin response to a carbohydrate challenge is well defined in normoglycaemic as well as dysglycaemic (prediabetes and type 2 diabetes (T2DM)) individuals, the response of co-secreted beta-cell products (C-peptide, proinsulin and proinsulin intermediates) is less well defined. This analysis aimed to establish the expected glycaemic and pancreatic beta-cell responses to a standardised mixed meal in individuals with impaired glucose tolerance (IGT) and T2DM alongside reference ranges established in normoglycaemic individuals (NGT). Methods: A total of 743 adults (104 NGT, 85 IGT and 554 T2DM) were included, none of whom were on any anti-diabetic medication at the time of initial testing. All attended following a 10 h fast, before consuming a 500 kcal solid mixed meal (calorie contribution: 58% carbohydrates, 22% fat and 20% protein). Blood samples were collected every 30 min for the 4.5 h duration of the test for the determination of plasma glucose, insulin, C-peptide and intact and total proinsulin. Median profiles with corresponding 2.5th and 97.5th percentile lines to display the expected range were calculated and plotted for the three participant groups. Results: Median profiles with ranges over a 4.5 h meal period have been created for glucose, insulin, C-peptide and intact and total proinsulin, along with respective fasting and post-meal intervals in the three participant groups with differing glycaemic status. Conclusions: The resulting profiles and ranges allow for comparison in responses to a carbohydrate challenge in individuals across the glycaemic spectrum. Journal Article Diabetology 7 2 30 MDPI AG 2673-4540 reference profiles; beta-cell responses; insulin; C-peptide; proinsulin 2 2 2026 2026-02-02 10.3390/diabetology7020030 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Other Novo Nordisk 2026-03-16T12:09:28.9183466 2026-02-13T14:08:42.2546268 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Biomedical Science Gareth Dunseath 0000-0001-6022-862X 1 David Owens 0000-0003-1002-1238 2 Steve Luzio 0000-0002-7206-6530 3 71417__36419__354532df311d4b9381c4e67cdc821339.pdf 71417.VoR.pdf 2026-03-16T12:07:10.2478699 Output 861994 application/pdf Version of Record true © 2026 by the authors. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. true eng https://creativecommons.org/licenses/by/4.0/
title Reference Glycaemic and Beta-Cell Profiles in Response to a Standardised Meal Challenge in Adults Across the Glycaemic Spectrum
spellingShingle Reference Glycaemic and Beta-Cell Profiles in Response to a Standardised Meal Challenge in Adults Across the Glycaemic Spectrum
Gareth Dunseath
David Owens
Steve Luzio
title_short Reference Glycaemic and Beta-Cell Profiles in Response to a Standardised Meal Challenge in Adults Across the Glycaemic Spectrum
title_full Reference Glycaemic and Beta-Cell Profiles in Response to a Standardised Meal Challenge in Adults Across the Glycaemic Spectrum
title_fullStr Reference Glycaemic and Beta-Cell Profiles in Response to a Standardised Meal Challenge in Adults Across the Glycaemic Spectrum
title_full_unstemmed Reference Glycaemic and Beta-Cell Profiles in Response to a Standardised Meal Challenge in Adults Across the Glycaemic Spectrum
title_sort Reference Glycaemic and Beta-Cell Profiles in Response to a Standardised Meal Challenge in Adults Across the Glycaemic Spectrum
author_id_str_mv fccbba9edcaee08a839a3c5cff8cbe19
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author_id_fullname_str_mv fccbba9edcaee08a839a3c5cff8cbe19_***_Gareth Dunseath
2fd4b7c3f82c6d3bd546eff61ff944e9_***_David Owens
01491e1cd582746a654fad9addf0de16_***_Steve Luzio
author Gareth Dunseath
David Owens
Steve Luzio
author2 Gareth Dunseath
David Owens
Steve Luzio
format Journal article
container_title Diabetology
container_volume 7
container_issue 2
container_start_page 30
publishDate 2026
institution Swansea University
issn 2673-4540
doi_str_mv 10.3390/diabetology7020030
publisher MDPI AG
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Biomedical Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Biomedical Science
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description Background: The pancreatic beta-cell hormone insulin regulates the metabolism of carbohydrates, as well as fats and protein. While the insulin response to a carbohydrate challenge is well defined in normoglycaemic as well as dysglycaemic (prediabetes and type 2 diabetes (T2DM)) individuals, the response of co-secreted beta-cell products (C-peptide, proinsulin and proinsulin intermediates) is less well defined. This analysis aimed to establish the expected glycaemic and pancreatic beta-cell responses to a standardised mixed meal in individuals with impaired glucose tolerance (IGT) and T2DM alongside reference ranges established in normoglycaemic individuals (NGT). Methods: A total of 743 adults (104 NGT, 85 IGT and 554 T2DM) were included, none of whom were on any anti-diabetic medication at the time of initial testing. All attended following a 10 h fast, before consuming a 500 kcal solid mixed meal (calorie contribution: 58% carbohydrates, 22% fat and 20% protein). Blood samples were collected every 30 min for the 4.5 h duration of the test for the determination of plasma glucose, insulin, C-peptide and intact and total proinsulin. Median profiles with corresponding 2.5th and 97.5th percentile lines to display the expected range were calculated and plotted for the three participant groups. Results: Median profiles with ranges over a 4.5 h meal period have been created for glucose, insulin, C-peptide and intact and total proinsulin, along with respective fasting and post-meal intervals in the three participant groups with differing glycaemic status. Conclusions: The resulting profiles and ranges allow for comparison in responses to a carbohydrate challenge in individuals across the glycaemic spectrum.
published_date 2026-02-02T05:34:02Z
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