About Glucose Control

By the time diabetes is diagnosed using conventional laboratory methods, patients may already have significant cardiovascular disease.  Meridian Valley Lab is proud to offer one of the most sensitive assessments of glucose control, the Kraft Prediabetes Profile.  This test allows for much earlier detection of insulin resistance than traditional tests, with the potential to arrest the development of diabetes and cardiovascular disease.

The Work of Dr. Joseph Kraft

Joseph Kraft, MD was a clinical pathologist at St. Joseph Hospital in Chicago from 1972 to 1998.  There, Dr. Kraft oversaw 14,384 oral glucose tolerance tests with insulin assays and studied the impact of insulin levels as a predictor of diabetes development. Dr. Kraft’s 1975 paper in Laboratory Medicine demonstrates that measuring the insulin response during a routine oral glucose tolerance test dramatically improves the test’s sensitivity for pre-diabetes.  These added insulin assays led to the discovery that many patients with normal or equivocal glucose tolerance results with standard testing showed abnormal insulin responses.  Dr. Kraft termed this condition “diabetes in situ.”  Today this condition is better known as insulin resistance.  In turn, early dietary interventions arrested and in some cases reversed the development of diabetes.

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.