Format

Send to

Choose Destination
Diabetes Res Clin Pract. 2020 Mar;161:108075. doi: 10.1016/j.diabres.2020.108075. Epub 2020 Feb 11.

Clinical utility of 30-min plasma glucose for prediction of type 2 diabetes among people with prediabetes: Ancillary analysis of the diabetes community lifestyle improvement program.

Author information

1
Department of Medicine, Division of Hospital Medicine, Emory University School of Medicine, Atlanta, GA, USA. Electronic address: ram.jagannathan@emory.edu.
2
Emory Global Diabetes Research Center, Hubert Department of Global Health, Emory University, Atlanta, GA, USA.
3
Madras Diabetes Research Foundation, Chennai, India.

Abstract

AIMS:

To examine the clinical utility of 30-min plasma glucose (30-min-PG) measurement during an oral glucose tolerance (OGTT) in predicting type 2 diabetes (T2DM).

RESEARCH DESIGN AND METHODS:

Data from a 3-year, randomized, controlled, primary prevention trial among 548 Asian Indians with prediabetes were analyzed. Participants underwent OGTT with PG measurements at fasting, 30-min, and 2-h at baseline and annually until the end of the study. Multivariable Cox regression models were constructed to calculate the risk of developing diabetes based on 30-min-PG levels. Improvement in prediction performance gained by adding an elevated level of 30-min-PG over prediabetic categories was calculated using the area-under-curve (AUC), net-reclassification (NRI), and integrated discrimination improvement (IDI) statistics.

RESULTS:

At the end of follow-up, 30.4% of individuals had been diagnosed with T2DM by ADA criteria. Based on the maximally selected log-rank statistics, the optimal 30-min-PG cut point for predicting incident T2DM was >182 mg/dl. Multivariable-adjusted Cox regression models showed an independent association between elevated 30-min-PG (>182 mg/dl) and incident diabetes (hazard ratio (95% CI): 1.85 [1.32, 2.59]; Dxy = 0.353, c-statistic = 0.676). The addition of an elevated 30-min-PG (>182 mg/dl) model significantly improved the prediction of diabetes (Δdeviance: -15.4; ΔAUC: 0.11; NRIcontinuous: 0.51; IDI: 0.08) compared with IFG model alone) in individuals with prediabetes.

CONCLUSION:

In prediabetic individuals, baseline 30-min-PG independently predicted T2DM and significantly improved reclassification and discrimination. Therefore, 30-min-PG should be considered as part of the routine testing in addition to FPG and 2-h-PG for better risk stratification.

KEYWORDS:

30-min-plasma glucose; Diabetes prediction; Net reclassification improvement; OGTT; Prediabetes; Predictive utility

Conflict of interest statement

Declaration of Competing Interest The authors declared that there is no conflict of interest.

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center