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Lessons learned from the 1-hour post-load glucose level during OGTT: Current screening recommendations for dysglycaemia should be revised.

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Bergman, Michael Jagannathan, Ram Buysschaert, Martin [UCL] Pareek, Manan Olsen, Michael H Dankner, Rachel

This perspective covers a novel area of research describing the inadequacies of current approaches for diagnosing dysglycaemia and proposes that the 1-hour post-load glucose level during the 75-g oral glucose tolerance test may serve as a novel biomarker to detect dysglycaemia earlier than currently recommended screening criteria for glucose disorders. Considerable evidence suggests that a 1-hour post-load plasma glucose value ≥155 mg/dl (8.6 mmol/L) may identify individuals with reduced β-cell function prior to progressing to prediabetes and diabetes and is highly predictive of those likely to progress to diabetes more than the HbA or 2-hour post-load glucose values. An elevated 1-hour post-load glucose level was a better predictor of type 2 diabetes than isolated 2-hour post-load levels in Indian, Japanese, and Israeli and Nordic populations. Furthermore, epidemiological studies have shown that a 1-hour PG ≥155 mg/dl (8.6 mmol/L) predicted progression to diabetes as well as increased risk for microvascular disease and mortality when the 2-hour level was <140 mg/dl (7.8 mmol/L). The risk of myocardial infarction or fatal ischemic heart disease was also greater among subjects with elevated 1-hour glucose levels as were risks of retinopathy and peripheral vascular complications in a Swedish cohort. The authors believe that the considerable evidence base supports redefining current screening and diagnostic recommendations with the 1-hour post-load level. Measurement of the 1-hour PG level would increase the likelihood of identifying a larger, high-risk group with the additional practical advantage of potentially replacing the conventional 2-hour oral glucose tolerance test making it more acceptable in a clinical setting.

Document type Article de périodique (Journal article) – Article de recherche
Publication date 2018
Language Anglais
Journal information "Diabetes - Metabolism: Research and Reviews" - Vol. 34, no. 5, p. e2992 (2018)
Peer reviewed yes
Publisher Wiley-Blackwell ((United Kingdom) Oxford)
issn 1520-7552
e-issn 1520-7560
Publication status Publié
Affiliations UCL - (SLuc) Service d'endocrinologie et de nutrition
UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition
Keywords HbA1c ; diabetes ; impaired fasting glucose ; impaired glucose tolerance ; oral glucose tolerance test ; prediabetes
Links
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Bibliographic reference Bergman, Michael ; Jagannathan, Ram ; Buysschaert, Martin ; Pareek, Manan ; Olsen, Michael H ; et. al. Lessons learned from the 1-hour post-load glucose level during OGTT: Current screening recommendations for dysglycaemia should be revised.. In: Diabetes - Metabolism: Research and Reviews, Vol. 34, no. 5, p. e2992 (2018)
Permanent URL http://hdl.handle.net/2078.1/197723