scholarly journals 30-minute postload plasma glucose levels during an oral glucose tolerance test predict the risk of future type 2 diabetes: the Hisayama Study

2020 ◽  
Vol 8 (1) ◽  
pp. e001156
Author(s):  
Yoichiro Hirakawa ◽  
Jun Hata ◽  
Masahito Yoshinari ◽  
Mayu Higashioka ◽  
Daigo Yoshida ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Plasma Glucose ◽  
Glucose Tolerance Test ◽  
Predictive Ability ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Glucose Levels ◽  
Increased Risk ◽  
Traditional Risk Factors

IntroductionTo investigate the associations of 30 min postload plasma glucose (30 mPG) levels during an oral glucose tolerance test (OGTT) with the risk of future diabetes in a general Japanese population.Research design and methodsA total of 2957 Japanese community-dwelling residents without diabetes, aged 40–79 years, participated in the examinations in 2007 and 2008 (participation rate, 77.1%). Among them, 2162 subjects who received 75 g OGTT in a fasting state with measurements of plasma glucose level at 0, 30, and 120 min were followed up for 7 years (2007–2014). Cox’s proportional hazards model was used to estimate HRs and their 95% CIs of each index for the development of type 2 diabetes using continuous variables and quartiles with adjustment for traditional risk factors. The influence of 30 mPG on the predictive ability was estimated with Harrell’s C-statistics, integrated discrimination improvement (IDI), and the continuous net reclassification index (cNRI).ResultsDuring follow-up, 275 subjects experienced type 2 diabetes. Elevated 30 mPG levels were significantly associated with increased risk of developing diabetes (p<0.01 for trend): the multivariable-adjusted HR was 8.41 (95% CI 4.97 to 14.24) for the highest versus the lowest quartile, and 2.26 (2.04 to 2.52) per 1 SD increase. This association was attenuated but remained significant after further adjustment for fasting and 2-hour postload plasma glucose levels. Incorporation of 30 mPG into the model including traditional risk factors with fasting and 2-hour postload plasma glucose levels for diabetes improved the predictive ability of type 2 diabetes (improvement in Harrell’s C-statistics values: from 0.828 to 0.839, p<0.01; IDI: 0.016, p<0.01; cNRI: 0.103, p=0.37).ConclusionsElevated 30 mPG levels were associated with increased risk of diabetes, and inclusion of 30 mPG levels significantly improved the predictive ability for future diabetes, suggesting that 30 mPG may be useful for identifying high-risk populations for type 2 diabetes.

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>

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>

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

Diabetes Care ◽  
2021 ◽  
Vol 44 (4) ◽  
pp. 1062-1069
Author(s):  
Vasudha Ahuja ◽  
Pasi Aronen ◽  
T.A. Pramodkumar ◽  
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

scholarly journals A Nutraceutical Combination of Cinnamon, Purple Onion, and Tea Linked with Key Enzymes on Treatment of Type 2 Diabetes

2021 ◽  
Author(s):  
Lebin Weng ◽  
Ting-Hsu Chen ◽  
Liyue Huang ◽  
Dong Lai ◽  
Yaw-Syan Fu ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Maximal Response ◽  
Oral Glucose ◽  
Postprandial Plasma Glucose ◽  
Glucose Levels ◽  
High Fructose ◽  
Tea Extract

Abstract Background: Diabetes mellitus (DM) is concomitant with significant morbidity and mortality and its prevalence is accumulative worldwide. The conventional antidiabetic agents are known to mitigate the symptoms of diabetes; however, they may also cause adverse effects. This study explores the efficacy of polyherbal dietary supplement cinnamon, purple onion, and tea on the mediation of postprandial hyperglycemia for in the search of combinations with a maximal response. Materials and methods: A starch solution (3 g/kg Bwt) of oral starch tolerance test (OSTT) and glucose solution (4 g/kg Bwt) of oral glucose tolerance test (OGTT) with and without cinnamon, purple onion, tea extract (15 mg/kg Bwt), and mixture (each 5 mg/kg Bwt, 1:1:1), metformin (14 mg/kg Bwt), or acarbose (50 mg/kg Bwt) was administered to high fat plus high fructose-induced diabetic mice after an overnight fast. Postprandial plasma glucose levels were measured and incremental areas under the response curve were calculated. Results: Compared with acarbose, the mixture of extracts (purple onion, cinnamon, and tea) indicated decreasing blood glucose in OSTT. In OGTT, the mixture of extracts showed greater efficacy for hypoglycemia when compared with metformin. The molecular docking of α-Amylase, α-Glucosidase, and AMPK confirmed the putatively acting molecules from the extracts of purple onion, cinnamon, and tea. Conclusions: Overall, this investigation evidenced a beneficial mediation for the progression of lowering blood glucose with a combinatory extract of cinnamon, dietary onion, and tea, implicating their prospective as nutraceuticals that might ameliorate hyperglycemia in diabetes.

Sign in / Sign up

Export Citation Format

Share Document