One-hour plasma glucose concentration and the metabolic syndrome identify subjects at high risk for future type 2 diabetes.
OBJECTIVE
To assess the efficacy of 1-h plasma glucose concentration and the metabolic syndrome in predicting future risk of type 2 diabetes.


METHODS
A total of 1,611 subjects from the San Antonio Heart Study, who were free of type 2 diabetes at baseline; who had plasma glucose and insulin concentrations measured at time 0, 30, 60, and 120 min during the oral glucose tolerance test (OGTT); and who had their diabetes status determined with an OGTT after 7-8 years of follow-up, were evaluated. Two models, based on glucose tolerance status, 1-h plasma glucose concentration, and presence of the metabolic syndrome, were tested in predicting the risk for type 2 diabetes at 7-8 years of follow-up.


RESULTS
A cutoff point of 155 mg/dl for the 1-h plasma glucose concentration during the OGTT was used to stratify subjects in each glucose tolerance group into low, intermediate, and high risk for future type 2 diabetes. A model based upon 1-h plasma glucose concentration, Adult Treatment Panel (ATP) III criteria for the metabolic syndrome, and fasting plasma glucose, independent of 2-h plasma glucose, performed equally well in stratifying nondiabetic subjects into low, intermediate, and high risk for future type 2 diabetes and identified a group of normal glucose-tolerant subjects who were at very high risk for future type 2 diabetes.


CONCLUSIONS
The plasma glucose concentration at 1 h during the OGTT is a strong predictor of future risk for type 2 diabetes. A plasma glucose cutoff point of 155 mg/dl and the ATP III criteria for the metabolic syndrome can be used to stratify nondiabetic subjects into three risk groups: low, intermediate, and high risk.
Abdul-Ghani
Muhammad A
MA
Divisions of Diabetes and Epidemiology, University of Texas Health Science Center at San Antonio, Texas, USA. abdulghani@uthscsa.edu
Abdul-Ghani
Tamam
T
Ali
Nibal
N
Defronzo
Ralph A
RA
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D049628:Body Size; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000150:complications; D008875:Middle Aged; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology
D001786:Blood Glucose