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Pediatr Diabetes. 2019 Mar;20(2):154-159. doi: 10.1111/pedi.12803. Epub 2018 Dec 27.

Two- vs one-hour glucose tolerance testing: Predicting prediabetes in adolescent girls with obesity.

Author information

1
National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
2
Section on Ethnicity and Health, Diabetes, Endocrinology and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), Bethesda, Maryland.
3
Human Development and Family Studies, Colorado State University; Community and Behavioral Health, Colorado School of Public Health; and Pediatric Endocrinology, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, Colorado.

Abstract

BACKGROUND:

During an oral glucose tolerance test (OGTT), morphological features of the glucose curve (monophasic curve, glucose peak >30 minutes and 1-hour glucose ≥ 155 mg/dL) maybe associated with higher prediabetes risk, but their reproducibility and predictive ability in adolescents with obesity are unknown.

METHODS:

Nondiabetic adolescent girls with obesity underwent a multiple-sample OGTT at baseline (n = 93), 6 weeks (n = 83), and 1 year (n = 72). Short-term reproducibility (baseline to 6 weeks) and the predictive ability for prediabetes (baseline to 1 year) for each feature were compared with standard fasting and 2-hour OGTT diagnostic criteria.

RESULTS:

There was fair/moderate short-term reproducibility (κ < 0.5) for all morphological features. At 1 year, compared with standard OGTT criteria, the areas under the receiver operating curve (ROC-AUCs) for glucose peak > 30 minutes, 1 hour ≥155 mg/dL or a combination of the two criteria were comparable (all P > 0.05), but the monophasic curve had the lowest ROC-AUC (P < 0.001).

CONCLUSIONS:

In adolescent girls with obesity, glucose peak > 30 minutes and/or glucose ≥155 mg/dL had similar reproducibility and 1-year predictive ability for prediabetes compared with standard OGTT criteria. The shortened 1-hour OGTT may provide diagnostic equivalence for prediabetes risk with the additional advantage of a less time-consuming risk assessment.

KEYWORDS:

OGTT; adolescence; glucose tolerance; obesity; prediabetes; reproducibility

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