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Fasting blood glucose in determining the prevalence of diabetes in a large, homogeneous population of Caucasian middle‐aged women
Author(s) -
LARSSON H.,
AHRÉN B.,
LINDGÄRDE F.,
BERGLUND G.
Publication year - 1995
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1995.tb00882.x
Subject(s) - medicine , diabetes mellitus , receiver operating characteristic , homogeneous , impaired glucose tolerance , population , glucose tolerance test , predictive value , predictive value of tests , gastroenterology , glucose test , endocrinology , type 2 diabetes , insulin resistance , environmental health , physics , thermodynamics
. Objectives. To determine the usefulness of a single, fasting blood glucose (FBG) value in measuring the prevalence of diabetes mellitus in a large, homogeneous population. Design. Fasting blood glucose and 2‐h oral glucose tolerance test (OGTT) values were determined. Based on the results of the OGTT, the sensitivity and specificity of different cut‐off levels of FBG for the diagnosis of diabetes were assessed. ROC (receiver operating characteristic) analysis was performed on the data. Setting. A health screening unit at the University Hospital in Malmö, Sweden. Subjects. A total of 1843 Caucasian women without known diabetes aged 55–57 years. Results. The prevalence of previously undiagnosed diabetes was 3.9% and the prevalence of impaired glucose tolerance (IGT) was 27.9% using the WHO cut‐off values for 2‐h blood glucose values after an OGTT. With an FBG cut‐off value of 6.7 mmol IT −1 , the sensitivity of a single FBG value was 36.6%. Reducing the cut‐off value to 6.0 mmol L −1 increased the sensitivity to 53.4%. At a cut‐off level of 4.8 mmol L −1 , the sensitivity reached the high value of 85.9%, but the specificity was only 45% and the predictive value of a positive test as low as 5.9%. ROC analysis showed that the optimal cut‐off value for FBG in this population was 5.3 mmol L −1 , giving a sensitivity and specificity of 77% but a positive predictive value of only 11.9%. Conclusions. This study has shown that in a large and homogeneous Caucasian population of women aged 55–57 years with a high prevalence of IGT, a single FBG value is not useful as a screening tool for diabetes mellitus.