Narasimmal Sai Prasanna1, Anandakumar Amutha1, Thyparambil Aravindakshan Pramodkumar1, Ranjit Mohan Anjana1, Ulagamathesan Venkatesan1, Miranda Priya1, Rajendra Pradeepa1, Viswanathan Mohan2. 1. Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, ICMR Centre for Advanced Research on Diabetes, Gopalapuram, Chennai, India. 2. Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, ICMR Centre for Advanced Research on Diabetes, Gopalapuram, Chennai, India. Electronic address: drmohans@diabetes.ind.in.
Abstract
AIM: To analyse the OGTT glycemic parameters - fasting, 1h and 2h plasma glucose values singly and in various combinations; with respect to their prediction of future dysglycemia in subjects with normal glucose tolerance (NGT). METHODS: Electronic medical records of individuals who underwent an OGTT between 1991 and 2016 at a tertiary diabetes centre were analysed. NGT subjects who had at least one more follow up OGTT (n=1356) were selected for the study. Regarding their prediction of future dysglycemia, the glycemic parameters-Fasting plasma glucose (FPG), 1h plasma glucose (1HrPG) and 2h plasma glucose (2HrPG) were analysed separately and also in different combinations. HbA1c and the combined use of HbA1c and FPG were also compared. Receiver operating characteristic (ROC) curve analysis was performed to assess the capability of various glycemic parameters to discriminate between NGT and dysglycemia. The WHO criteria were used to define dysglycemia as the presence of prediabetes (Impaired fasting glucose and/or Impaired glucose tolerance) or diabetes. RESULTS: 318(23.4%) developed prediabetes (median follow up 3.5years) and 134(10%) developed diabetes (median follow up 5.6years). The 1hrPG had a significantly higher AUC (0.684, 0.716) compared to FPG (0.560 and 0.593) and 2hrPG (0.644 and 0.618) for prediabetes and diabetes respectively. Adding the FPG or the 2hrPG to the 1HrPG did not significantly improve the AUC beyond 1HrPG alone. The 1HrPG also predicted diabetes better than HbA1c as well as the combined use of HbA1c and FPG. CONCLUSION: The 1HrPG value during OGTT is a good predictor of future dysglycemia among NGT subjects.
AIM: To analyse the OGTT glycemic parameters - fasting, 1h and 2h plasma glucose values singly and in various combinations; with respect to their prediction of future dysglycemia in subjects with normal glucose tolerance (NGT). METHODS: Electronic medical records of individuals who underwent an OGTT between 1991 and 2016 at a tertiary diabetes centre were analysed. NGT subjects who had at least one more follow up OGTT (n=1356) were selected for the study. Regarding their prediction of future dysglycemia, the glycemic parameters-Fasting plasma glucose (FPG), 1h plasma glucose (1HrPG) and 2h plasma glucose (2HrPG) were analysed separately and also in different combinations. HbA1c and the combined use of HbA1c and FPG were also compared. Receiver operating characteristic (ROC) curve analysis was performed to assess the capability of various glycemic parameters to discriminate between NGT and dysglycemia. The WHO criteria were used to define dysglycemia as the presence of prediabetes (Impaired fasting glucose and/or Impaired glucose tolerance) or diabetes. RESULTS: 318(23.4%) developed prediabetes (median follow up 3.5years) and 134(10%) developed diabetes (median follow up 5.6years). The 1hrPG had a significantly higher AUC (0.684, 0.716) compared to FPG (0.560 and 0.593) and 2hrPG (0.644 and 0.618) for prediabetes and diabetes respectively. Adding the FPG or the 2hrPG to the 1HrPG did not significantly improve the AUC beyond 1HrPG alone. The 1HrPG also predicted diabetes better than HbA1c as well as the combined use of HbA1c and FPG. CONCLUSION: The 1HrPG value during OGTT is a good predictor of future dysglycemia among NGT subjects.
Authors: Michael Bergman; Muhammad Abdul-Ghani; Ralph A DeFronzo; Melania Manco; Giorgio Sesti; Teresa Vanessa Fiorentino; Antonio Ceriello; Mary Rhee; Lawrence S Phillips; Stephanie Chung; Celeste Cravalho; Ram Jagannathan; Louis Monnier; Claude Colette; David Owens; Cristina Bianchi; Stefano Del Prato; Mariana P Monteiro; João Sérgio Neves; Jose Luiz Medina; Maria Paula Macedo; Rogério Tavares Ribeiro; João Filipe Raposo; Brenda Dorcely; Nouran Ibrahim; Martin Buysschaert Journal: Diabetes Res Clin Pract Date: 2020-06-01 Impact factor: 5.602
Authors: Vasudha Ahuja; Pasi Aronen; T A Pramodkumar; Helen Looker; Angela Chetrit; Aini H Bloigu; Auni Juutilainen; Cristina Bianchi; Lucia La Sala; Ranjit Mohan Anjana; Rajendra Pradeepa; Ulagamadesan Venkatesan; Sarvanan Jebarani; Viswanathan Baskar; Teresa Vanessa Fiorentino; Patrick Timpel; Ralph A DeFronzo; Antonio Ceriello; Stefano Del Prato; Muhammad Abdul-Ghani; Sirkka Keinänen-Kiukaanniemi; Rachel Dankner; Peter H Bennett; William C Knowler; Peter Schwarz; Giorgio Sesti; Rie Oka; Viswanathan Mohan; Leif Groop; Jaakko Tuomilehto; Samuli Ripatti; Michael Bergman; Tiinamaija Tuomi Journal: Diabetes Care Date: 2021-04 Impact factor: 19.112