Accuracy of 1-Hour Plasma Glucose During the Oral Glucose Tolerance Test in Diagnosis of Type 2 Diabetes in Adults: A Meta-analysis

Vasudha Ahuja, Pasi Aronen, T. A. Pramodkumar, Helen Looker, Angela Chetrit, Aini H. Bloigu, Auni Juutilainen, Cristina Bianchi, Lucia La Sala, Ranjit Mohan Anjana, Rajendra Pradeepa, Ulagamadesan Venkatesan, Sarvanan Jebarani, Viswanathan Baskar, Teresa Vanessa Fiorentino, Patrick Timpel, Ralph A. DeFronzo, Antonio Ceriello, Stefano Del Prato, Muhammad Abdul-GhaniSirkka Keinänen-Kiukaanniemi, Rachel Dankner, Peter H. Bennett, William C. Knowler, Peter Schwarz, Giorgio Sesti, Rie Oka, Viswanathan Mohan, Leif Groop, Jaakko Tuomilehto, Samuli Ripatti, Michael Bergman, Tiinamaija Tuomi

Forskningsoutput: TidskriftsbidragÖversiktsartikelPeer review

3 Citeringar (SciVal)

Sammanfattning

OBJECTIVE: 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 cutoff of 1-h PG for detection of type 2 diabetes using 2-h PG as the gold standard. RESEARCH DESIGN AND METHODS: We included 15 studies with 35,551 participants from multiple ethnic groups (53.8% Caucasian) and 2,705 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 cutoff for detection of 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). RESULTS: Three cutoffs 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 cutoff of 11.6 mmol/L (95% CI 10.6, 12.6) had a sensitivity of 0.92 (0.87, 0.95), specificity of 0.91 (0.88, 0.93), area under the curve 0.939 (95% confidence region for sensitivity at a given specificity: 0.904, 0.946), and a positive predictive value of 45%. CONCLUSIONS: The 1-h PG of ≥11.6 mmol/L during OGTT has 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.

Originalspråkengelska
Sidor (från-till)1062-1069
Antal sidor8
TidskriftDiabetes Care
Volym44
Utgåva4
DOI
StatusPublished - 2021

Ämnesklassifikation (UKÄ)

  • Endokrinologi och diabetes

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