scholarly journals Role of Glycated Hemoglobin in the Prediction of Future Risk of T2DM

2011 ◽  
Vol 96 (8) ◽  
pp. 2596-2600 ◽  
Author(s):  
Muhammad A. Abdul-Ghani ◽  
Tamam Abdul-Ghani ◽  
Gabriele Müller ◽  
Antje Bergmann ◽  
Sabine Fischer ◽  
...  
Keyword(s):  
Plasma Glucose ◽  
Roc Curve ◽  
Logistic Model ◽  
Predictive Power ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Multivariate Logistic Model

Abstract Aim: The aim of this study was to assess the predictive power of glycated hemoglobin (HbA1c) for future type 2 diabetes risk. Research Design and Methods: Six hundred eighty-seven subjects who were free of type 2 diabetes mellitus (T2DM) participated in the study. Each subject received a 75-g oral glucose tolerance test at baseline and 624 received a repeat oral glucose tolerance test after 3.5 ± 0.1 yr of follow-up. Anthropometric measurements, lipid profile, and HbA1c were measured during the baseline visit. Logistic multivariate models were created with T2DM status at follow-up as the dependent variable and other parameters as the independent variables. The receiver-operating characteristic (ROC) was used to assess the predictive discrimination of the various models. Results: HbA1c was a significant predictor of future T2DM risk (area under the ROC curve = 0.73, P < 0.0001). A HbA1c cut point of 5.65% had the maximal sum of sensitivity and specificity. Although the area under the ROC curve of HbA1c was smaller than the area under the ROC curve of both the 1-h plasma glucose concentration and a multivariate logistic model (including anthropometric parameters, lipid profile, and fasting plasma glucose), the addition of HbA1c to both the 1-h plasma glucose and the multivariate logistic model significantly increased their predictive power. Conclusion: Although HbA1c alone is a weaker predictor of future T2DM risk compared with the 1-h plasma glucose, it provides additive information about future T2DM risk when added to previously published prediction models.

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 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.

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 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 The 1-Hour Plasma Glucose: Common Link Across the Glycemic Spectrum

2021 ◽  
Vol 12 ◽  
Author(s):  
Michael Bergman
Keyword(s):  
Plasma Glucose ◽  
Glucose Tolerance Test ◽  
Cell Function ◽  
Diabetes Type 2 ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Populations At Risk

Evidence from populations at risk for type 1 diabetes, type 2 diabetes or gestational diabetes substantiates the 1-hour plasma glucose as a sensitive alternative marker for identifying high-risk individuals when ß-cell function is relatively more functional. An elevated 1-hour plasma glucose could therefore diagnose dysglycemia and risk for complications across the glycemic spectrum. Reducing the 2-hour oral glucose tolerance test to 1-hour would reduce the burden on patients, likely reduce costs, and enhance its accessibility in practice.

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