Modelling of OGTT curve identifies 1 h plasma glucose level as a strong predictor of incident type 2 diabetes: results from two prospective cohorts.

Abstract

AIMS/HYPOTHESIS:

The relevance of the OGTT in predicting type 2 diabetes is unclear. We assessed the performance of 14 OGTT glucose traits in type 2 diabetes prediction.

METHODS:

We studied 2,603 and 2,386 Europeans from the Botnia study and Malmö Prevention Project (MPP) cohorts with baseline OGTT data. Over a follow-up period of 4.94 years and 23.5 years, 155 (5.95%) and 467 (19.57%) participants, respectively, developed type 2 diabetes. The main outcome was incident type 2 diabetes.

RESULTS:

One-hour plasma glucose (1h-PG) was a fair/good predictor of incident type 2 diabetes in the Botnia study and MPP (AUC for receiver operating characteristic [AUCROC] 0.80 [0.77, 0.84] and 0.70 [0.68, 0.73]). 1h-PG alone outperformed the prediction model of multiple clinical risk factors (age, sex, BMI, family history of type 2 diabetes) in the Botnia study and MPP (AUCROC 0.75 [0.72, 0.79] and 0.67 [0.64, 0.70]). The same clinical risk factors added to 1h-PG modestly increased prediction for incident type 2 diabetes (Botnia, AUCROC 0.83 [0.80, 0.86]; MPP, AUCROC 0.74 [0.72, 0.77]). 1h-PG also outperformed HbA1c in predicting type 2 diabetes in the Botnia cohort. A 1h-PG value of 8.9 mmol/l and 8.4 mmol/l was the optimal cut-point for initial screening and selection of high-risk individuals in the Botnia study and MPP, respectively, and represented 30% and 37% of all participants in these cohorts. High-risk individuals had a substantially increased risk of incident type 2 diabetes (OR 8.0 [5.5, 11.6] and 3.8 [3.1, 4.7]) and captured 75% and 62% of all incident type 2 diabetes in the Botnia study and MPP.

CONCLUSIONS/INTERPRETATION:

1h-PG is a valuable prediction tool for identifying adults at risk for future type 2 diabetes.

• Authors: Akram Alyass, Peter Almgren, Mikael Akerlund, Jonathan Dushoff, Bo Isomaa, Peter Nilsson, Tiinamaija Tuomi, Valeriya Lyssenko, Leif Groop, David Meyre
• Journal: Diabetologia (Diabetologia) Vol. 58 Issue 1 Pg. 87-97 (Jan 2015) ISSN: 1432-0428 [Electronic] Germany
• PMID: 25292440 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose

Topics

• Adult
• Blood Glucose (analysis)
• Canada (epidemiology)
• Diabetes Mellitus, Type 2 (blood, diagnosis, epidemiology)
• Female
• Follow-Up Studies
• Glucose Tolerance Test
• Humans
• Incidence
• Male
• Middle Aged
• Models, Theoretical
• Prognosis
• Prospective Studies