The fasting plasma glucose cut-point predicting a diabetic 2-h OGTT glucose level depends on the phenotype.
To assess the use of fasting plasma glucose (FPG) alone for the screening of diabetes as defined by a 2-h plasma glucose (2-h PG) > or =11.1 mmol/l following a 75-g oral glucose tolerance test, we collated the results from 17512 subjects aged 30-89 years without a previous history of diabetes from 12 general population-based Asian studies. The performance of FPG corresponding to the 2-h PG > or =11.1 mmol/l was characterized. The prevalence of diabetes was 4.0% by the FPG criteria only and 6.0% by the 2-h PG criteria only. The FPG value of 7.0 mmol/l gave a sensitivity for diabetes as defined by a 2-h PG > or =11.1 mmol/l of 46% and specificity of 99%. The FPG associated with a 2-h PG > or =11.1 mmol/l with optimal sensitivity and specificity was 5.8 mmol/l (sensitivity 79%, specificity 85%). The optimal FPG cut-point was affected by gender, age, body mass index and the presence of hypertension, and the resulting sensitivity and specificity corresponding to each optimal cut-point changed. The FPG was a specific but insensitive screening test for diabetes defined by 2-h PG > or =11.1 mmol/l. There seems to be ethnic differences with respect to optimal FPG cut-point, and different screening strategies may be necessary in different parts of the world.
Nakagami
Tomoko
T
nakagami@dmc.twmu.ac.jp
Qiao
Qing
Q
Tuomilehto
Jaakko
J
Balkau
Beverley
B
Carstensen
Bendix
B
Tajima
Naoko
N
Iwamoto
Yasuhiko
Y
Borch-Johnsen
Knut
K
Borch-Jonsen
Knut
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis* / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011237:Predictive Value of Tests; D015995:Prevalence; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012727:Sex Characteristics; D013997:Time Factors
D001786:Blood Glucose