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Confirming Glycemic Status in the Diabetes Prevention Program: Implications for Diagnosing Diabetes in High Risk Adults

Authors
Journal
Journal of Diabetes and its Complications
1056-8727
Publisher
Elsevier
Volume
27
Issue
2
Identifiers
DOI: 10.1016/j.jdiacomp.2012.09.012
Keywords
  • Diabetes Mellitus
  • Screening
  • Epidemiology
Disciplines
  • Medicine

Abstract

Abstract Aims To examine the ability of fasting plasma glucose (FPG) and/or 2-h glucose to confirm diabetes and to determine the proportion of participants with HbA1c ≥6.5%. Methods Diabetes confirmation rates were calculated after a single elevated FPG and/or 2-h glucose on an oral glucose tolerance test (OGTT) using a confirmatory OGTT performed within 6weeks. Results 772 (24%) participants had elevated FPG or 2-h glucose on an OGTT that triggered a confirmation visit. There were 101 triggers on FPG alone, 574 on 2-h glucose alone, and 97 on both. Only 47% of participants who triggered had confirmed diabetes. While the confirmation rate for FPG was higher than that for 2-h glucose, the larger number of 2-h glucose triggers resulted in 87% of confirmed cases triggering on 2-h glucose. Confirmation rates increased to 75% among persons with FPG ≥126mg/dl and HbA1c ≥6.5%. Conclusions Only half of the persons with elevated FPG and IGT were subsequently confirmed to have diabetes. At current diagnostic levels, more persons trigger on 2-h glucose than on FPG, but fewer of these persons have their diagnoses confirmed. In individuals with FPG ≥126mg/dl and HbA1c ≥6.5%, the confirmation rate was increased.

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