1-hour post-OGTT glucose improves the early prediction of type 2 diabetes by clinical and metabolic markers
G Peddinti, M Bergman, T Tuomi… - The Journal of Clinical …, 2019 - academic.oup.com
G Peddinti, M Bergman, T Tuomi, L Groop
The Journal of Clinical Endocrinology & Metabolism, 2019•academic.oup.comContext Early prediction of dysglycemia is crucial to prevent progression to type 2 diabetes.
The 1-hour postload plasma glucose (PG) is reported to be a better predictor of dysglycemia
than fasting plasma glucose (FPG), 2-hour PG, or glycated hemoglobin (HbA1c). Objective
To evaluate the predictive performance of clinical markers, metabolites, HbA1c, and PG and
serum insulin (INS) levels during a 75-g oral glucose tolerance test (OGTT). Design and
Setting We measured PG and INS levels at 0, 30, 60, and 120 minutes during an OGTT in …
The 1-hour postload plasma glucose (PG) is reported to be a better predictor of dysglycemia
than fasting plasma glucose (FPG), 2-hour PG, or glycated hemoglobin (HbA1c). Objective
To evaluate the predictive performance of clinical markers, metabolites, HbA1c, and PG and
serum insulin (INS) levels during a 75-g oral glucose tolerance test (OGTT). Design and
Setting We measured PG and INS levels at 0, 30, 60, and 120 minutes during an OGTT in …
Context
Early prediction of dysglycemia is crucial to prevent progression to type 2 diabetes. The 1-hour postload plasma glucose (PG) is reported to be a better predictor of dysglycemia than fasting plasma glucose (FPG), 2-hour PG, or glycated hemoglobin (HbA1c).
Objective
To evaluate the predictive performance of clinical markers, metabolites, HbA1c, and PG and serum insulin (INS) levels during a 75-g oral glucose tolerance test (OGTT).
Design and Setting
We measured PG and INS levels at 0, 30, 60, and 120 minutes during an OGTT in 543 participants in the Botnia Prospective Study, 146 of whom progressed to type 2 diabetes within a 10-year follow-up period. Using combinations of variables, we evaluated 1527 predictive models for progression to type 2 diabetes.
Results
The 1-hour PG outperformed every individual marker except 30-minute PG or mannose, whose predictive performances were lower but not significantly worse. HbA1c was inferior to 1-hour PG according to DeLong test P value but not false discovery rate. Combining the metabolic markers with PG measurements and HbA1c significantly improved the predictive models, and mannose was found to be a robust metabolic marker.
Conclusions
The 1-hour PG, alone or in combination with metabolic markers, is a robust predictor for determining the future risk of type 2 diabetes, outperforms the 2-hour PG, and is cheaper to measure than metabolites. Metabolites add to the predictive value of PG and HbA1c measurements. Shortening the standard 75-g OGTT to 1 hour improves its predictive value and clinical usability.
Oxford University Press