Efficacy of 1‐hour postload plasma glucose as a suitable measurement in predicting type 2 diabetes and diabetes‐related complications: A post hoc analysis of the 30‐year follow‐up of the Da Qing IGT and Diabetes Study

• Published in: Diabetes, obesity & metabolism Vol. 26; no. 6; pp. 2329 - 2338
• Main Authors: Peng, Minying, He, Siyao, Wang, Jinping, An, Yali, Qian, Xin, Zhang, Bo, Zhang, Lihong, Chen, Bo, Yang, Zhiwei, Li, Guangwei, Gong, Qiuhong
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.2024; Wiley Subscription Services, Inc
• Subjects: 1‐hour glucose; Cardiovascular diseases; Diabetes; diabetes complication; Diabetes mellitus (non-insulin dependent); Glucose; Microvasculature; Mortality; prediabetes; screening; 1-hour glucose; screening; prediabetes; diabetes complication
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/dom.15547

Aim To evaluate whether 1‐hour plasma glucose (1hPG) can be a comparable measurement to 2‐hour plasma glucose (2hPG) in identifying individuals at high risk of developing diabetes. Methods A total of 1026 non‐diabetic subjects in the Da Qing IGT and Diabetes Study were included and classified according to baseline postload 1hPG. The participants were followed up and assessed at 6‐, 20‐ and 30year follow‐up for outcomes including diabetes, all‐cause and cardiovascular mortality, cardiovascular disease (CVD) events, and microvascular disease. We then conducted a proportional hazards analysis in this post hoc study to determine the risks of developing type 2 diabetes and its complications in a ‘1hPG‐normal’ group (1hPG <8.6 mmol/L) and a ‘1hPG‐high’ group (≥8.6 mmol/L). The predictive values of 1hPG and 2hPG were evaluated using a time‐dependent receiver‐operating characteristic (ROC) curve. Results Compared with the 1hPG‐normal group, the 1hPG‐high group had increased risk of diabetes (hazard ratio [HR] 4.45, 95% CI 3.43–5.79), all‐cause mortality (HR 1.46, 95% CI 1.07–2.01), CVD mortality (HR 1.84, 95% CI 1.16–2.95), CVD events (HR 1.39, 95% CI 1.03–1.86) and microvascular disease (HR 1.70, 95% CI: 1.03–2.79) after adjusting for confounders. 1hPG exhibited a higher area under the ROC curve (AUC) for predicting diabetes than 2hPG during the long‐term follow‐up (AUC [1hPG vs. 2hPG]: 10 years: 0.86 vs. 0.84, p = 0.08; 20 years: 0.88 vs. 0.87, p = 0.04; 30 years: 0.85 vs. 0.82, p = 0.009). Conclusions Elevated 1hPG level (≥8.6 mmol/L) was associated with increased risk of developing type 2 diabetes and its long‐term complications, and could be considered as a suitable measurement for identifying individuals at high risk of type 2 diabetes.