Lessons learned from the 1-hour post-load glucose level during OGTT: Current screening recommendations for dysglycaemia should be revised

Michael Bergman*, Ram Jagannathan, Martin Buysschaert, Manan Pareek, Michael H. Olsen, Peter M. Nilsson, José Luis Medina, Jesse Roth, Angela Chetrit, Leif Groop, Rachel Dankner

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

This perspective covers a novel area of research describing the inadequacies of current approaches for diagnosing dysglycaemia and proposes that the 1-hour post-load glucose level during the 75-g oral glucose tolerance test may serve as a novel biomarker to detect dysglycaemia earlier than currently recommended screening criteria for glucose disorders. Considerable evidence suggests that a 1-hour post-load plasma glucose value ≥155 mg/dl (8.6 mmol/L) may identify individuals with reduced β-cell function prior to progressing to prediabetes and diabetes and is highly predictive of those likely to progress to diabetes more than the HbA1c or 2-hour post-load glucose values. An elevated 1-hour post-load glucose level was a better predictor of type 2 diabetes than isolated 2-hour post-load levels in Indian, Japanese, and Israeli and Nordic populations. Furthermore, epidemiological studies have shown that a 1-hour PG ≥155 mg/dl (8.6 mmol/L) predicted progression to diabetes as well as increased risk for microvascular disease and mortality when the 2-hour level was <140 mg/dl (7.8 mmol/L). The risk of myocardial infarction or fatal ischemic heart disease was also greater among subjects with elevated 1-hour glucose levels as were risks of retinopathy and peripheral vascular complications in a Swedish cohort. The authors believe that the considerable evidence base supports redefining current screening and diagnostic recommendations with the 1-hour post-load level. Measurement of the 1-hour PG level would increase the likelihood of identifying a larger, high-risk group with the additional practical advantage of potentially replacing the conventional 2-hour oral glucose tolerance test making it more acceptable in a clinical setting.

Original languageEnglish
Article numbere2992
JournalDiabetes - Metabolism: Research and Reviews (Print Edition)
Volume34
Issue number5
Number of pages8
ISSN1520-7552
DOIs
Publication statusPublished - Jul 2018

Keywords

  • diabetes
  • HbA
  • impaired fasting glucose
  • impaired glucose tolerance
  • oral glucose tolerance test
  • prediabetes
  • Diabetes Mellitus, Type 2/blood
  • Glucose Tolerance Test
  • Prognosis
  • Humans
  • Risk Factors
  • Prediabetic State/blood
  • Blood Glucose/analysis
  • Biomarkers/blood
  • Practice Guidelines as Topic/standards
  • Glycated Hemoglobin A/analysis
  • Hyperglycemia/blood

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    Bergman, M., Jagannathan, R., Buysschaert, M., Pareek, M., Olsen, M. H., Nilsson, P. M., Medina, J. L., Roth, J., Chetrit, A., Groop, L., & Dankner, R. (2018). Lessons learned from the 1-hour post-load glucose level during OGTT: Current screening recommendations for dysglycaemia should be revised. Diabetes - Metabolism: Research and Reviews (Print Edition), 34(5), [e2992]. https://doi.org/10.1002/dmrr.2992