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Published on: January 7, 2018
Criteria for oral glucose tolerance testing of obese minority youth
Mala Puri1, Katherine Freeman, Mireya Garcia
1Division of Pediatric Endocrinology, Children's Hospital at Montefiore, Bronx, NY, USA.
Aim:
To identify those obese minority youth at greatest risk for having an abnormal oral glucose tolerance test (OGTT) indicating impaired glucose tolerance (IGT) or type 2 diabetes mellitus (DM2).
Study Design And Methods:
167 children, who met the ADA criteria for T2DM screening, underwent an OGTT. Logistic regression models were derived for girls, boys, and both. Based on significant variables, algorithms yielding 100% sensitivity were derived to identify candidates for screening.
Results:
12% of children screened had an abnormal OGTT. Girls who met the algorithm criteria for screening (HOMA > 4.5) had an abnormal OGTT with a sensitivity of 100% (95% confidence interval [CI] 0.988-1.0) and specificity of 53.7% (95% CI 0.41-0.648). Boys who met the algorithm screening criteria (HOMA >13, or HbAlc > 5.8%, or total cholesterol > 200 mg/dl) had an abnormal OGTT with a sensitivity of 100% (95% CI 0.979-1.000) and specificity of 76.6% (95% CI 0.632-0.849). The model was validated using a large patient sample, yielding similar results.
Conclusions:
In obese pubertal minority youth meeting the ADA criteria for DM2 screening, these algorithm screening criteria can be useful in identifying those at risk youth who should undergo an OGTT.
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