How should we evaluate the patients with elevated 1 h-plasma glucose?

• Published in: Muller journal of medical sciences and research (Mangalore) Vol. 9; no. 2; pp. 58 - 62
• Main Authors: Paek, Ri-Hyang, Ri, Hak-Chol, Pae, Chol-Min
• Format: Journal Article
• Language: English
• Published: Wolters Kluwer India Pvt. Ltd 01.07.2018; Medknow Publications and Media Pvt. Ltd; Wolters Kluwer Medknow Publications
• Subjects: 1 h-plasma glucose; 75 g oral glucose tolerance test; cutoff value; Diabetes mellitus; Glucose; Homeostasis; impaired glucose tolerance; insulin resistance; Medical schools; Prediabetic state; Type 2 diabetes; 1 h-plasma glucose; impaired glucose tolerance; cutoff value; diabetes mellitus; 75 g oral glucose tolerance test; insulin resistance
• ISSN: 0975-9727
• DOI: 10.4103/mjmsr.mjmsr_25_18

Objectives: This study evaluated the cutoff values of 1 h-plasma glucose (1 h-PG) for the diagnosis of diabetes mellitus and impaired glucose tolerance (IGT), and demonstrated how to evaluate the patients with elevated 1 h-PG. Subjects and Methods: All patients (n = 1433) without known impaired glucose homeostasis (diabetes mellitus [DM] or prediabetes) that have been submitted to the Hospital of the Pyongyang Medical College Kim Il Sung University were enrolled in this study for evaluation of their glucose homeostasis. Results: The area under the receiver operating characteristic of 1 h-PG during 75 g oral glucose tolerance test for diagnosis of DM and IGT were 0.944 ± 0.020 (95% confidence interval [CI]: 0.906-0.983) and 0.964 ± 0.009 (95% CI: 0.944-0.984), respectively. The most optimal cutoff value of 1 h-PG for DM and IGT were 231.0 mg/dL and 161 mg/dL, respectively About 10.4% of normal glucose tolerance (NGT) subjects diagnosed by the present American Diabetes Association (ADA) criteria had 1 h-PG equal to 161 mg/dL or above, their insulin secretion level of pancreas was as low as IGT patient, insulin resistance was higher than NGT subjects with 1 h-PG <161 mg/dL. Moreover, 29.6% of "IGT" patients diagnosed by the present ADA criteria had 1 h-PG equal to 231 mg/dL or above, their insulin secretion level of pancreas was as low as DM patients, insulin resistance was lower than DM and similar to IGT patients with 1 h-PG <231 mg/dL. Conclusions: The cutoff value of 1 h-PG for DM and IGT is 231 mg/dL and 161 mg/dL, it has high sensitivity and specificity for the diagnosis of DM and IGT. The patients with elevated 1 h-PG should be considered as impaired glucose homeostasis (IGT or DM), and therefore treated in time.