scholarly journals Clinical Utility of 30-Min Postload Plasma Glucose in Paediatric Obesity

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A450-A450
Author(s):  
Sarah Wing-yiu Poon ◽  
Joanna Yuet-ling Tung
Keyword(s):  
High Risk ◽  
Plasma Glucose ◽  
Adult Population ◽  
Vascular Complications ◽  
Cell Loss ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Insulinogenic Index ◽  
Cutoff Value ◽  
Paediatric Obesity

Abstract Introduction: Intermediary glucose measurements at other time points in a standard 2-hour oral glucose tolerance test (OGTT) is increasingly being investigated, and a number of studies have demonstated strong predictive value of 1-hour plasma glucose (PG) in identifying subjects with high risk of future diabetes and vascular complications. The association between 30-minute PG and incidence of diabetes is less extensively studied and all the suggested 30-minute PG cutoff values in current literature are derived from adult population. Our study aimed to evaluate the optimal cutoff value of 30-minute PG in predicting abnormal OGTT (prediabetes/diabetes) in a cohort of paediatric subjects with overweight or obesity. Since 30-minute PG could be easily performed even in a busy clinic setting, such cutoff allows clinicians identify high risk subjects who should proceed to a 2-hour OGTT. Methods: Record of 332 paediatric subjects with overweight/obesity who had OGTT done in a tertiary unit from January 2012 to December 2018 was reviewed. Standard OGTT was performed and blood samples for PG and insulin were obtained at 0 minute, 30 minutes and 120 minutes. Subjects with prediabetic and diabetic response were considered together as a group (abnormal OGTT group) for statistical analysis. 30-min PG and insulinogenic index (IGI) were compared, and 30-min PG cutoff which predicts abnormal OGTT response was derived. Results: Our cohort consists of 97.3% Chinese with mean age of 15.4 ± 2.3 years and mean BMI z-score of 2.7 ± 0.6. Sixty subjects (18.1%) had abnormal OGTT – out of which 47 (14.2%) and 13 (3.9%) had prediabetes and diabetes range of glycaemic response respectively. 30-minute PG was statistically higher in the abnormal OGTT group compared to the normal OGTT group (9.6 vs 7.9 mmol/L, p=0.001). IGI was statistically lower in the abnormal OGTT group compared to the normal group (262.1 vs 377.2, p=0003). 30-min PG ≥ 9.2 mmol/L predicts abnormal OGTT with best combination of sensitivity and specficity (AUC 0.77, sensitivty 62.1%, specificity 83.7%). Conclusion: Children with abnormal OGTT reseponse showed impaired first phase insulin secretion suggestive of beta-cell loss. Instead of performing a 2-hour OGTT in every child referred for obesity, 30-min PG, with a cutoff value of 9.2mmol/L, could be used as a stratification tool in identifying high risk subjects who should return for a 2-hour OGTT in another visit.

scholarly journals Prevalence of diabetes mellitus in patients with acromegaly

2014 ◽  
Vol 3 (2) ◽  
pp. 93-98 ◽  
Author(s):  
A V Dreval ◽  
I V Trigolosova ◽  
I V Misnikova ◽  
Y A Kovalyova ◽  
R S Tishenina ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
General Population ◽  
Glucose Tolerance ◽  
Risk Group ◽  
Adult Population ◽  
Tolerance Test ◽  
Population Based ◽  
High Risk Group ◽  
Oral Glucose

Early carbohydrate metabolism disorders (ECMDs) and diabetes mellitus (DM) are frequently associated with acromegaly. We aimed to assess the prevalence of ECMDs in patients with acromegaly and to compare the results with those in adults without acromegaly using two population-based epidemiologic surveys. We evaluated 97 patients with acromegaly in several phases of their disease (mean age, 56 years and estimated duration of acromegaly, 12.5 years). An oral glucose tolerance test was done in those not yet diagnosed with DM to reveal asymptomatic DM or ECMDs (impaired glucose tolerance+impaired fasting glucose). Comparisons were made between patients with acromegaly and participants from the general adult population (n=435) and an adult population with multiple type 2 diabetes risk factors (n=314), matched for gender, age and BMI. DM was diagnosed in 51 patients with acromegaly (52.5%) and 14.3% of the general population (P<0.001). The prevalence of ECMDs was also higher in patients with acromegaly than in the general population and in the high-risk group; only 22% of patients with acromegaly were normoglycaemic. The prevalence of newly diagnosed ECMDs or DM was 1.3–1.5 times higher in patients with acromegaly compared with the high-risk group. Patients with acromegaly having ECMDs or DM were older, more obese and had longer disease duration and higher IGF1 levels (Z-score). Logistic regression showed that the severity of glucose derangement was predicted by age, BMI and IGF1 levels. In patients with acromegaly, the prevalence of DM and ECMDs considerably exceeds that of the general population and of a high-risk group, and development of DM depends on age, BMI and IGF1 levels.

