One-Hour Oral Glucose Tolerance Tests for the Prediction and Diagnostic Surveillance of Type 1 Diabetes
(2020) In The Journal of clinical endocrinology and metabolism 105(11).- Abstract
CONTEXT: Once islet autoantibody-positive individuals are identified, predicting which individuals are at highest risk for type 1 diabetes (T1D) is important. A metabolic risk score derived from 2-hour oral glucose tolerance test (OGTT) data, the Diabetes Prevention Trial-Type 1 risk score (DPTRS), can accurately predict T1D. However, 2-hour OGTTs are time-consuming and costly. OBJECTIVE: We aimed to determine whether a risk score derived from 1-hour OGTT data can predict T1D as accurately as the DPTRS. Secondarily, we evaluated whether a 1-hour glucose value can be used for diagnostic surveillance. METHODS: The DPTRS was modified to derive a 1-hour OGTT risk score (DPTRS60) using fasting C-peptide, 1-hour glucose and C-peptide, age,... (More)
CONTEXT: Once islet autoantibody-positive individuals are identified, predicting which individuals are at highest risk for type 1 diabetes (T1D) is important. A metabolic risk score derived from 2-hour oral glucose tolerance test (OGTT) data, the Diabetes Prevention Trial-Type 1 risk score (DPTRS), can accurately predict T1D. However, 2-hour OGTTs are time-consuming and costly. OBJECTIVE: We aimed to determine whether a risk score derived from 1-hour OGTT data can predict T1D as accurately as the DPTRS. Secondarily, we evaluated whether a 1-hour glucose value can be used for diagnostic surveillance. METHODS: The DPTRS was modified to derive a 1-hour OGTT risk score (DPTRS60) using fasting C-peptide, 1-hour glucose and C-peptide, age, and body mass index. Areas under receiver operating curves (ROCAUCs) were used to compare prediction accuracies of DPTRS60 with DPTRS in Diabetes Prevention Trial-Type 1 (DPT-1) (n = 654) and TrialNet Pathway to Prevention (TNPTP) (n = 4610) participants. Negative predictive values (NPV) for T1D diagnosis were derived for 1-hour glucose thresholds. RESULTS: ROCAUCs for T1D prediction 5 years from baseline were similar between DPTRS60 and DPTRS (DPT-1: 0.805 and 0.794; TNPTP: 0.832 and 0.847, respectively). DPTRS60 predicted T1D significantly better than 2-hour glucose (P < .001 in both cohorts). A 1-hour glucose of less than 180 mg/dL had a similar NPV, positive predictive value, and specificity for T1D development before the next 6-month visit as the standard 2-hour threshold of less than 140 mg/dL (both ≥ 98.5%). CONCLUSION: A 1-hour OGTT can predict T1D as accurately as a 2-hour OGTT with minimal risk of missing a T1D diagnosis before the next visit.
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- author
- Simmons, Kimber M. ; Sosenko, Jay M. ; Warnock, Megan ; Geyer, Susan ; Ismail, Heba M. ; Elding Larsson, Helena LU and Steck, Andrea K.
- publishing date
- 2020-11-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- autoantibody, diagnosis, metabolic risk, oral glucose tolerance test, prediction, type 1 diabetes
- in
- The Journal of clinical endocrinology and metabolism
- volume
- 105
- issue
- 11
- publisher
- Oxford University Press
- external identifiers
-
- pmid:32844178
- scopus:85091691945
- ISSN
- 1945-7197
- DOI
- 10.1210/clinem/dgaa592
- language
- English
- LU publication?
- no
- id
- 32e7c52e-d6cb-4e27-94fa-cefcc58b00c3
- date added to LUP
- 2020-10-23 12:32:48
- date last changed
- 2024-07-25 02:36:07
@article{32e7c52e-d6cb-4e27-94fa-cefcc58b00c3, abstract = {{<p>CONTEXT: Once islet autoantibody-positive individuals are identified, predicting which individuals are at highest risk for type 1 diabetes (T1D) is important. A metabolic risk score derived from 2-hour oral glucose tolerance test (OGTT) data, the Diabetes Prevention Trial-Type 1 risk score (DPTRS), can accurately predict T1D. However, 2-hour OGTTs are time-consuming and costly. OBJECTIVE: We aimed to determine whether a risk score derived from 1-hour OGTT data can predict T1D as accurately as the DPTRS. Secondarily, we evaluated whether a 1-hour glucose value can be used for diagnostic surveillance. METHODS: The DPTRS was modified to derive a 1-hour OGTT risk score (DPTRS60) using fasting C-peptide, 1-hour glucose and C-peptide, age, and body mass index. Areas under receiver operating curves (ROCAUCs) were used to compare prediction accuracies of DPTRS60 with DPTRS in Diabetes Prevention Trial-Type 1 (DPT-1) (n = 654) and TrialNet Pathway to Prevention (TNPTP) (n = 4610) participants. Negative predictive values (NPV) for T1D diagnosis were derived for 1-hour glucose thresholds. RESULTS: ROCAUCs for T1D prediction 5 years from baseline were similar between DPTRS60 and DPTRS (DPT-1: 0.805 and 0.794; TNPTP: 0.832 and 0.847, respectively). DPTRS60 predicted T1D significantly better than 2-hour glucose (P < .001 in both cohorts). A 1-hour glucose of less than 180 mg/dL had a similar NPV, positive predictive value, and specificity for T1D development before the next 6-month visit as the standard 2-hour threshold of less than 140 mg/dL (both ≥ 98.5%). CONCLUSION: A 1-hour OGTT can predict T1D as accurately as a 2-hour OGTT with minimal risk of missing a T1D diagnosis before the next visit.</p>}}, author = {{Simmons, Kimber M. and Sosenko, Jay M. and Warnock, Megan and Geyer, Susan and Ismail, Heba M. and Elding Larsson, Helena and Steck, Andrea K.}}, issn = {{1945-7197}}, keywords = {{autoantibody; diagnosis; metabolic risk; oral glucose tolerance test; prediction; type 1 diabetes}}, language = {{eng}}, month = {{11}}, number = {{11}}, publisher = {{Oxford University Press}}, series = {{The Journal of clinical endocrinology and metabolism}}, title = {{One-Hour Oral Glucose Tolerance Tests for the Prediction and Diagnostic Surveillance of Type 1 Diabetes}}, url = {{http://dx.doi.org/10.1210/clinem/dgaa592}}, doi = {{10.1210/clinem/dgaa592}}, volume = {{105}}, year = {{2020}}, }