Differences in physiological response to an oral glucose tolerance test in adult Maasai men and women

May 22, 2026Acta diabetologica

Differences in body responses to a sugar test in adult Maasai men and women

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Abstract

Mean fasting glucose concentration was 5.2 mmol/L in men compared to 4.9 mmol/L in women.

Women exhibited a higher mean GLP-1 concentration at 2 hours post-glucose load (8.5 vs. 5.1 pmol/L).
Total area-under-the-curve for GLP-1 was significantly higher in women compared to men (1336 vs. 870 pmol x min).
Regression analyses indicated higher values of insulin, C-peptide, and GLP-1 in women after adjusting for sex and BMI.
Findings suggest sex differences in glucose metabolism among Maasai, impacting insulin and incretin hormone responses.

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AIMS: Rural, agro-pastoralist Maasai in East Africa exhibit low prevalence of diabetes, yet little is known about their physiological response to glucose loads and whether sex has an impact on glucose metabolism, including incretin hormones.

METHODS: We included 58 (29 men, 29 women) adult Maasai without diabetes living in rural Tanzania. Clinical background characteristics were measured, and they were exposed to an oral glucose tolerance test (OGTT) after an overnight fast. Plasma glucose, insulin/C-peptide, glucagon, glucose-dependent insulinotropic polypeptide (GIP), and glucagon-like peptide-1 (GLP-1) were analysed.

RESULTS: Mean age was 34.8 (range 17-65) years, and mean body mass index (BMI) was 20.3 (range 14.0-30.9) kg/mwith two individuals being overweight and 14 being underweight. Men had a higher mean fasting glucose concentration (5.2 vs. 4.9 mmol/L, p = 0.031), while women exhibited a higher OGTT-derived mean GLP-1 concentration at 2-h (8.5 vs. 5.1 pmol/L, p = 0.005). Total area-under-the-curve (tAUC) for GLP-1 was higher in women compared to men (1336 vs. 870 pmol x min, p = 0.011). Sex- and BMI-adjusted regression analyses for tAUC showed higher values of insulin, C-peptide and GLP-1 in women (p < 0.10). 2

CONCLUSIONS: Sex differences were found in fasting glucose and OGTT-derived insulin/C-peptide and GLP-1 concentrations. Research using more sophisticated methodology is needed to further explain the glucose metabolism phenotype in Maasai people.

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Differences in physiological response to an oral glucose tolerance test in adult Maasai men and women

Abstract

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