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Meridian Valley Lab’s Kraft Prediabetes Profile is a timed test that measures the patient’s insulin response to a measured glucose challenge and return to baseline over a 4-hour period. This test looks at patterns of insulin response rather than a strict cut-off point for glucose. These patterns delineate the severity of insulin resistance, as a patient progresses from normal insulin sensitivity to postprandial hyperinsulinemia to the insulinopenic state found in beta-cell exhaustion. This spectrum of insulin response allows the clinician to identify insulin resistance early in its development. (This holds true even when fasting and 2 hour post-challenge glucose levels are normal and fasting insulin is below 10μIU/mL.) The resulting evaluation of insulin resistance severity can be used to monitor efficacy of treatment.

The Kraft Prediabetes Profile measures patterns of insulin activity after drinking a glucose challenge. Dr. Kraft identified five patterns of insulin response that begins with normal sensitivity and progresses to severe insulin resistance and then finally to an insulinopenic state.

Picture4The five patterns of insulin response correspond with the timing of the insulin peak after the glucose challenge. Normally, insulin peaks quickly after a meal (or glucose challenge in this case) and then drops precipitously back to baseline (Pattern I). As insulin resistance becomes more severe, the insulin response to glucose peaks later and later (Patterns II-IIIB). In Pattern IV, insulin is high in the fasting state and rises even further in attempt to keep blood sugar under control. Islet cell exhaustion is illustrated by Pattern V, or insulinopenia, in which the patient’s pancreas is no longer able to produce an adequate amount of insulin.

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