A novel disposition index without insulin is an earlier and sensitive predictor of type 2 diabetes than current diagnostic criteria
Authors' conclusion
Using only three glucose measurements without measuring insulin, mDI-woI provides a simple, sensitive, and clinically practical early marker that outperforms current diabetes criteria for predicting T2D progression, with strong potential for large-scale studies.
Study context
- Population
- Healthy Koreans (age 51.2 ± 8.6 years, BMI 24.5 ± 3.1 kg/m²)
- Participants
- 5,742 participants
- Exposure
- Model-derived disposition index without insulin (mDI-woI) vs current diabetes biomarkers and oral disposition index (oDI)
- Outcome
- Prediction of incident T2D (AUC-ROC)
- Follow-up
- Up to 14 years
Methodological detailsbiennial follow-up up to 14 years, repeated OGTTs
- Biennial follow-up up to 14 years
- Repeated OGTTs
Main finding
As reported in the abstract
Prediction of incident T2D
| Group | AUC |
|---|---|
| mDI-woI | 0.79 |
| Mean G | 0.79 |
| FPG | 0.67 |
| 1 h-PG | 0.77 |
| 2 h-PG | 0.72 |
| HbA1c | 0.71 |
| oDI | 0.68 |
AUC
mDI-woI0.79
Mean G0.79
FPG0.67
1 h-PG0.77
2 h-PG0.72
HbA1c0.71
oDI0.68
- mDI-woI and mean G outperformed FPG, 1 h-PG, 2 h-PG, HbA1c and oDI
- all P < 0.001
Observational data: associations, not effects.
Further findings
Timing of risk detection in progressors to T2D · baseline
Years
- mDI-woI earlier than mean G
- 4
- mDI-woI earlier than 1 h-PG
- 4.5
- Baseline mDI-woI, mean G and 1-PG exceeded thresholds while fasting and 2 h glucose were below prediabetes cutoffs
Original publication
A novel disposition index without insulin is an earlier and sensitive predictor of type 2 diabetes than current diagnostic criteria. Diabetes Res Clin Pract. Published 29 January 2026. doi:10.
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