[Development of the cookie test for the early detection and analyses of metabolic risk factors of the life style related diseases and its significance].

While with toleranG 30% of the healthy subjects showed reactive hypoglycemia(2 h BS below 80 mg/dl) with symptoms, with cookie tests none showed hypoglycemia nor adverse effect. In National Cardiovascular Center, the rate of reactive hypoglycemia was 4.1% and in those with 2 h BS below 50 mg was 0.5%. The incidence seemed to be various according to the insulin reserve of pancreatic beta-cells. In subjects with life style related disorder, additional abnormalities other than basal were revealed together with insulin resistance(AUCInsulin, AUCInsulin x AUCGlucose). In subjects with exercise habit, who exhibited lower energy expenditure at rest but higher VO2max, shwoed smaller increase of blood glucose and insulin above basal on cookie test, indicating increased insulin sensitivity. A new snack test in subjects without exocrine pancreatic disorder serves natural carbohydrate(75 g) and fat source(24 g). The test has less adverse effects, like reactive hypoglycemia. The test revealed glucose intolerance, diabetes, hyperinsulinemia, postprandial dyslipidemia and insulin resistance more efficiently than in the routinely performed OGTT (liquid glucose) or fat loading test.

[Evaluation of SMBG values using various instruments and clinical significance of forearm SMBG measurement].

Whole blood or plasma glucose values were compared between those measured using various instruments for SMBG and automated analyses in samples (antecubital vein) from 20 approximately 70 years old obtained at cookie tests. A good correlation between values in whole blood SMBG and plasma automated analyses values greater than r = 0.94 was observed for instruments A, C, F, and H, and the per cent difference from the automated values was less than 5% for A, B, E and H. Per cent difference of SMBG values by I was -16% in whole blood and -9% in plasma, suggesting the possibility of measuring real values in whole blood. With plasma, a good correlation greater than r = 0.95 was noted for A, C, F and K, and the per cent difference less than 10% was noted for C, E, F and I. A relatively good correlation (r: 0.63 approximately 0.90) between forearm SMBG value and plasma automated values was noted with the % difference of the mean less than 11%. During cookie test, there is no significant difference between forearm SMBG values and antecubital plasma automated values. Values at finger tips are significantly greater by 5 approximately 20% over automated plasma values. In conclusion, whole blood values by most of the SMBG instruments are well correlated with plasma automated values, although some disagreement was noted. Values at forearm are not different from plasma val ues of antecubital vein, while at finger tip SMBG values showed higher levels. The measurement at forearm is therefore recommended, and in addition the pain is less.