scholarly journals Fasting Plasma Glucose and the HbA1c Are Not Optimal Screening Modalities for the Diagnosis of New Diabetes in Previously Undiagnosed Asian Indian Community Participants

2018 ◽  
Vol 28 (1) ◽  
pp. 19 ◽  
Author(s):  
Rosaley Prakaschandra ◽  
Datshanna Prakesh Naidoo
Keyword(s):  
High Risk ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Predictive Accuracy ◽  
Positive Family History ◽  
Tolerance Test ◽  
Undiagnosed Diabetes ◽  
Oral Glucose ◽  
Fasting Plasma ◽  
Optimal Screening

<p class="Pa7"><strong>Objectives: </strong>There is no definitive consensus on the screening algorithm in high-risk com­munities for diabetes. The aims of our study were to determine the prevalence of undi­agnosed diabetes in a high-risk community using the oral glucose tolerance test (OGTT), as well as determine the value of anthropo­metric measurements and other measures of glycemia in the detection of diabetes.</p><p class="Pa7"><strong>Method: </strong>All participants from the Phoenix Lifestyle project without known diabetes, and who had undergone an OGTT were selected for study. Anthropometric measure­ments were collected according to accepted guidelines. Diabetes was diagnosed if fasting plasma glucose (FPG) ≥7.0 mmol/l, if 2-hour plasma glucose level during OGTT was ≥ 11.0 mmol/l, or if HbA1c ≥ 6.5%.</p><p class="Pa7"><strong>Results: </strong>The prevalence of newly diagnosed diabetes was 14.3% (11.7 % age standard­ized) (women=15.4%; men=11.8%). The prevalence rates were underestimated using FPG criteria, but overestimated when using the HbA1c. The AUC (area under the receiver-operator characteristics curve) was highest for FPG (.879), HbA1c (.855), then anthropometry measures (BMI=.621; waist circumference=.627). For diabetes, at levels <span style="text-decoration: underline;">&gt;</span>6.3, the discriminant ability (DA) of HbA1c was highest (79%), while a cut-point of ≥5.5mmol/l for FPG yielded a DA= 81.5% (82% sensitivity; 81%; specificity of 81%). There was a low level of agreement between the FPG (Kappa = .506), HbA1c (Kappa = .537), and the OGTT. Age- and sex-adjusted independent determinants of diabetes using stepwise backward logistic regression were age, triglyceride levels and a positive family history for diabetes.</p><p class="Default"><strong>Conclusion: </strong>Neither the HbA1c nor the FPG approached adequate predictive accuracy in the diagnosis of diabetes. In view of the high prevalence of undiagnosed diabetes, this study underscores the need for ongoing national surveillance data.</p><p class="Default"><em>Ethn Dis. </em>2018;28(1):19-24; doi:10.18865/ed.28.1.19.</p>

scholarly journals Oral Magnesium Supplementation for Treating Glucose Metabolism Parameters in People with or at Risk of Diabetes: A Systematic Review and Meta-Analysis of Double-Blind Randomized Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4074
Author(s):  
Nicola Veronese ◽  
Ligia J. Dominguez ◽  
Damiano Pizzol ◽  
Jacopo Demurtas ◽  
Lee Smith ◽  
...  
Keyword(s):  
At Risk ◽  
Insulin Sensitivity ◽  
High Risk ◽  
Glucose Metabolism ◽  
Plasma Glucose ◽  
Meta Analysis ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Double Blind ◽  
Oral Magnesium

There is a large and growing body of literature focusing on the use of oral magnesium (Mg) supplementation for improving glucose metabolism in people with or at risk of diabetes. We therefore aimed to investigate the effect of oral Mg supplementation on glucose and insulin-sensitivity parameters in participants with diabetes or at high risk of diabetes, compared with a placebo. Several databases were searched investigating the effect of oral Mg supplementation vs placebo in patients with diabetes or conditions at high risk of diabetes. Data were reported as standardized mean differences (SMDs) with their 95% confidence intervals (CIs) using follow-up data of glucose and insulin-sensitivity parameters. Compared with placebo, Mg supplementation reduced fasting plasma glucose in people with diabetes. In people at high risk of diabetes, Mg supplementation significantly improved plasma glucose per se, and after a 2 h oral glucose tolerance test. Furthermore, Mg supplementation demonstrated an improvement in insulin sensitivity markers. In conclusion, Mg supplementation appears to have a beneficial role and improves glucose parameters in people with diabetes. Moreover, our work indicates that Mg supplementation may improve insulin-sensitivity parameters in those at high risk of diabetes.

