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.

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

Oral Glucose Tolerance Test with Insulin Assay and the evaluation of Insulin Resistance and Impaired Beta-cell function in primary prevention for Type 2 Diabetes

2020 ◽  
pp. 1-7
Keyword(s):  
Insulin Resistance ◽  
Glucose Tolerance ◽  
Beta Cell ◽  
Beta Cell Function ◽  
Glucose Tolerance Test ◽  
Cell Function ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

Background: Insulin resistance and impaired beta-cell function are associated with type 2 diabetes mellitus (T2DM). Many insulin resistance and beta-cell function indices have been developed using the data from an oral glucose tolerance test (OGTT) with insulin assay. However, insulin assays are not widely used along with the OGTT in primary prevention outpatient clinics. We aimed to evaluate the association of having impaired fasting glucose (IFG), impaired glucose tolerance (IGT), isolated or combined, with insulin resistance and impaired beta-cell function in subjects at risk for T2DM. Methods: This is a cross-sectional study that included 376 subjects who underwent an OGTT who had at least two risk factors for T2DM without any chronic disease. Results: Participants were 51.6±8.2 years old, 71.8% were women, had a mean body mass index (BMI) of 30.1±6.5 kg/m2, 42.4% had obesity and 26.7% hypertension. A HOMA-IR ≥2.5 was independently associated with male sex, BMI>25kg/m2, and with isolatedIFG, isolated-IGT, or combined (p<0.05 for all). On the other hand, only overweight, but not obesity, was independently associated with impaired beta-cell function (disposition index <1.24). Additionally, combined IFG and IGT had 29.7 higher odds to have impaired beta-cell function compared with those that had a normal OGTT. Conclusions: IFG alone, IGT alone, or the presence of both, are associated with higher odds to have insulin resistance and impaired beta-cell function in asymptomatic subjects at risk for T2DM without any chronic disease. Further studies are needed to evaluate this associations with the risk to develop T2DM, cardiovascular events and mortality.

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