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Ahuja, V.* ; Aronen, P.* ; Pramodkumar, T.A.* ; Looker, H.* ; Chetrit, A.* ; Bloigu, A.H.* ; Juutilainen, A.* ; Bianchi, C.* ; La Sala, L.* ; Anjana, R.M.* ; Pradeepa, R.* ; Venkatesan, U.* ; Jebarani, S.* ; Baskar, V.* ; Fiorentino, T.V.* ; Timpel, P.* ; DeFronzo, R.A.* ; Ceriello, A.* ; Del Prato, S.* ; Abdul-Ghani, M.* ; Keinänen-Kiukaanniemi, S.* ; Dankner, R.* ; Bennett, P.H.* ; Knowler, W.C.* ; Schwarz, P.E. ; Sesti, G.* ; Oka, R.* ; Mohan, V.* ; Groop, L.* ; Tuomilehto, J.* ; Ripatti, S.* ; Bergman, M.* ; Tuomi, T.*

Accuracy of 1-hour plasma glucose during the oral glucose tolerance test in diagnosis of type 2 diabetes in adults: A meta-analysis.

Diabetes Care 44, 1062-1069 (2021)
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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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Publication type Article: Journal article
Document type Scientific Article
ISSN (print) / ISBN 0149-5992
e-ISSN 1935-5548
Journal Diabetes Care
Quellenangaben Volume: 44, Issue: 4, Pages: 1062-1069 Article Number: , Supplement: ,
Publisher American Diabetes Association
Publishing Place Alexandria, Va.
Reviewing status Peer reviewed
Institute(s) Institute for Pancreatic Beta Cell Research (IPI)
Grants Finnish Diabetes Research Foundation
Foundation for Life and Health in Finland
Signe and Ane Gyllenberg Foundation
Finnish Medical Society
Paavo Nurmi Foundation
State Research Funding via the Helsinki University Hospital
Perklen Foundation
Narpes Health Care Foundation
Ahokas Foundation
Swedish Cultural Foundation in Finland
Ollqvist Foundation
Academy of Finland
Folkhalsan Research Foundation
Sigrid Juselius Foundation
University of Helsinki
Nordic Center of Excellence in Disease Genetics
European Union (EXGENESIS project)
European Union (MOSAIC project)
Ministry of Education in Finland
Municipal Health Care Center and Hospital in Jakobstad
Health Care Center in Vasa
Finnish Cultural Foundation Central Fund
Division of Intramural Research of National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
Japan Health Promotion Foundation
Toyama Medical Association
Roche Diagnostics
Bayer Pharma
Boehringer Ingelheim
DCURE Foundation
Eli Lilly, Italy
Health Care Center in Narpes
Health Care Center in Korsholm
Pfizer Inc.
Regeneron Pharmaceuticals
European Research Council under the European Union's Seventh Framework Programme (FP7/2007-2013)/ERC grant
European Foundation for the Study of Diabetes
Fondazione Romeo ad Enrica Invernizzi-Milano, an EFSD/Sanofi program
Italian Ministry of Health-Ricerca Corrente
FoRiSID, Rome, Italy