Two- vs one-hour glucose tolerance testing: Predicting prediabetes in adolescent girls with obesity

Pediatr Diabetes. 2019 Mar;20(2):154-159. doi: 10.1111/pedi.12803. Epub 2018 Dec 27.

Abstract

Background: During an oral glucose tolerance test (OGTT), morphological features of the glucose curve (monophasic curve, glucose peak >30 minutes and 1-hour glucose ≥ 155 mg/dL) maybe associated with higher prediabetes risk, but their reproducibility and predictive ability in adolescents with obesity are unknown.

Methods: Nondiabetic adolescent girls with obesity underwent a multiple-sample OGTT at baseline (n = 93), 6 weeks (n = 83), and 1 year (n = 72). Short-term reproducibility (baseline to 6 weeks) and the predictive ability for prediabetes (baseline to 1 year) for each feature were compared with standard fasting and 2-hour OGTT diagnostic criteria.

Results: There was fair/moderate short-term reproducibility (κ < 0.5) for all morphological features. At 1 year, compared with standard OGTT criteria, the areas under the receiver operating curve (ROC-AUCs) for glucose peak > 30 minutes, 1 hour ≥155 mg/dL or a combination of the two criteria were comparable (all P > 0.05), but the monophasic curve had the lowest ROC-AUC (P < 0.001).

Conclusions: In adolescent girls with obesity, glucose peak > 30 minutes and/or glucose ≥155 mg/dL had similar reproducibility and 1-year predictive ability for prediabetes compared with standard OGTT criteria. The shortened 1-hour OGTT may provide diagnostic equivalence for prediabetes risk with the additional advantage of a less time-consuming risk assessment.

Keywords: OGTT; adolescence; glucose tolerance; obesity; prediabetes; reproducibility.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Blood Glucose / analysis
  • Blood Glucose / metabolism*
  • Child
  • Cognitive Behavioral Therapy
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / prevention & control
  • Disease Progression
  • Female
  • Glucose Tolerance Test / methods
  • Humans
  • Overweight / blood
  • Overweight / complications
  • Overweight / diagnosis
  • Overweight / therapy
  • Patient Education as Topic / methods
  • Pediatric Obesity / blood*
  • Pediatric Obesity / complications*
  • Pediatric Obesity / diagnosis
  • Pediatric Obesity / therapy
  • Prediabetic State / blood*
  • Prediabetic State / diagnosis*
  • Prediabetic State / pathology
  • Prediabetic State / therapy
  • Predictive Value of Tests
  • Prognosis
  • Reproducibility of Results
  • Retrospective Studies
  • Time Factors

Substances

  • Blood Glucose