Role of various indices derived from an oral glucose tolerance test in the prediction of conversion from prediabetes to type 2 diabetes

• Published in: Diabetes research and clinical practice 2014-11, Vol.106 (2), p.351-359
• Main Authors: Kim, Ye An, Ku, Eu Jeong, Khang, Ah Reum, Hong, Eun Shil, Kim, Kyoung Min, Moon, Jae Hoon, Choi, Sung Hee, Park, Kyong Soo, Jang, Hak Chul, Lim, Soo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Blood Glucose - analysis; Blood Glucose - metabolism; C-Peptide - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - pathology; Disease Progression; Endocrinology & Metabolism; Female; Follow-Up Studies; Glucose Intolerance - blood; Glucose Intolerance - diagnosis; Glucose Intolerance - epidemiology; Glucose Tolerance Test; Health Status Indicators; Humans; Insulin - blood; Insulin resistance; Insulin Resistance - physiology; Male; Middle Aged; Oral glucose tolerance test; Prediabetes; Prediabetic State - blood; Prediabetic State - diagnosis; Prediabetic State - epidemiology; Prediabetic State - pathology; Risk; Type 2 diabetes; β-Cell function
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2014.08.014

Abstract Aims The clinical implications of prediabetes for development of type 2 diabetes may differ for Asian ethnicity. We investigated various indices derived from a 2-h oral glucose tolerance test (OGTT) in people with prediabetes to predict their future risk of diabetes. Methods We recruited 406 consecutive subjects with prediabetes from 2005 to 2006 and followed them up every 3–6 months for up to 9 years. Prediabetes was defined as isolated impaired fasting glucose (IFG), isolated impaired glucose tolerance (IGT), combined glucose intolerance (CGI), or isolated elevated HbA1c (5.7–6.4%, 39–46 mmol/mol) without IFG or IGT. The rate of diabetes conversion was compared between prediabetes categories. The association of glycemic indices with development of diabetes was also investigated. Results Eighty-one patients were diagnosed with diabetes during the 9-year follow-up (median 46.0 months). The rate of diabetes conversion was higher in subjects with CGI (31.9%), or isolated IGT (18.5%) than in those with isolated IFG (15.2%) or isolated elevated HbA1c (10.9%). Surrogate markers reflecting β-cell dysfunction were more closely associated with diabetes conversion than insulin resistance indices. Subjects with a 30-min postload glucose ≥165 mg/dL and a 30-min C-peptide