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Two‐ vs one‐hour glucose tolerance testing: Predicting prediabetes in adolescent girls with obesity
Author(s) -
Kasturi Kannan,
Onuzuruike Anthony U.,
Kunnam Shwetha,
Shomaker Lauren B.,
Yanovski Jack A.,
Chung Stephanie T.
Publication year - 2019
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12803
Subject(s) - prediabetes , medicine , reproducibility , receiver operating characteristic , area under the curve , glucose tolerance test , diabetes mellitus , obesity , impaired glucose tolerance , impaired fasting glucose , endocrinology , type 2 diabetes , insulin resistance , statistics , mathematics
Background During an oral glucose tolerance test (OGTT), morphological features of the glucose curve (monophasic curve, glucose peak >30 minutes and 1‐hour glucose ≥ 155 mg/dL) maybe associated with higher prediabetes risk, but their reproducibility and predictive ability in adolescents with obesity are unknown. Methods Nondiabetic adolescent girls with obesity underwent a multiple‐sample OGTT at baseline ( n = 93), 6 weeks ( n = 83), and 1 year ( n = 72). Short‐term reproducibility (baseline to 6 weeks) and the predictive ability for prediabetes (baseline to 1 year) for each feature were compared with standard fasting and 2‐hour OGTT diagnostic criteria. Results There was fair/moderate short‐term reproducibility (κ < 0.5) for all morphological features. At 1 year, compared with standard OGTT criteria, the areas under the receiver operating curve (ROC‐AUCs) for glucose peak > 30 minutes, 1 hour ≥155 mg/dL or a combination of the two criteria were comparable (all P > 0.05), but the monophasic curve had the lowest ROC‐AUC ( P < 0.001). Conclusions In adolescent girls with obesity, glucose peak > 30 minutes and/or glucose ≥155 mg/dL had similar reproducibility and 1‐year predictive ability for prediabetes compared with standard OGTT criteria. The shortened 1‐hour OGTT may provide diagnostic equivalence for prediabetes risk with the additional advantage of a less time‐consuming risk assessment.