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Diabetes Care Publish Ahead of Print published online ahead of print February 29, 2008
DOI: 10.2337/dc07-2282
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Original Research

Age, BMI, and Race are Less Important Than Random Plasma Glucose To Identify Risk Of Glucose Intolerance. SIGT 5

David C Ziemer, MD1, Paul Kolm, PhD2, William S Weintraub, MD2, Viola Vaccarino, MD, PhD3,,2, Mary K Rhee, MD, MS1, Jane M Caudle, MLn1, Jade M. Irving1, David D Koch, PhD4, K M Venkat Narayan, MD, MPH, MBA5,,6 and Lawrence S Phillips, MD1,,7

Endocrinology and Metabolism1 and
Cardiology3
Medicine5
Pathology & Laboratory Medicine4
Emory University Hubert Global Health6
Veterans Administration Medical Center7
Atlanta, GA, Christiana Care Health System2, Newark, DE

medlsp{at}emory.edu

ABSTRACT

Objective: Age, BMI, and race/ethnicity are used in NIDDK/ADA guidelines to prompt screening, but cutoffs have not been evaluated rigorously.

Methods: RPG was measured and 75g OGTTs performed in 1139 individuals without known diabetes. Screening performance was assessed by logistic regression and AROC.

Results: NIDDK/ADA indicators age>45+BMI>25 provided significant detection of both diabetes and dysglycemia (both AROCs 0.63), but screening was better with continuous-variable models of age, BMI, and race, and better still with models of age, BMI, race, gender, and family history (AROC 0.78 and 0.72). However, screening was even better with RPG alone (AROCs 0.81 and 0.72). RPG >125 mg/dl could be used to prompt further evaluation with an OGTT.

Conclusions: Use of age, BMI, and race/ethnicity in guidelines for screening to detect diabetes and prediabetes may be less important than evaluation of RPG. RPG should be investigated further as a convenient, inexpensive screen with good predictive utility.


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Copyright © 2008 by the American Diabetes Association.