Detecting Prediabetes and Diabetes: Agreement between Fasting Plasma Glucose and Oral Glucose Tolerance Test in Thai Adults.

Wichai Aekplakorn,Aungsumalin Mungkung,Kornsinun Chaiyajit,Chanidsa Chantapoon,Pranee Luckanajantachote,Rachada Pipatsart,Wilarwan Sripho,Valla Tantayotai,Premsuree Sansom,Pongpat Chawarokorn,Kasetsak Luanseng,Sakawduan Numsangkul,Tuanjai Burapasiriwat,Watchira Lakhamkaew,Anek Thanonghan,Mayuree Kungsri,Rungnapa Boonkean,Nutchanat Tatsato

doi:10.1155/2015/396505

Abstract

Aim. To evaluate an agreement in identifying dysglycemia between fasting plasma glucose (FPG) and the 2 hr postprandial glucose tolerance test (OGTT) in a population with high risk of diabetes. Methods. A total of 6,884 individuals aged 35–65 years recruited for a community-based diabetes prevention program were tested for prediabetes including impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), and diabetes. The agreement was assessed by Kappa statistics. Logistic regression was used to examine factors associated with missed prediabetes and diabetes by FPG. Results. A total of 2671 (38.8%) individuals with prediabetes were identified. The prevalence of prediabetes identified by FPG and OGTT was 32.2% and 22.3%, respectively. The proportions of diabetes classified by OGTT were two times higher than those identified by FPG (11.0% versus 5.4%, resp.). The Kappa statistics for agreement of both tests was 0.55. Overall, FPG missed 46.3% of all prediabetes and 54.7% of all diabetes cases. Prediabetes was more likely to be missed by FPG among female, people aged <45 yrs, and those without family history of diabetes. Conclusion. The detection of prediabetes and diabetes using FPG only may miss half of the cases. Benefit of adding OGTT to FPG in some specific groups should be confirmed.

Highlights

Identification of individuals with a high risk of developing diabetes and early diagnosis of diabetes are worthwhile for further prevention and early treatment of diabetes, respectively
The objective of this study was to evaluate and document the degree of agreement between fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT) in the population with a high risk of diabetes. We examined factors, such as age, sex, or being hypertensive or obese, and explored whether they are associated with undetected prediabetes and diabetes by FPG
There was poor agreement between the classification of prediabetes and diabetes defined by FPG and OGTT (Kappa value, 0.55)

Summary

Introduction

Identification of individuals with a high risk of developing diabetes and early diagnosis of diabetes are worthwhile for further prevention and early treatment of diabetes, respectively. Effective lifestyle and pharmacologic interventions to delay development of diabetes in people with high risk have been established [1]. Whether screening of diabetes in Journal of Diabetes Research the general population is cost-effective or improves health outcomes compared with routine clinical diagnosis remains inconclusive. Screening for prediabetes and diabetes among high risk population with appropriate intervention is more effective than screening for diabetes alone [3]. In a health care setting, FPG is used to identify diabetes among high risk groups because of the convenience and low cost compared with OGTT. The objective of this study was to evaluate and document the degree of agreement between FPG and OGTT in the population with a high risk of diabetes. We examined factors, such as age, sex, or being hypertensive or obese, and explored whether they are associated with undetected prediabetes and diabetes by FPG

Objectives

Methods

Results

Conclusion