Background: According to current literature 1-h glucose ≥155 mg/dl during an oral glucose tolerance test (OGTT) is considered an independent predictor of β-cell deterioration and future progression to prediabetes in obese individuals.
Objective and hypotheses: To investigate whether determination of glucose level obtained 1-h after glucose load can improve predictive ability of prediabetes.
Method: Ninety-eight overweight/obese youngsters aged 2.616.5 years were included for analysis. History taking, physical examination and an OGTT were performed. In order to predict prediabetes, defined as impaired fasting glucose and/or impaired glucose tolerance, four models were evaluated: i) a basic model including demographics (gender, pubertal stage, BMI percentile, ethnic origin, hypertension, hypercholesterolemia, acanthosis nigricans, history of gestational diabetes, parental family history of diabetes type 2 or obesity and birth weight below 5th percentile-for-gestational-age), ii) a second one combining the basic model plus measurement of fasting glucose, iii) a third one that compiled the basic model and the 1-h glucose level obtained during the OGTT, and iv) a fourth model that incorporated both fasting and 1-h glucose level into the basic model.
Results: Prediabetes was diagnosed in 67/98 participants (69.4%). The basic model significantly contributed to prediction of prediabetes (area under the curve (AUC): 0.74, 95% CI: 0.6360.851). The additional determination of fasting glucose or 1-h glucose level obtained during the OGTT also increased the predictive ability (AUC: 0.84, 95 %CI: 0.750.92 and AUC: 0.80, 95 %CI: 0.700.89 respectively).The fourth model, comprised of all previous parameters (basic model+fasting+1-h glucose), predicted prediabetes to even a further degree (AUC: 0.87, 95 %CI: 0.80.94).
Conclusion: The 1-h glucose appears to be a reliable parameter to detect prediabetes, especially in combination with demographic and clinical characteristics as well as fasting glucose levels.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology