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

Ahuja, Vasudha LU ; Aronen, Pasi ; Pramodkumar, T. A. ; Looker, Helen ; Chetrit, Angela ; Bloigu, Aini H. ; Juutilainen, Auni ; Bianchi, Cristina ; La Sala, Lucia and Anjana, Ranjit Mohan , et al. (2021) In Diabetes Care 44(4). p.1062-1069
Abstract

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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Diabetes Care
volume
44
issue
4
pages
8 pages
publisher
American Diabetes Association
external identifiers
  • scopus:85103231563
  • pmid:33741697
ISSN
1935-5548
DOI
10.2337/dc20-1688
language
English
LU publication?
yes
id
88d43823-4d4c-4e2e-a23d-d854397ab228
date added to LUP
2021-04-07 11:20:57
date last changed
2024-06-16 11:57:01
@article{88d43823-4d4c-4e2e-a23d-d854397ab228,
  abstract     = {{<p>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.</p>}},
  author       = {{Ahuja, Vasudha and Aronen, Pasi and Pramodkumar, T. A. and Looker, Helen and Chetrit, Angela and Bloigu, Aini H. and Juutilainen, Auni and Bianchi, Cristina and La Sala, Lucia and Anjana, Ranjit Mohan and Pradeepa, Rajendra and Venkatesan, Ulagamadesan and Jebarani, Sarvanan and Baskar, Viswanathan and Fiorentino, Teresa Vanessa and Timpel, Patrick and DeFronzo, Ralph A. and Ceriello, Antonio and Del Prato, Stefano and Abdul-Ghani, Muhammad and Keinänen-Kiukaanniemi, Sirkka and Dankner, Rachel and Bennett, Peter H. and Knowler, William C. and Schwarz, Peter and Sesti, Giorgio and Oka, Rie and Mohan, Viswanathan and Groop, Leif and Tuomilehto, Jaakko and Ripatti, Samuli and Bergman, Michael and Tuomi, Tiinamaija}},
  issn         = {{1935-5548}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{1062--1069}},
  publisher    = {{American Diabetes Association}},
  series       = {{Diabetes Care}},
  title        = {{Accuracy of 1-Hour Plasma Glucose During the Oral Glucose Tolerance Test in Diagnosis of Type 2 Diabetes in Adults : A Meta-analysis}},
  url          = {{http://dx.doi.org/10.2337/dc20-1688}},
  doi          = {{10.2337/dc20-1688}},
  volume       = {{44}},
  year         = {{2021}},
}