Clinical implication of fasting and post-challenged plasma glucose in diagnosis of diabetes mellitus
Journal
Endocrine
Journal Volume
48
Journal Issue
2
Pages
511-518
Date Issued
2015
Author(s)
Abstract
Fasting plasma glucose (FPG) is the preferred test in diagnosis of diabetes mellitus (DM) to 2-h post-challenged plasma glucose (2hPG). There is little information available on the comparison between FPG and 2hPG diagnostic criteria. This study included adult participants (?18?years old) of the NHANES 2005–2010 with FPG, 2hPG, and BMI measured. Subjects with established DM were excluded. The sensitivity of FPG and 2hPG diagnostic criteria was compared as the main outcome measure. Among 5,782 subjects, 476 subjects (8.23?%) were diagnosed with DM by either FPG, 2hPG, or both criteria. Among the subjects meeting the criterion of FPG, those with 2hPG <200?mg/dL were younger (57?±?16 vs. 61?±?15?years old, P?<?0.05, mean?±?STD) and less obese (30.81?±?7.89 vs. 32.71?±?6.68?kg/m2, P?<?0.05) as compared to those with 2hPG ?200?mg/dL. Among the subjects meeting the criterion of 2hPG, those with FPG <126?mg/dL were more female (55.41 vs. 39.88?%, P?<?0.0002), less obese (29.24?±?5.83 vs. 32.71?±?6.68?kg/m2, P?<?0.000001), lower diastolic blood pressure (67?±?12 vs. 71?±?14?mmHg, P?<?0.02), and less family history of DM (36.35 vs. 48.47?%, P?<?0.02) as compared to those with FPG ?126?mg/dL. The sensitivity of diagnosis of DM was only 41.37?% for FPG criterion, while it was 66.53?% for 2hPG criterion. Thus, compared to 2hPG criterion, FPG criterion had a lower sensitivity detecting new cases of DM. The use of FPG criterion would more likely result in underdiagnosing DM, especially in female and less obese subjects, as compared to the use of 2hPG criterion. ? 2014, Springer Science+Business Media New York.
SDGs
Other Subjects
glucose blood level; adult; age; aged; analysis; blood; body mass; diabetes mellitus; diet restriction; female; glucose blood level; glucose tolerance test; human; male; middle aged; sensitivity and specificity; sex difference; standards; time; Adult; Age Factors; Aged; Blood Glucose; Body Mass Index; Diabetes Mellitus; Fasting; Female; Glucose Tolerance Test; Humans; Male; Middle Aged; Sensitivity and Specificity; Sex Factors; Time Factors
Publisher
Humana Press Inc.
Type
journal article