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Does "afternoon diabetes" predict diabetes?

R J Jarrett, G C Viberti, H A Sayegh

    British Medical Journal
    |March 4, 1978
    PubMed
    Summary
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    Morning glucose tolerance tests can predict future diabetes. Calculating the area under the curve in 1969 accurately identified men who later developed diabetes, outperforming afternoon tests.

    Area of Science:

    • Endocrinology
    • Metabolic Health
    • Diabetes Prediction

    Background:

    • Oral glucose tolerance tests (OGTT) are used to diagnose diabetes.
    • Assessing diurnal variations in glucose metabolism is crucial for understanding diabetes progression.

    Purpose of the Study:

    • To evaluate the predictive value of morning and afternoon OGTTs for future diabetes development.
    • To determine if the area under the glucose tolerance curve (AUC) can better predict diabetes onset.

    Main Methods:

    • Twenty-eight men underwent morning and afternoon OGTTs in 1969 and again in 1975.
    • Analysis included comparing results based on British Diabetic Association criteria.
    • Calculation of the AUC for morning OGTTs was performed.

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    Main Results:

    • Seven men showed abnormal afternoon glucose levels in 1969, while four developed diabetes by 1975.
    • The AUC from morning OGTTs in 1969 was a superior predictor of subsequent diabetes.
    • All four men who progressed to diabetes had morning AUCs exceeding 1000 units, distinguishing them from others.

    Conclusions:

    • Morning OGTTs, particularly the AUC, offer better prediction of future diabetes than afternoon tests.
    • Obesity was associated with progression to diabetes but was a less reliable predictor than morning glucose AUC.
    • Diurnal glucose tolerance patterns may indicate early metabolic changes preceding overt diabetes.