Diagnostic criteria for diabetes mellitus and other categories of glucose intolerance: 1997 criteria by the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (ADA), 1998 WHO consultation criteria, and 1985 WHO criteria. World Health Organization.
To compare 1997 ADA diagnostic criteria for diabetes mellitus and other categories of glucose intolerance/1998 WHO Consultation criteria versus 1985 WHO criteria, we analyzed data from a 75-g oral glucose tolerance test (OGTT) performed on 1051 high-risk subjects without medical history of diabetes at Diabetes Screening Clinic, Ramathibodi Hospital, Thailand. There were 372 males and 679 females, aged (mean +/- S.D.) = 50.3 +/- 12.55 years, BMI = 25.62 +/- 4.39 kg/m2. If fasting plasma glucose (FPG) was used as recently recommended then 54.1, 20.4, and 25.5% of cases were classified as normal, impaired fasting glucose (IFG), and diabetic, respectively. In diagnosing diabetes using a full OGTT based on the 1985 WHO criteria as the reference test, FPG > or = 7 mmol/l had a sensitivity of 57.7%, specificity of 97.4%, positive predictive value of 94.0%, and negative predictive value of 76.4%; 53.7% of subjects with IFG had 2-h plasma glucose > or = 11.1 mmol/l. The 1997 ADA/1998 WHO Consultation criteria and 1985 WHO criteria for a full OGTT yield similar overall results. FPG ( > or = 7 mmol/l) was not sensitive for diagnosing diabetes. Moreover, about half of the subjects with IFG were actually diabetic. Therefore, OGTT remains a valuable test in diagnosing diabetes and classifying various categories of glucose intolerance.
Department of Medicine and Research Center, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand.
G
G
Puavilai
S
S
Chanprasertyotin
A
A
Sriphrapradaeng
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis* / Q000378:metabolism; D003920:Diabetes Mellitus / Q000145:classification* / Q000175:diagnosis*; D005260:Female; D018149:Glucose Intolerance / Q000145:classification* / Q000175:diagnosis*; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012955:Societies, Medical; D013785:Thailand; D014837:Voluntary Health Agencies; D014944:World Health Organization
D001786:Blood Glucose