1. Accuracy of 1-Hour Plasma Glucose During the Oral Glucose Tolerance Test in Diagnosis of Type 2 Diabetes in Adults: A Meta-analysis.
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Ahuja, Vasudha, Aronen, Pasi, Pramodkumar, T.A., Looker, Helen, Chetrit, Angela, Bloigu, Aini H., Juutilainen, Auni, Bianchi, Cristina, La Sala, Lucia, Anjana, Ranjit Mohan, Pradeepa, Rajendra, Venkatesan, Ulagamadesan, Jebarani, Sarvanan, Baskar, Viswanathan, Fiorentino, Teresa Vanessa, Timpel, Patrick, DeFronzo, Ralph A., Ceriello, Antonio, Del Prato, Stefano, and Abdul-Ghani, Muhammad
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GLUCOSE tolerance tests , *BLOOD sugar , *TYPE 2 diabetes diagnosis , *TYPE 2 diabetes , *CONFORMANCE testing , *CONFIDENCE regions (Mathematics) , *FASTING , *META-analysis , *DIABETES - Abstract
Objective: One-hour plasma glucose (1-h PG) during the oral glucose tolerance test (OGTT) is an accurate predictor of type 2 diabetes. We performed a meta-analysis to determine the optimum cutoff of 1-h PG for detection of type 2 diabetes using 2-h PG as the gold standard.Research Design and Methods: We included 15 studies with 35,551 participants from multiple ethnic groups (53.8% Caucasian) and 2,705 newly detected cases of diabetes based on 2-h PG during OGTT. We excluded cases identified only by elevated fasting plasma glucose and/or HbA1c. We determined the optimal 1-h PG threshold and its accuracy at this cutoff for detection of diabetes (2-h PG ≥11.1 mmol/L) using a mixed linear effects regression model with different weights to sensitivity/specificity (2/3, 1/2, and 1/3).Results: Three cutoffs of 1-h PG, at 10.6 mmol/L, 11.6 mmol/L, and 12.5 mmol/L, had sensitivities of 0.95, 0.92, and 0.87 and specificities of 0.86, 0.91, and 0.94 at weights 2/3, 1/2, and 1/3, respectively. The cutoff of 11.6 mmol/L (95% CI 10.6, 12.6) had a sensitivity of 0.92 (0.87, 0.95), specificity of 0.91 (0.88, 0.93), area under the curve 0.939 (95% confidence region for sensitivity at a given specificity: 0.904, 0.946), and a positive predictive value of 45%.Conclusions: The 1-h PG of ≥11.6 mmol/L during OGTT has a good sensitivity and specificity for detecting type 2 diabetes. Prescreening with a diabetes-specific risk calculator to identify high-risk individuals is suggested to decrease the proportion of false-positive cases. Studies including other ethnic groups and assessing complication risk are warranted. [ABSTRACT FROM AUTHOR]- Published
- 2021
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