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Effect of phosphorus on the oral glucose tolerance test

Phosphate infusion under euglycemic conditions have been reported to influence insulin sensitivity, with an increased rate of glucose disposal. While hypophosphatemia was found to be associated with insulin insensitivity and impaired glucose tolerance. It was also reported that healthy non-diabetic individuals with low serum phosphate levels tend to have elevated blood glucose levels and reduced insulin sensitivity in the 2 h postprandial period. The rise in insulin levels is known to reduce serum phosphate due to the shift of extracellular phosphate to the intracellular region. In view of the increased intake poor dietary P (refined cereals, sugar and sweeteners), it became questionable whether phosphate can affect the postprandial glycaemia. The objectives of the study were to determine the effect of phosphate on postprandial glycaemia, insulinemia and insulin sensitivity in an oral glucose tolerance test (OGTT). Eight healthy male subjects of normal BMI were recruited. Each subject was exposed in random order to two experimental solutions: (1) glucose solution containing 75 g glucose; (2) glucose and phosphate solution, containing 75 g glucose and 500 mg P. Blood samples were collected at fasting, and after drinking the solutions at 15, 30, 60, 90, 120, 180 and 240 min. Serum insulin, glucose, total phosphate and inorganic phosphate were measured. Homoeostatic model assessment (HOMA) was calculated to determine insulin sensitivity.