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Aims/Introduction  The conventional oral glucose tolerance test ( OGTT ) cannot detect future diabetics among isolated impaired fasting glucose (is‐ IFG ) nor normal glucose tolerant ( NGT ) groups. By analyzing the relationship between fasting ( FPG ) and 2‐h plasma glucose (2hPG), the present study identifies is‐ IFG  subjects liable to worsening glucose homeostasis.    Materials and Methods  Oral glucose tolerance test was carried out in 619 patients suffering from obesity, hypertension or dyslipidemia, whose  FPG  was in the 100–125 mg/dL range. We calculated the percentage increment of 2hPG with respect to  FPG  (PG%) in these patients using the formula: ([2hPG − FPG] / FPG) × 100. Differences in β‐cell function within is‐IFG patients were assessed by estimated insulin sensitivity index ( EISI ), first‐phase insulin release (1stPH) and 1stPH/1/EISI (1stPH corrected ).    Results  Diabetes was diagnosed in 69 patients (11.2%), combined  IFG /impaired glucose tolerance ( IGT ) in 185 patients (29.9%) and is‐ IFG  in 365 patients (58.9%). Is‐IFG was subdivided into  PG % tertile groups: the percentage of females increased from 25% in the lowest to 45.2% in the highest tertile (χ 2  = 18.7,  P  < 0.001). Moving from the lowest to the highest  PG % tertile group, insulin and 2hPG concentrations rose, whereas  FPG ,  EISI , and 1stPH corrected  decreased progressively and significantly. Furthemore,  PG % correlated inversely with  EISI  ( r  = −0.44,  P  < 0.0001) and 1stPH corrected  ( r  = −0.38,  P  < 0.0001).    Conclusions  Oral glucose tolerance test does differentiate the great heterogeneity in metabolic disorders of patients with  FPG  100–125 mg/dL. Furthermore,  PG % can expand the diagnostic power of  OGTT  in the is‐ IFG  range by distinguishing metabolic phenotypes very likely to herald different clinical risks.

Oral glucose tolerance test‐based calculation identifies different glucose intolerance phenotypes within the impaired fasting glucose range