Oral Glucose Tolerance Test May Predict Risk for Type 2 Diabetes

From Medscape Medical News

In the August 2008 issue of Diabetes Care, researchers from the University of Texas Health Science Center at San Antonio, Texas, revealed from their study that a 1-hour oral glucose tolerance test (OGTT) is a strong predictor of the risk for type 2 diabetes.

The goal of this study is to evaluate the efficacy of 1-hour plasma glucose concentration and the metabolic syndrome to predict the risk for type 2 diabetes. The data they gathered was from the subjects who were enrolled in the San Antonio Heart Study (SAHS) and who had either a normal blood glucose level or with impaired glucose tolerance (IGT). IGT is diagnosed by determining the blood sugar level after a two-hour 75-g oral glucose intake. There were 2,616 eligible subjects with normal sugar levels. The sugar levels were take at baseline and 7 to 8 years after.

They assigned a cutoff level of 155 mg/dL for the 1-hour OGTT and used the Metabolic Syndrome criteria as laid out by the US National Heart, Lung, and Blood Institute's Adult Treatment Panel III (ATP-III). What they found are, among others:

• Persons with a 155 mg/dL or more after a 1-hour OGTT, there is a 32% risk for those with metabolic syndrome versus 9.4% without.
  
• Those with impaired glucose tolerance, a 37% risk for those with a level of 155 mg/dL or more after a 1-hour OGTT versus 10% for those who had less than
  155 mg/dL.
• In those with a level below 155 mg/dL after a 1-hour OGTT, there was a 3.2% risk for those with no metabolic syndrome and 7.8% for those who had metabolic syndrome.
  

Thus, the authors recommended that people with normal glucose levels must be stratified into low, intermediate, and high-risk based on the 1-hour OGTT and the presence of the Metabolic syndrome.

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Oral Glucose Tolerance Test May Predict Risk for Type 2 Diabetes

Comment:

In essence, the following risk factors can have a high predictive value for future type 2 diabetes:

1. The presence of an impaired glucose tolerance (IGT), using the two-hour 75-g oral glucose tolerance testing.
   
2. A level of 155 mg/dL blood sugar or more after a one-hour 75-g oral glucose tolerance testing.
3. The presence of the metabolic syndrome that includes: high blood pressure, a high fasting blood sugar, high cholesterol level, a low HDL (or good) cholesterol, high triglycerides, and obesity (waist circumference measurement).

In addition, the American Diabetes Association recommends that persons having impaired glucose tolerance must be given metformin in addition to exercise and diet so as to prevent the development of type 2 diabetes.

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