title: Modelling of OGTT curve identifies 1 h plasma glucose level as a strong predictor of incident type 2 diabetes: results from two prospective cohorts.
abstract: OBJECTIVE
  The relevance of the OGTT in predicting type 2 diabetes is unclear. We assessed the performance of 14 OGTT glucose traits in type 2 diabetes prediction.
  
  
  METHODS
  We studied 2,603 and 2,386 Europeans from the Botnia study and Malmö Prevention Project (MPP) cohorts with baseline OGTT data. Over a follow-up period of 4.94 years and 23.5 years, 155 (5.95%) and 467 (19.57%) participants, respectively, developed type 2 diabetes. The main outcome was incident type 2 diabetes.
  
  
  RESULTS
  One-hour plasma glucose (1h-PG) was a fair/good predictor of incident type 2 diabetes in the Botnia study and MPP (AUC for receiver operating characteristic [AUCROC] 0.80 [0.77, 0.84] and 0.70 [0.68, 0.73]). 1h-PG alone outperformed the prediction model of multiple clinical risk factors (age, sex, BMI, family history of type 2 diabetes) in the Botnia study and MPP (AUCROC 0.75 [0.72, 0.79] and 0.67 [0.64, 0.70]). The same clinical risk factors added to 1h-PG modestly increased prediction for incident type 2 diabetes (Botnia, AUCROC 0.83 [0.80, 0.86]; MPP, AUCROC 0.74 [0.72, 0.77]). 1h-PG also outperformed HbA1c in predicting type 2 diabetes in the Botnia cohort. A 1h-PG value of 8.9 mmol/l and 8.4 mmol/l was the optimal cut-point for initial screening and selection of high-risk individuals in the Botnia study and MPP, respectively, and represented 30% and 37% of all participants in these cohorts. High-risk individuals had a substantially increased risk of incident type 2 diabetes (OR 8.0 [5.5, 11.6] and 3.8 [3.1, 4.7]) and captured 75% and 62% of all incident type 2 diabetes in the Botnia study and MPP.
  
  
  CONCLUSIONS
  1h-PG is a valuable prediction tool for identifying adults at risk for future type 2 diabetes.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Michael DeGroote Centre for Learning & Discovery, Room 3205, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Akram
authors.initials: A
authors.lastname: Alyass
authors.forename: Peter
authors.initials: P
authors.lastname: Almgren
authors.forename: Mikael
authors.initials: M
authors.lastname: Akerlund
authors.forename: Jonathan
authors.initials: J
authors.lastname: Dushoff
authors.forename: Bo
authors.initials: B
authors.lastname: Isomaa
authors.forename: Peter
authors.initials: P
authors.lastname: Nilsson
authors.forename: Tiinamaija
authors.initials: T
authors.lastname: Tuomi
authors.forename: Valeriya
authors.initials: V
authors.lastname: Lyssenko
authors.forename: Leif
authors.initials: L
authors.lastname: Groop
authors.forename: David
authors.initials: D
authors.lastname: Meyre
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D002170:Canada / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose