Alternative tests versus measurement of fasting plasma glucose and oral glucose tolerance test for diagnosis of pediatric type 2 pre-diabetes

2017 ◽  
Vol 15 (8) ◽  
pp. 2028-2032 ◽  
Author(s):  
Dagmar Tučková ◽  
Miloslav Klugar ◽  
Tomasz Lasota ◽  
Jakub Lasák ◽  
Jared M. Campbell ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Versus Measurement

scholarly journals Accuracy of 1-Hour Plasma Glucose During the Oral Glucose Tolerance Test in Diagnosis of Type 2 Diabetes in Adults: A Meta-analysis

2021 ◽  
Author(s):  
Vasudha Ahuja ◽  
Pasi Aronen ◽  
TA Pramod Kumar ◽  
Helen Looker ◽  
Angela Chetrit ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Plasma Glucose ◽  
Glucose Tolerance Test ◽  
Meta Analysis ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

<b>Objective </b>One-hour plasma glucose (1-h PG) during the oral glucose tolerance test (OGTT) is an accurate predictor of type 2 diabetes. We performed a meta-analysis to determine the optimum cut-off of 1-h PG to detect type 2 diabetes using 2-h PG as the gold standard. <p><b>Research Design and Methods </b>We included 15 studies with 35,551 participants from multiple ethnic groups (53.8% Caucasian) and 2705 newly detected cases of diabetes based on 2-h PG during OGTT. We excluded cases identified only by elevated fasting plasma glucose and/or HbA1c. We determined the optimal 1-h PG threshold and its accuracy at this cut-off to detect diabetes (2-h PG ≥ 11.1 mmol/L) using a mixed linear effects regression model with different weights to sensitivity/specificity (2/3, 1/2, and 1/3). </p> <p><b>Results</b> Three cut-offs of 1-h PG at 10.6 mmol/L, 11.6 mmol/L, and 12.5 mmol/L had sensitivities of 0.95, 0.92, and 0.87 and specificities of 0.86, 0.91, and 0.94 at weights 2/3, 1/2, and 1/3, respectively. The cut-off of 11.6 mmol/L (95% CI 10.6, 12.6) had a sensitivity 0.92 (0.87, 0.95), specificity of 0.91 (0.88, 0.93), AUC 0.939 (95% confidence region for sensitivity at a given specificity: 0.904, 0.946), and a positive predictive value of 45%.</p> <p><b>Conclusions</b> The 1-h PG of ≥ 11.6 mmol/L during OGTT <a>has a </a>good sensitivity and specificity for detecting type 2 diabetes. Prescreening with a diabetes-specific risk calculator to identify high-risk individuals is suggested to decrease the proportion of false-positive cases. Studies including other ethnic groups and assessing complication risk are warranted.</p>

Oral glucose tolerance test within the scope of prenatal care: Evaluation 2010–2012

2015 ◽  
Vol 38 (2) ◽  
Author(s):  
Erich Krendl ◽  
Maria Elisabeth Mustafa
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Pregnant Women ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

AbstractGeneral screening for gestational diabetes mellitus (GDM) is recommended in Austria since 2010. As a result of the guidelines, pregnant women are tested between 24 and 28 weeks of gestation with the 75 g/2 h-oral glucose tolerance test (75 g/2 h-OGTT). The aim of this study was to evaluate the prevalence of GDM in our laboratory retrospectively. Furthermore, we wanted to study the pattern of abnormal 1 h- and 2 h-glucose values from 75 g/2 h-OGTTs compared with fasting plasma glucose values. Further testing of GDM patients after delivery is recommended. As a result of this issue we analyzed all follow-up screening.Standardized 75 g/2 h-OGTTs were assessed in 3963 pregnant women. The cut-off value for fasting plasma glucose (FPG) is ε 5.1 mmol/L, for 1 h value ε 10.0 mmol/L, and for 2 h value ε 8.5 mmol/L. One or more abnormal values were considered as GDM, respectively.GDM was detected in 8.5% (n=335) of the tested pregnant women. Elevated FPG values were measured in 5.1% (n=201). These are 60% of all GDM patients. After delivery we analyzed 14 out of 335 GDM patients (4.2%) to reevaluate postpartum glucose tolerance with the standard OGTT (World Health Organization criteria).GDM is a common disease, and in our study 8.5% of pregnancies were affected. When and how to screen is still a matter of discussion. One strategy to become more cost-effective is to use a two-step screening algorithm including FPG measurement and a risk estimation model. In postpartum follow-up, there is still considerable potential to reduce diabetes-associated illness and costs.

scholarly journals A New Look at Screening and Diagnosing Diabetes Mellitus

2008 ◽  
Vol 93 (7) ◽  
pp. 2447-2453 ◽  
Author(s):  
Christopher D. Saudek ◽  
William H. Herman ◽  
David B. Sacks ◽  
Richard M. Bergenstal ◽  
David Edelman ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Consensus Process ◽  
Specific Test

Abstract Objective: Diabetes is underdiagnosed. About one third of people with diabetes do not know they have it, and the average lag between onset and diagnosis is 7 yr. This report reconsiders the criteria for diagnosing diabetes and recommends screening criteria to make case finding easier for clinicians and patients. Participants: R.M.B. invited experts in the area of diagnosis, monitoring, and management of diabetes to form a panel to review the literature and develop consensus regarding the screening and diagnosis of diabetes with particular reference to the use of hemoglobin A1c (HbA1c). Participants met in open session and by E-mail thereafter. Metrika, Inc. sponsored the meeting. Evidence: A literature search was performed using standard search engines. Consensus Process: The panel heard each member’s discussion of the issues, reviewing evidence prior to drafting conclusions. Principal conclusions were agreed on, and then specific cut points were discussed in an iterative consensus process. Conclusions: The main factors in support of using HbA1c as a screening and diagnostic test include: 1) HbA1c does not require patients to be fasting; 2) HbA1c reflects longer-term glycemia than does plasma glucose; 3) HbA1c laboratory methods are now well standardized and reliable; and 4) errors caused by nonglycemic factors affecting HbA1c such as hemoglobinopathies are infrequent and can be minimized by confirming the diagnosis of diabetes with a plasma glucose (PG)-specific test. Specific recommendations include: 1) screening standards should be established that prompt further testing and closer follow-up, including fasting PG of 100 mg/dl or greater, random PG of 130 mg/dl or greater, or HbA1c greater than 6.0%; 2) HbA1c of 6.5–6.9% or greater, confirmed by a PG-specific test (fasting plasma glucose or oral glucose tolerance test), should establish the diagnosis of diabetes; and 3) HbA1c of 7% or greater, confirmed by another HbA1c- or a PG-specific test (fasting plasma glucose or oral glucose tolerance test) should establish the diagnosis of diabetes. The recommendations are offered for consideration of the clinical community and interested associations and societies.

Sign in / Sign up

Export Citation Format

Share Document