scholarly journals Four Plasma Glucose and Insulin Responses to a 75 g OGTT in Healthy Young Japanese Women

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Kei Takahashi ◽  
Hidetaka Nakamura ◽  
Hiroshi Sato ◽  
Hideto Matsuda ◽  
Kazuo Takada ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Plasma Glucose ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Peak Time ◽  
Insulinogenic Index ◽  
Late Type ◽  
Physical Measurements ◽  
Altered Glucose

The incidence of diabetes has been gradually increasing, not only in middle-aged individuals but also in young individuals. However, insulin and glucose patterns have not been investigated in apparently healthy young individuals, as they are typically grouped as controls. In this study, we investigated and classified glucose and insulin patterns in healthy young women. Sixty-two nonobese women without metabolic disease were recruited. The subjects underwent a 75 g oral glucose tolerance test (OGTT), physical measurements, and a biochemical examination. Two subjects displayed impaired glucose tolerance. The 62 subjects were categorized into four patterns by plasma glucose and insulin peak time during OGTT: normal type (n=39), insulin-late type (n=11), insulin- and glucose-late type (n=7), and insulin-very late type (n=5). OGTT glucose and insulin levels at all time points, insulinogenic index, HOMA-IR, and glucose area under the curve (AUC) significantly differed among the four groups. However, insulin AUC did not significantly differ. We did not detect significant differences in body condition or biochemical measurements. Our study demonstrated that some healthy young individuals might have delayed insulin secretion by OGTT. Early detection of altered glucose metabolism might be helpful to improve lifestyle choices and prevent progression to diabetes.

scholarly journals Incidence of diabetes mellitus and associated risk factors in the adult population of the Basque country, Spain

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Inés Urrutia ◽  
◽  
Alicia Martín-Nieto ◽  
Rosa Martínez ◽  
J Oriol Casanovas-Marsal ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Family History ◽  
Basque Country ◽  
Adult Population ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Family History Of Diabetes ◽  
History Of ◽  
Incident Cases

AbstractThe aim of this study was to estimate the incidence of diabetes mellitus in the Basque Country and the risk factors involved in the disease by reassessing an adult population after 7 years of follow-up. In the previous prevalence study, 847 people older than 18 years were randomly selected from all over the Basque Country and were invited to answer a medical questionnaire, followed by a physical examination and an oral glucose tolerance test. In the reassessment, the same variables were collected and the resulting cohort comprised 517 individuals of whom 43 had diabetes at baseline. The cumulative incidence of diabetes was 4.64% in 7 years and the raw incidence rate was 6.56 cases/1000 person-years (95%CI: 4.11–9.93). Among the incident cases, 59% were undiagnosed. The most strongly associated markers by univariate analyses were age > 60 years, dyslipidaemia, prediabetes and insulin resistance. We also found association with hypertension, obesity, family history of diabetes and low education level. Multivariate analysis adjusted for age and sex showed that a set of risk factors assessed together (dyslipidaemia, waist-to-hip-ratio and family history of diabetes) had great predictive value (AUC-ROC = 0.899, 95%CI: 0.846–0.953, p = 0.942), which suggests the need for early intervention before the onset of prediabetes.

Glucose tolerance and insulin action in healthy centenarians

1996 ◽  
Vol 270 (5) ◽  
pp. E890-E894 ◽  
Author(s):  
G. Paolisso ◽  
A. Gambardella ◽  
S. Ammendola ◽  
A. D'Amore ◽  
V. Balbi ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Plasma Glucose ◽  
Insulin Action ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Fat Free Mass ◽  
Whole Body ◽  
Glucose Disposal ◽  
Oral Glucose ◽  
Aged Subjects

