Detecting Prediabetes and Diabetes: Agreement between Fasting Plasma Glucose and Oral Glucose Tolerance Test in Thai Adults.
OBJECTIVE
To evaluate an agreement in identifying dysglycemia between fasting plasma glucose (FPG) and the 2 hr postprandial glucose tolerance test (OGTT) in a population with high risk of diabetes.


METHODS
A total of 6,884 individuals aged 35-65 years recruited for a community-based diabetes prevention program were tested for prediabetes including impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), and diabetes. The agreement was assessed by Kappa statistics. Logistic regression was used to examine factors associated with missed prediabetes and diabetes by FPG.


RESULTS
A total of 2671 (38.8%) individuals with prediabetes were identified. The prevalence of prediabetes identified by FPG and OGTT was 32.2% and 22.3%, respectively. The proportions of diabetes classified by OGTT were two times higher than those identified by FPG (11.0% versus 5.4%, resp.). The Kappa statistics for agreement of both tests was 0.55. Overall, FPG missed 46.3% of all prediabetes and 54.7% of all diabetes cases. Prediabetes was more likely to be missed by FPG among female, people aged <45 yrs, and those without family history of diabetes.


CONCLUSIONS
The detection of prediabetes and diabetes using FPG only may miss half of the cases. Benefit of adding OGTT to FPG in some specific groups should be confirmed.
Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Wichai
W
Aekplakorn
School of Nursing, Walailak University, Tha Sala, Nakhon Si Thammarat 80161, Thailand.
Valla
V
Tantayotai
Khon Buri Hospital, Khon Buri District, Nakhon Ratchasima 30250, Thailand.
Sakawduan
S
Numsangkul
Nakhon Ratchasima City Municipality, Nakhon Ratchasima 30000, Thailand.
Wilarwan
W
Sripho
Tha Sala Hospital, Tha Sala District, Nakhon Si Thammarat 80160, Thailand.
Nutchanat
N
Tatsato
Tha Sala Hospital, Tha Sala District, Nakhon Si Thammarat 80160, Thailand.
Tuanjai
T
Burapasiriwat
Buddhachinaraj Hospital, Muang District, Phitsanulok 65000, Thailand.
Rachada
R
Pipatsart
Buddhachinaraj Hospital, Muang District, Phitsanulok 65000, Thailand.
Premsuree
P
Sansom
Samutsakhon Hospital, Muang District, Samutsakhon 74000, Thailand.
Pranee
P
Luckanajantachote
Samutsakhon Hospital, Muang District, Samutsakhon 74000, Thailand.
Pongpat
P
Chawarokorn
Thatphanom Crown Prince Hospital, Thatphanom District, Nakhon Phanom 48110, Thailand.
Anek
A
Thanonghan
Thatphanom Crown Prince Hospital, Thatphanom District, Nakhon Phanom 48110, Thailand.
Watchira
W
Lakhamkaew
Pakplee Hospital, Pakplee District, Nakhon Nayok 26130, Thailand.
Aungsumalin
A
Mungkung
Nonghualing Health Center, Pakplee District, Nakhon Nayok 26130, Thailand.
Rungnapa
R
Boonkean
Phrae Hospital, Muang District, Phrae 54000, Thailand.
Chanidsa
C
Chantapoon
Phrae Hospital, Muang District, Phrae 54000, Thailand.
Mayuree
M
Kungsri
Wang Wiset Hospital, Wang Wiset District, Trang 92220, Thailand.
Kasetsak
K
Luanseng
Wang Wiset Hospital, Wang Wiset District, Trang 92220, Thailand.
Kornsinun
K
Chaiyajit
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000473:pathology; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis* / Q000208:ethnology; D005260:Female; D018149:Glucose Intolerance / Q000097:blood; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011236:Prediabetic State / Q000175:diagnosis* / Q000208:ethnology / Q000473:pathology; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013785:Thailand
D001786:Blood Glucose