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Leif Groop

Leif Groop

Principal investigator

Leif Groop

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

Author

  • 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-Ghani
  • Sirkka 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

Summary, in English

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.

Department/s

  • Genomics, Diabetes and Endocrinology
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • Diabetic Complications

Publishing year

2021

Language

English

Pages

1062-1069

Publication/Series

Diabetes Care

Volume

44

Issue

4

Document type

Journal article review

Publisher

American Diabetes Association

Topic

  • Endocrinology and Diabetes

Status

Published

Research group

  • Genomics, Diabetes and Endocrinology
  • Diabetic Complications

ISBN/ISSN/Other

  • ISSN: 1935-5548