The 1-Hour Plasma Glucose: Common Link Across the Glycemic Spectrum

Michael Bergman

doi:10.3389/fendo.2021.752329

Abstract

Evidence from populations at risk for type 1 diabetes, type 2 diabetes or gestational diabetes substantiates the 1-hour plasma glucose as a sensitive alternative marker for identifying high-risk individuals when ß-cell function is relatively more functional. An elevated 1-hour plasma glucose could therefore diagnose dysglycemia and risk for complications across the glycemic spectrum. Reducing the 2-hour oral glucose tolerance test to 1-hour would reduce the burden on patients, likely reduce costs, and enhance its accessibility in practice.

Highlights

The heterogeneity of diabetes has been the subject of considerable discussion given the complexity of classifying diabetes further mitigated by genetics and environmental factors [1, 2]
While type 1 diabetes is generally diagnosed based on the presence of antibodies and type 2 diabetes by obesity and insulin resistance, it has become increasingly evident that younger individuals with type 1 diabetes may be insulin resistant and overweight or obese adolescents can have type 2 diabetes and the metabolic syndrome [1]
In TrialNet Pathway to Prevention (TNPTP) as well, an Index60 value ≥2.00 identified more individuals with characteristics typical of type 1 diabetes than glucose criteria [25]. These findings suggest that the Index60 threshold ≥2.00 could diagnose type 1 diabetes earlier [24, 25]

Summary

Michael Bergman*

Division of Endocrinology, Diabetes and Metabolism, VA New York Harbor Healthcare System, NYU Grossman School of Medicine, New York, NY, United States. Evidence from populations at risk for type 1 diabetes, type 2 diabetes or gestational diabetes substantiates the 1-hour plasma glucose as a sensitive alternative marker for identifying high-risk individuals when ß-cell function is relatively more functional. An elevated 1-hour plasma glucose could diagnose dysglycemia and risk for complications across the glycemic spectrum. Reducing the 2-hour oral glucose tolerance test to 1-hour would reduce the burden on patients, likely reduce costs, and enhance its accessibility in practice. Specialty section: This article was submitted to Clinical Diabetes, a section of the journal Frontiers in Endocrinology

INTRODUCTION

DISCUSSION