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Evaluating the 1-h post-load glucose level to predict future type 2 diabetes.

Anni E Saunajoki1, Juha P Auvinen2, Aini H Bloigu1

  • 1Center for Life Course Health Research, University of Oulu, Oulu, Finland.

Diabetes Research and Clinical Practice
|January 14, 2020
PubMed
Summary

Adding a 2-hour glucose test to fasting and 1-hour glucose measurements does not improve type 2 diabetes risk prediction. The 1-hour glucose level alone showed the strongest predictive ability in this study.

Keywords:
1-h post-load glucoseOGTTPredictionType 2 diabetes

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Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Diabetes Research

Background:

  • Type 2 diabetes risk prediction relies on various glucose measurements.
  • Fasting and 1-hour post-load glucose levels are commonly used predictors.
  • The incremental value of the 2-hour post-load glucose level remains under investigation.

Purpose of the Study:

  • To assess if including the 2-hour post-load glucose level enhances the prediction of type 2 diabetes risk.
  • To compare the predictive performance of fasting, 1-hour, and 2-hour glucose levels.
  • To determine the optimal glucose measurement for predicting incident type 2 diabetes.

Main Methods:

  • Prospective population-based cohort study of 654 individuals without type 2 diabetes.
  • Oral glucose tolerance tests (OGTT) performed at baseline and after 12 years, measuring glucose at 0, 60, and 120 minutes.
  • Receiver-operating characteristic (ROC) curve analysis used to evaluate predictive accuracy.

Main Results:

  • The addition of the 2-hour glucose level to a model with fasting and 1-hour glucose did not significantly improve type 2 diabetes prediction (AUC 0.83 vs. 0.82, p=0.23).
  • The 1-hour glucose level demonstrated the highest predictive accuracy (AUC 0.81).
  • Fasting (AUC 0.71) and 2-hour (AUC 0.72) glucose levels showed lower predictive power compared to the 1-hour level.

Conclusions:

  • The 2-hour post-load glucose measurement does not add significant predictive value for new-onset type 2 diabetes when fasting and 1-hour glucose levels are already considered.
  • The 1-hour glucose level appears to be a more potent predictor of type 2 diabetes risk than fasting or 2-hour levels in this cohort.