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Leif Groop

Leif Groop

Principal investigator

Leif Groop

Lessons learned from the 1-hour post-load glucose level during OGTT : Current screening recommendations for dysglycaemia should be revised

Author

  • Michael Bergman
  • Ram Jagannathan
  • Martin Buysschaert
  • Manan Pareek
  • Michael H. Olsen
  • Peter M. Nilsson
  • José Luis Medina
  • Jesse Roth
  • Angela Chetrit
  • Leif Groop
  • Rachel Dankner

Summary, in English

This perspective covers a novel area of research describing the inadequacies of current approaches for diagnosing dysglycaemia and proposes that the 1-hour post-load glucose level during the 75-g oral glucose tolerance test may serve as a novel biomarker to detect dysglycaemia earlier than currently recommended screening criteria for glucose disorders. Considerable evidence suggests that a 1-hour post-load plasma glucose value ≥155 mg/dl (8.6 mmol/L) may identify individuals with reduced β-cell function prior to progressing to prediabetes and diabetes and is highly predictive of those likely to progress to diabetes more than the HbA1c or 2-hour post-load glucose values. An elevated 1-hour post-load glucose level was a better predictor of type 2 diabetes than isolated 2-hour post-load levels in Indian, Japanese, and Israeli and Nordic populations. Furthermore, epidemiological studies have shown that a 1-hour PG ≥155 mg/dl (8.6 mmol/L) predicted progression to diabetes as well as increased risk for microvascular disease and mortality when the 2-hour level was <140 mg/dl (7.8 mmol/L). The risk of myocardial infarction or fatal ischemic heart disease was also greater among subjects with elevated 1-hour glucose levels as were risks of retinopathy and peripheral vascular complications in a Swedish cohort. The authors believe that the considerable evidence base supports redefining current screening and diagnostic recommendations with the 1-hour post-load level. Measurement of the 1-hour PG level would increase the likelihood of identifying a larger, high-risk group with the additional practical advantage of potentially replacing the conventional 2-hour oral glucose tolerance test making it more acceptable in a clinical setting.

Department/s

  • Internal Medicine - Epidemiology
  • Genomics, Diabetes and Endocrinology
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health

Publishing year

2018-03-24

Language

English

Publication/Series

Diabetes/Metabolism Research and Reviews

Volume

34

Issue

5

Document type

Journal article

Publisher

John Wiley & Sons Inc.

Topic

  • Endocrinology and Diabetes

Keywords

  • Diabetes
  • HbA
  • Impaired fasting glucose
  • Impaired glucose tolerance
  • Oral glucose tolerance test
  • Prediabetes

Status

Published

Research group

  • Internal Medicine - Epidemiology
  • Genomics, Diabetes and Endocrinology

ISBN/ISSN/Other

  • ISSN: 1520-7552