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. 2009;6(2):117-23.
doi: 10.1900/RDS.2009.6.117. Epub 2009 Aug 10.

Comparison of fasting glucose with post-load glucose values and glycated hemoglobin for prediction of type 2 diabetes: the Isfahan diabetes prevention study

Mohsen Janghorbani  1 , Masoud Amini
Affiliations

Comparison of fasting glucose with post-load glucose values and glycated hemoglobin for prediction of type 2 diabetes: the Isfahan diabetes prevention study

Mohsen Janghorbani et al. Rev Diabet Stud. 2009.

Abstract

Objectives: The aim of this study was to compare the ability of fasting plasma glucose (FPG), post-load plasma glucose values and glycated hemoglobin (HbA1c) to predict progression to diabetes in non-diabetic first-degree relatives (FDR) of patients with type 2 diabetes.

Methods: A total of 701 non-diabetic FDR of diabetic patients aged 20-70 years surveyed in 2003 to 2005 were followed until 2008 for the onset of type 2 diabetes mellitus. At baseline and at follow-ups, participants underwent a standard 75 g 2-hour oral glucose tolerance test (OGTT). Prediction of progression to type 2 diabetes was assessed by using area under the receiver-operating characteristic (ROC) curves based upon measurement of FPG, post-load glucose values and HbA1c.

Results: The incidence of type 2 diabetes was 33.9 per 1000 person-years in men and 48.6 in women. The incidence rates were 4.6, 50.7, and 99.7 per 1000 person-years in FDR with normal glucose tolerance, impaired fasting glucose and impaired glucose tolerance respectively. FPG value was a better predictor of progression to diabetes than any post-load glucose values or HbA1c. The areas under the ROC curves were 0.811 for fasting, 0.752 for 1/2-hour, 0.782 for 1-hour and 0.756 for 2-hour glucose vs. 0.634 for HbA1c (p < 0.001).

Conclusions: FPG had more discriminatory power to distinguish between individuals at risk for diabetes and those who were not at risk than post-load glucose values during OGTT or HbA1c. Our findings support the American Diabetes Association recommendation of using FPG concentration to diagnose diabetes.

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Figures

Figure 1
Figure 1
Receiver operating characteristic (ROC) curves for fasting, 1/2-hour, 1-hour and 2-hour glucose and HbA1c for prediction of type 2 diabetes in non-diabetic first-degree relatives of patients with type 2 diabetes. The estimated area under the ROC curves and their 95% confidence intervals are shown in Table 3.
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