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One-hour postload glucose concentration predicts future diabetes
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The risk for developing diabetes may be predicted using 1-hour postload glucose concentration in adults with normal glucose tolerance, according to recent study results.
Nam H. Cho, MD, PhD, of the department of preventive medicine, Ajou University School of Medicine in Korea, Hak Chul Jang, MD, PhD, of the department of internal medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital in Korea, and colleagues evaluated data from the Korean Genome and Epidemiology Study on 5,703 adults (mean age, 51.3 years; mean BMI, 24.2 kg/m2) with normal glucose tolerance to determine whether 1-hour glucose concentration can predict future diabetes. Standard 75-g oral glucose tolerance tests were performed every 2 years for 12 years to estimate indices of insulin sensitivity and beta-cell function.
During follow-up, 10.3% of participants developed diabetes with a mean time to progression of 6.8 years. Compared with participants who did not develop diabetes, participants who did develop diabetes were older and more often male; had greater mean BMI, waist circumference and waist-to-hip ratio; had higher levels for systolic and diastolic blood pressure, plasma glucose concentration, total cholesterol, LDL cholesterol, triglyceride, aspartate transaminase, alanine transaminase, creatinine and high-sensitivity C-reactive protein; had increased homeostasis model of assessment for insulin resistance (HOMA-IR) and HbA1c; and had lower beta-cell function, insulin sensitivity and oral disposition index.
A cutoff value of at least 8 mmol/L for 1-hour postload plasma glucose concentration for predicting diabetes yielded 70% sensitivity and 68% specificity, according to the researchers.
Compared with participants with normal glucose tolerance and low 1-hour postload plasma glucose concentration (< 8 mmol/L), participants with normal glucose tolerance and high 1-hour postload plasma glucose concentration had higher BP, HbA1c level and triglyceride concentration after adjustment for age, sex, BMI and family history of diabetes.
Participants with a 1-hour postload glucose concentration of at least 8 mmol/L had a 2.84-fold increased risk for incident diabetes after full adjustment.
“In this community-based 12-year prospective cohort study, 1-[hour] postload plasma glucose concentration, which represents the early deterioration of [beta]-cell function, was an independent predictor of future diabetes mellitus after adjusting for conventional risk factors, including fasting and 2-[hour] postload glucose concentrations,” the researchers wrote. “In conclusion, we propose the cutoff value of 8 mmol/L for the 1-[hour] glucose concentration during the OGTT can identify people at high risk of future diabetes mellitus, even though they are classified as having ‘normal’ glucose metabolism in the current guideline.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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