One-hour post-load plasma glucose as a strong predictor of future risk for type 2 diabetes
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A total of 2442 subjects from the Botnia study, without baseline type 2 diabetes, received an oral glucose tolerance test (OGTT) at baseline and after 7-8 years of follow-up in order to assess the efficacy of post-load plasma glucose (PG) concentration in predicting future risk of type 2 diabetes as compared to prediction models based on the measurement of fasting plasma glucose (FPG) concentration. The risk for future type 2 diabetes was assessed with the area under the ROC for prediction models based upon measurement of the FPG (i) with or without 1-h PG during the OGTT and (ii) with or without metabolic syndrome (ATP III criteria). The results revealed that prediction models based on measurement of FPG were weak predictors, whereas the addition of 1-h PG markedly increased the predictive value for the risk of future type 2 diabetes. To stratify subjects in each glucose tolerance group into low-, intermediate- and high-risk for future type 2 diabetes, a cutoff point of 155 mg/dL for the 1-h PG during OGTT plus the presence of metabolic syndrome were used. Plasma glucose concentration at 1 hour during the OGTT appears to be a strong predictor of future risk for type 2 diabetes, adding to the prediction power of models based upon measurements made during the fasting condition.
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