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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Enhanced predictive capability of a 1-hour oral glucose tolerance test: A prospective population-based cohort study
Diabetes Care, Volume 41, No. 1, Year 2018
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Description
OBJECTIVE To examine whether the 1-h blood glucose measurement would be a more suitable screening tool for assessing the risk of diabetes and its complications than the 2-h measurement. RESEARCH DESIGN AND METHODS We conducted a prospective population-based cohort study of 4,867men, randomly selected fromprespecified birth cohorts between 1921 and 1949,who underwent an oral glucose tolerance test with blood glucose measurements at 0, 1, and 2 h. Subjects were followed for up to 39 years, with registry-based recording of events. Discriminative abilities of elevated 1-h (≥8.6 mmol/L) versus 2-h (≥7.8 mmol/L) glucose for predicting incident type 2 diabetes, vascular complications, andmortality were compared using Kaplan-Meier analysis, Cox proportional hazards regression, and net reclassification improvement. RESULTS Median agewas 48 years (interquartile range [IQR] 48-49). During follow-up (median 33 years [IQR 24-37]), 636 (13%) developed type 2 diabetes. Elevated 1-h glucose was associatedwith incident diabetes (hazard ratio 3.40 [95% CI 2.90-3.98], P < 0.001) and provided better risk assessment than impaired glucose tolerance (Harrell concordance index 0.637 vs. 0.511, P < 0.001). Addition of a 1-hmeasurement in subjects stratified by fasting glucose provided greater net reclassification improvement than the addition of a 2-h measurement (0.214 vs. 0.016, respectively). Finally, the 1-h glucose was significantly associated with vascular complications and mortality. CONCLUSIONS The 1-h blood glucose level is a stronger predictor of future type 2 diabetes than the 2-h level and is associated with diabetes complications and mortality. © 2017 by the American Diabetes Association.
Authors & Co-Authors
Pareek, Manan
United States, Boston
Harvard Medical School
Denmark, Odense
Odense Universitetshospital
Denmark, Holbak
Holbæk Sygehus
Bhatt, Deepak L.
United States, Boston
Harvard Medical School
Nielsen, Mette Lundgren
Denmark, Odense
Odense Universitetshospital
Jagannathan, Ram
United States, New York
New York University
Eriksson, Karl Fredrik
Sweden, Malmo
Lund University Diabetes Centre
Nilsson, Peter M.
Sweden, Malmo
Lund University Diabetes Centre
Bergman, Michael I.
United States, New York
Nyu Grossman School of Medicine
Olsen, Michael Hecht
Denmark, Odense
Odense Universitetshospital
Denmark, Holbak
Holbæk Sygehus
Statistics
Citations: 87
Authors: 8
Affiliations: 6
Identifiers
Doi:
10.2337/dc17-1351
ISSN:
01495992
Research Areas
Environmental
Health System And Policy
Noncommunicable Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative