title: A reassessment of fasting plasma glucose concentrations in population screening for diabetes mellitus in a community of northern European ancestry: the Wadena City Health Study.
abstract: In current clinical and research practice, the determination of diabetic status depends largely on plasma glucose levels 2 h after the ingestion of a standard 75-g glucose load, the oral glucose tolerance test (OGTT). The OGTT, however, remains inconvenient, not highly reproducible, and costly, especially for large-scale studies and population screening tests. Fasting plasma glucose (FPG) determinations are convenient, reliable, and valid measures of glucose intolerance, but the currently prescribed cut-off point of 140 mg/dl (7.8 mM) lacks sensitivity. We evaluated the reliability and validity of fasting plasma glucose (FPG) values compared with other measures of hyperglycemia for a diagnosis of diabetes in a population-based study of carbohydrate metabolism in Wadena, Minnesota, a community of predominantly northern European ancestry. As a part of this effort, a random sample of Wadena adults, stratified by age and gender, plus all known, previously diagnosed diabetics participated in 2 days of baseline testing and were followed prospectively and retested 5 years later. Cross-sectional analyses of baseline data are presented in this article. Diabetic status was ascertained by administering a standard OGTT according to National Diabetes Data Group (NDDG) specifications. Sensitivity and specificity levels obtained when using a FPG cut-off point of 6.4 mM were 95.2% and 97.4%, respectively. In study subjects with no known diagnosis of diabetes, the FPG cut-off point of 6.4 mM performed reasonably well with a sensitivity and specificity of 67.7% and 97.4%, respectively. (ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Minnesota Department of Health, University of Minnesota, Minneapolis 55440.
authors.forename: J P
authors.initials: JP
authors.lastname: Clements
authors.forename: L R
authors.initials: LR
authors.lastname: French
authors.forename: J R
authors.initials: JR
authors.lastname: Boen
authors.forename: J M
authors.initials: JM
authors.lastname: Sprafka
authors.forename: B
authors.initials: B
authors.lastname: Hedlund
authors.forename: F C
authors.initials: FC
authors.lastname: Goetz
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000208:ethnology; D005060:Europe / Q000208:ethnology; D005215:Fasting; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D044465:White People
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin