Two patients undergo a 50 g oral glucose test. Patient A: peak 160 mg/dL at 45 minutes, returns to 115 mg/dL at 2 hours. Patient B: peak 180 mg/dL at 30 minutes, 2-hour value 170 mg/dL. Which patient has the worse physiologic profile and why?

• A. Patient B has the worse profile because their glucose remains markedly elevated at 2 hours indicating impaired clearance and sustained hyperglycemia, increasing risk of complications compared to Patient A who clears glucose more effectively.
• B. Patient A is worse because an earlier later peak always predicts more severe insulin resistance regardless of the 2-hour value, which is the only determinant of risk.
• C. Neither; postprandial values are irrelevant — only fasting glucose and cholesterol determine diabetes severity.
• D. Both are equivalent because peak height alone determines risk and both peaks are within the same 20 mg/dL range so no difference exists.

Answer: (A)