[Screening of glucose intolerance with fasting blood samples]

Area of Science:

• Endocrinology
• Metabolic Disorders
• Clinical Diagnostics

Background:

• The oral glucose tolerance test (OGTT) is the standard for glucose intolerance screening but suffers from poor reproducibility.
• Glycemic control markers like HbA1c, 1,5-AG, and fasting blood glucose (FBG) are less affected by sampling conditions but show value overlap between normal and impaired glucose intolerance (IGT).

Purpose of the Study:

• To evaluate a combination testing approach for screening diabetes and identifying individuals at high risk for impaired glucose intolerance.
• To explore alternatives to the standard OGTT with improved reliability and diagnostic accuracy.

Main Methods:

• Assessed the diagnostic utility of combining FBG, HbA1c, and 1,5-AG levels.
• Compared the reproducibility and diagnostic performance against traditional OGTT and individual glycemic markers.

Main Results:

• The combination test of FBG, HbA1c, and 1,5-AG demonstrated durability for screening diabetes and high-risk IGT.
• Observed that lower 2-hour post-load glucose values in OGTT correlated with normal glucose tolerance upon re-examination, suggesting potential for risk stratification using fasting samples.

Conclusions:

• A combination test including FBG, HbA1c, and 1,5-AG offers a durable and potentially more reliable method for screening diabetes and high-risk IGT.
• Further research is needed to clarify the natural history of IGT and establish precise cut-off values for effective screening of impaired glucose intolerance at risk.