Two- vs one-hour glucose tolerance testing: Predicting prediabetes in adolescent girls with obesity

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Abstract

During an oral glucose tolerance test (OGTT), morphological features of the glucose curve (monophasic curve, glucose peak >30 minutes and 1-hour glucose ≥ 155 mg/dL) maybe associated with higher prediabetes risk, but their reproducibility and predictive ability in adolescents with obesity are unknown.

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Most cited references 28

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9. Cardiovascular Disease and Risk Management:Standards of Medical Care in Diabetes—2018

(2018)

The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

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beta-Cell function in subjects spanning the range from normal glucose tolerance to overt diabetes: a new analysis.

Andrea Mari, Ele Ferrannini, M. Matsuda … (2004)

The nature of the progressive beta-cell failure occurring as normal glucose tolerant (NGT) individuals progress to type 2 diabetes (T2DM) is incompletely understood. We measured insulin sensitivity (by a euglycemic insulin clamp) and insulin secretion rate (by deconvolution of plasma C-peptide levels during an oral glucose tolerance test) in 188 subjects [19 lean NGT (body mass index [BMI]

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Assessing the shape of the glucose curve during an oral glucose tolerance test.

Fausto Machicao, Fatemeh Shirkavand, Andreas Fritsche … (2003)

The oral glucose tolerance test (OGTT) is used to define the status of glucose tolerance based on the plasma glucose level at 120 min. The purpose of the present study was to identify parameters that determine the shape of the plasma glucose course measured at 0, 30, 60, 90, and 120 min during an OGTT. OGTT data from 551 subjects (485 with normal glucose tolerance [NGT] and 66 with impaired glucose tolerance [IGT]) were analyzed. We distinguished between "monophasic," "biphasic," and unclassified glucose shapes. A "shape" index based on the extent and the direction of the plasma glucose change in the second hour allowed us to treat shape as a continuous variable. In the biphasic group, the NGT-to-IGT ratio was slightly higher (173/20 vs. 209/40, P = 0.08) and the male-to-female ratio was lower (60/133 vs. 120/129, P = 0.0003). Subjects with a biphasic shape had significantly lower age, BMI, waist-to-hip ratio (WHR), HbA(1c), plasma glucose, and area under the insulin curve (insulin(AUC)) and a better estimated insulin sensitivity and secretion (using validated indexes) than monophasic subjects (all P < 0.05). By adjusting this shape index for glucose(AUC) (as continuous measure of glucose tolerance), correlations with age, BMI, WHR, HbA(1c), and insulin(AUC) were completely abolished. The adjusted shape index was still higher in female than in male subjects but lower in IGT than in NGT subjects (both P = 0.0003). Finally, we tested common polymorphisms in insulin receptor substrate (IRS)-1, IRS-2, calpain-10, hepatic lipase, and peroxisome proliferator-activated receptor-gamma for association with the shape index. We conclude that the plasma glucose shape during an OGTT depends on glucose tolerance and sex. In addition, genetic factors seem to play a role. The shape index may be a useful metabolic screening parameter in epidemiological and genetic association studies.

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Author and article information

Journal

Title: Pediatric Diabetes

Abbreviated Title: Pediatr Diabetes

Publisher: Wiley

ISSN: 1399543X

Publication date Created: March 2019

Publication date (Print): March 2019

Publication date (Electronic): December 27 2018

Volume: 20

Issue: 2

Pages: 154-159

Affiliations

[1 ]National Institute of Child Health and Human Development, National Institutes of Health; Bethesda Maryland

[2 ]Section on Ethnicity and Health, Diabetes, Endocrinology and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK); National Institutes of Health (NIH); Bethesda Maryland

[3 ]Human Development and Family Studies, Colorado State University; Community and Behavioral Health, Colorado School of Public Health; and Pediatric Endocrinology; University of Colorado School of Medicine/Children's Hospital Colorado; Aurora Colorado