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- Title
One-Hour Oral Glucose Tolerance Tests for the Prediction and Diagnostic Surveillance of Type 1 Diabetes.
- Authors
Simmons, Kimber M.; Sosenko, Jay M.; Warnock, Megan; Geyer, Susan; Ismail, Heba M.; Elding Larsson, Helena; Steck, Andrea K.; Simmons, Kimber M; Sosenko, Jay M; Ismail, Heba M; Elding Larsson, Helena; Steck, Andrea K
- Abstract
<bold>Context: </bold>Once islet autoantibody-positive individuals are identified, predicting which individuals are at highest risk for type 1 diabetes (T1D) is important. A metabolic risk score derived from 2-hour oral glucose tolerance test (OGTT) data, the Diabetes Prevention Trial-Type 1 risk score (DPTRS), can accurately predict T1D. However, 2-hour OGTTs are time-consuming and costly.<bold>Objective: </bold>We aimed to determine whether a risk score derived from 1-hour OGTT data can predict T1D as accurately as the DPTRS. Secondarily, we evaluated whether a 1-hour glucose value can be used for diagnostic surveillance.<bold>Methods: </bold>The DPTRS was modified to derive a 1-hour OGTT risk score (DPTRS60) using fasting C-peptide, 1-hour glucose and C-peptide, age, and body mass index. Areas under receiver operating curves (ROCAUCs) were used to compare prediction accuracies of DPTRS60 with DPTRS in Diabetes Prevention Trial-Type 1 (DPT-1) (n = 654) and TrialNet Pathway to Prevention (TNPTP) (n = 4610) participants. Negative predictive values (NPV) for T1D diagnosis were derived for 1-hour glucose thresholds.<bold>Results: </bold>ROCAUCs for T1D prediction 5 years from baseline were similar between DPTRS60 and DPTRS (DPT-1: 0.805 and 0.794; TNPTP: 0.832 and 0.847, respectively). DPTRS60 predicted T1D significantly better than 2-hour glucose (P < .001 in both cohorts). A 1-hour glucose of less than 180 mg/dL had a similar NPV, positive predictive value, and specificity for T1D development before the next 6-month visit as the standard 2-hour threshold of less than 140 mg/dL (both ≥ 98.5%).<bold>Conclusion: </bold>A 1-hour OGTT can predict T1D as accurately as a 2-hour OGTT with minimal risk of missing a T1D diagnosis before the next visit.
- Subjects
GLUCOSE tolerance tests; TYPE 1 diabetes; BODY mass index; DIAGNOSIS methods; AUTOANTIBODIES; RESEARCH; RESEARCH methodology; BLOOD sugar; EVALUATION research; MEDICAL cooperation; RISK assessment; COMPARATIVE studies; RESEARCH funding; DISEASE management
- Publication
Journal of Clinical Endocrinology & Metabolism, 2020, Vol 105, Issue 11, p1
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgaa592