Effect of time of day and fasting duration on measures of glycaemia: analysis from the Whitehall II Study
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
We aimed to study diurnal variation in glucose regulation by examining the effects of time of day and fasting duration on fasting plasma glucose (FPG), 2 h post-load plasma glucose (2hPG) and HbA1c levels.
We analysed data from 5,978 non-diabetic white men and women from the prospective Whitehall II Study. All studied participants fasted for at least 8 h before a clinical examination, which included an OGTT and anthropometric measurements. We fitted mixed-effects models for FPG, 2hPG and HbA1c as outcome variables, and time of day and/or fasting duration as explanatory variables. Models were adjusted for age, BMI and study phase.
Time of day and fasting duration were associated inversely with FPG and positively with 2hPG. The mean difference between measures at 08:00 and 15:00 hours in men/women was −0.46 (95% CI −0.50, −0.42) mmol/l/−0.39 (95% CI −0.46, −0.31) mmol/l and 1.39 (95% CI 1.25, 1.52) mmol/l/1.19 (95% CI 0.96, 1.42) mmol/l for FPG and 2hPG, respectively. HbA1c levels were independent of either time. Time of day and fasting duration were independently associated with 2hPG. In contrast, the effect of fasting duration on FPG was markedly attenuated with adjustment for time of day. Ageing, but not obesity, was associated with increased diurnal variation in glucose tolerance.
Both time of day and fasting duration should be considered in clinical practice and epidemiological studies, since they have clinically relevant effects on FPG and 2hPG levels. As biochemically expected, HbA1c levels are independent of time of blood sampling and fasting duration.
- Jarrett RJ, Keen H (1969) Diurnal variation of oral glucose tolerance: a possible pointer to the evolution of diabetes mellitus. BMJ 2:341–344 CrossRef
- Zimmet PZ, Wall JR, Rome R, Stimmler L, Jarrett RJ (1974) Diurnal variation in glucose tolerance: associated changes in plasma insulin, growth hormone, and non-esterified fatty acids. BMJ 1:485–488 CrossRef
- Mayer KH, Stamler J, Dyer A et al (1976) Epidemiologic findings on the relationship of time of day and time since last meal to glucose tolerance. Diabetes 25:936–943 CrossRef
- Troisi RJ, Cowie CC, Harris MI (2000) Diurnal variation in fasting plasma glucose: implications for diagnosis of diabetes in patients examined in the afternoon. JAMA 284:3157–3159 CrossRef
- Emberson JR, Whincup PH, Walker M, Thomas M, Alberti KGMM (2002) Biochemical measures in a population-based study: effect of fasting duration and time of day. Ann Clin Biochem 39:493–501 CrossRef
- Moebus S, Göres L, Lösch C, Jöckel K-H (2011) Impact of time since last caloric intake on blood glucose levels. Eur J Epidemiol 26:719–728 CrossRef
- Goldberg RJ, Ye C, Sermer M et al (2012) Circadian variation in the response to the glucose challenge test in pregnancy: implications for screening for gestational diabetes mellitus. Diabetes Care 35:1578–1584 CrossRef
- Tabák AG, Jokela M, Akbaraly TN, Brunner EJ, Kivimäki M, Witte DR (2009) Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study. Lancet 373:2215–2221 CrossRef
- Faerch K, Borch-Johnsen K, Vaag A, Jørgensen T, Witte DR (2010) Sex differences in glucose levels: a consequence of physiology or methodological convenience? The Inter99 study. Diabetologia 53:858–865 CrossRef
- Van Cauter E, Polonsky KS, Scheen AJ (1997) Roles of circadian rhythmicity and sleep in human glucose regulation. Endocr Rev 18:716–738 CrossRef
- Effect of time of day and fasting duration on measures of glycaemia: analysis from the Whitehall II Study
Volume 56, Issue 2 , pp 294-297
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Diurnal variation
- Fasting duration
- Oral glucose tolerance test
- Industry Sectors
- Author Affiliations
- 1. Department of Medical Physics and Medical Informatics, University of Szeged, Korányi fasor 9, H-6720, Szeged, Hungary
- 2. Steno Diabetes Center A/S, Gentofte, Denmark
- 3. Department of Epidemiology and Public Health, University College London, London, UK
- 4. First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary
- 5. Centre de Recherche Public de la Santé, Strassen, Luxembourg