Advancing age has been found to be associated with a decline in insulin action. Nevertheless, no study has been conducted in healthy centenarians. Our study investigates glucose tolerance and insulin action in centenarians. Fifty-two subjects were enrolled. The subjects were divided in three groups as follows: 1) adults (< 50 yr; n = 20);2) aged subjects (> 75 yr; n = 22); and 3) centenarians (> 100 yr; n = 14). Body composition was studied by bioimpedance analysis. In all subjects, an oral glucose tolerance test and euglycemic glucose clamp were performed. Centenarians have a lower fat-free mass (FFM) than aged subjects and adults, whereas fasting plasma glucose, triglycerides, free fatty acids, urea, and creatinine were not different in the groups studies. Centenarians had a 2-h plasma glucose concentration (6.0 +/- 0.2 mmol/l) that was lower than that in aged subjects (6.6 +/- 0.5 mmol/l, P < 0.05) but not different from adults [6.4 +/- 0.4 mmol/l, P = not significant (NS)]. During the clamp, plasma glucose and insulin concentrations were similar in the three groups. In these conditions, centenarians had a whole body glucose disposal (34.1 +/- 0.6 mumol.kg FFM-1.min 1) that was greater than that in aged subjects (23.3 +/- 0.5 mumol.kg FFM-1.min-1 P < 0.01) but not different from adults (34.6 +/- 0.5 mumol/kg x min, P = NS). In conclusion, our study demonstrates that centenarians compared with aged subjects had a preserved glucose tolerance and insulin action.

scholarly journals Hyperglycemia at 1h-OGTT in Pregnancy: A Reliable Predictor of Metabolic Outcomes?

2021 ◽  
Vol 12 ◽  
Author(s):  
Elena Succurro ◽  
Federica Fraticelli ◽  
Marica Franzago ◽  
Teresa Vanessa Fiorentino ◽  
Francesco Andreozzi ◽  
...  
Keyword(s):  
High Risk ◽  
Independent Predictor ◽  
Perinatal Outcomes ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Cell Dysfunction ◽  
Metabolic Outcomes ◽  
Impaired Insulin ◽  
In Pregnancy

Gestational diabetes mellitus (GDM) is associated with a high risk of developing type 2 diabetes (T2DM) and cardiovascular disease (CVD). Identifying among GDM women those who are at high risk may help prevent T2DM and, possibly CVD. Several studies have shown that in women with GDM, hyperglycemia at 1 h during an oral glucose tolerance test (OGTT) (1-h PG) is not only associated with an increase in adverse maternal and perinatal outcomes but is also an independent predictor of T2DM. Interestingly, also in pregnant women who did not meet the criteria for a GDM diagnosis, 1-h PG was an independent predictor of postpartum impaired insulin sensitivity and beta-cell dysfunction. Moreover, maternal 1- and 2-h PG levels have been found to be independently associated with insulin resistance and impaired insulin secretion also during childhood. There is evidence that hyperglycemia at 1h PG during pregnancy may identify women at high risk of future CVD, due to its association with an unfavorable CV risk profile, inflammation, arterial stiffness and endothelial dysfunction. Overall, hyperglycemia at 1h during an OGTT in pregnancy may be a valuable prediction tool for identifying women at a high risk of future T2DM, who may then benefit from therapeutic strategies aimed at preventing cardiovascular outcomes.

scholarly journals Parameters of Glucose Homeostasis in the Recognition of the Metabolic Syndrome in Young Adults with Prader–Willi Syndrome

2021 ◽  
Vol 10 (23) ◽  
pp. 5635
Author(s):  
Graziano Grugni ◽  
Antonio Fanolla ◽  
Fiorenzo Lupi ◽  
Silvia Longhi ◽  
Antonella Saezza ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Glucose Homeostasis ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Prader Willi Syndrome ◽  
Insulinogenic Index ◽  
Glucose Levels ◽  
The Metabolic Syndrome ◽  
Diagnostic Threshold ◽  
Age Related

To verify the accuracy of different indices of glucose homeostasis in recognizing the metabolic syndrome in a group of adult patients with Prader–Willi syndrome (PWS), 102 PWS patients (53 females/49 males), age ±SD 26.9 ± 7.6 yrs, Body Mass Index (BMI) 35.7 ± 10.7, were studied. The following indices were assessed in each subject during an oral glucose tolerance test (OGTT): 1 h (>155 mg/dL) and 2 h (140–199 mg/dL) glucose levels, the oral disposition index (ODI), the insulinogenic index (IGI), the insulin resistance (HOMA-IR) were evaluated at baseline, 1 h and 2 h. Although minor differences among indices were found, according to the ROC analysis, no index performed better in recognizing MetS. Furthermore, the diagnostic threshold levels changed over the years and therefore the age-related thresholds were calculated. The easily calculated HOMA-IR at baseline may be used to accurately diagnose MetS, thus avoiding more complicated procedures.

Sign in / Sign up

Export Citation Format

Share Document