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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.

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National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
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.
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.



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.


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.


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).


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.


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

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