Fasting Versus Post-Load Plasma Glucose Concentration and the Risk for Future Type 2 Diabetes: Results From The Botnia Study

Abstract

Aim: To assess the efficacy of post-load plasma glucose concentration in predicting future risk of T2DM, compared to prediction models based upon measurement of the fasting plasma glucose (FPG) concentration.

Research Design and Methods: 2442 subjects from the Botnia Study, who were free of T2DM at baseline, received an OGTT at baseline and after 7-8 years of follow. Future risk for T2DM was assessed with 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 the metabolic syndrome.

Results: Prediction models based on measurement of the FPG were weak predictors for the risk of future T2DM. Addition of 1-h PG markedly enhanced the prediction the risk of future T2DM. A cut point of 155 mg/dl for the 1-h PG during OGTT and presence of the metabolic syndrome were used to stratify subjects in each glucose tolerance group into low, intermediate and high risk for future T2DM.

Conclusion: The plasma glucose concentration at 1 hour during the OGTT is a strong predictor of future risk for T2DM and adds to the prediction power of models based upon measurements made during the fasting state. A plasma glucose cut point of 155 mg/dl plus the ATP III criteria for the metabolic syndrome can be used to stratify non-diabetic subjects into low, intermediate and high risk groups.