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.

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; Aronen, Pasi; Pramodkumar, T A; Looker, Helen; Chetrit, Angela; Bloigu, Aini H; Juutilainen, Auni; Bianchi, Cristina; La Sala, Lucia; Anjana, Ranjit Mohan; Pradeepa, Rajendra; Venkatesan, Ulagamadesan; Jebarani, Sarvanan; Baskar, Viswanathan; Fiorentino, Teresa Vanessa; Timpel, Patrick; Defronzo, Ralph A; Ceriello, Antonio; Del Prato, Stefano; Abdul-Ghani, Muhammad; Keinänen-Kiukaanniemi, Sirkka; Dankner, Rachel; Bennett, Peter H; Knowler, William C; Schwarz, Peter; Sesti, Giorgio; Oka, Rie; Mohan, Viswanathan; Groop, Leif; Tuomilehto, Jaakko; Ripatti, Samuli; Bergman, Michael; Tuomi, Tiinamaija. - In: DIABETES CARE. - ISSN 0149-5992. - 44:4(2021), pp. 1062-1069. [10.2337/dc20-1688]

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

Sesti, Giorgio
Writing – Review & Editing
;
2021

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 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.
2021
prediabetes; type 2 diabetes; meta-analysis; glucose tolerance test
01 Pubblicazione su rivista::01a Articolo in rivista
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; Aronen, Pasi; Pramodkumar, T A; Looker, Helen; Chetrit, Angela; Bloigu, Aini H; Juutilainen, Auni; Bianchi, Cristina; La Sala, Lucia; Anjana, Ranjit Mohan; Pradeepa, Rajendra; Venkatesan, Ulagamadesan; Jebarani, Sarvanan; Baskar, Viswanathan; Fiorentino, Teresa Vanessa; Timpel, Patrick; Defronzo, Ralph A; Ceriello, Antonio; Del Prato, Stefano; Abdul-Ghani, Muhammad; Keinänen-Kiukaanniemi, Sirkka; Dankner, Rachel; Bennett, Peter H; Knowler, William C; Schwarz, Peter; Sesti, Giorgio; Oka, Rie; Mohan, Viswanathan; Groop, Leif; Tuomilehto, Jaakko; Ripatti, Samuli; Bergman, Michael; Tuomi, Tiinamaija. - In: DIABETES CARE. - ISSN 0149-5992. - 44:4(2021), pp. 1062-1069. [10.2337/dc20-1688]
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