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Sang Hyun Ju  (Ju SH) 1 Article
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Clinical Implications of Using Post-Challenge Plasma Glucose Levels for Early Diagnosis of Type 2 Diabetes Mellitus in Older Individuals
Kyong Hye Joung, Sang Hyun Ju, Ji Min Kim, Sorim Choung, Jae Min Lee, Kang Seo Park, Hyun Jin Kim, Bon Jeong Ku
Diabetes Metab J. 2018;42(2):147-154.   Published online February 13, 2018
DOI: https://doi.org/10.4093/dmj.2018.42.2.147
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  • 5 Web of Science
  • 4 Crossref
AbstractAbstract PDFPubReader   
Background

The aim of this study was to explore the differences in the clinical characteristics and diagnostic rates of diabetes mellitus (DM) according to various criteria in different age groups and to evaluate the efficacy of each criterion for screening older patients.

Methods

We studied 515 patients and measured the fasting plasma glucose level (FPG), 2-hour plasma glucose level after the 75 g oral glucose tolerance test (2-hour postload glucose [2-h PG]), and glycosylated hemoglobin (HbA1c) for re-evaluation of hyperglycemia without a history of diabetes. Patients with newly diagnosed DM were grouped by age as younger (<65 years) or older (≥65 years).

Results

Older patients had significantly lower HbA1c, FPG, and 2-h PG levels and a higher homeostatic level of pancreatic β-cell function compared with younger patients (P<0.001). The older group had the lowest diagnostic rate when using the FPG level (45.5%) and the highest diagnostic rate when using the 2-h PG level (84.6%). These results were mostly due to the higher frequency of isolated post-challenge hyperglycemia in the older patients than in the younger group (28.8% vs. 9.2%). The use of both the FPG and HbA1c levels significantly enhanced the low diagnostic power when employing only the FPG levels in the older group (71.2% vs. 45.5%).

Conclusion

In the older patients, the 2-h PG level was the most accurate diagnostic criterion. When we consider the costs and convenience, a combination of the FPG and HbA1c criteria may be recommended as a screening test for DM in older people.

Citations

Citations to this article as recorded by  
  • International Diabetes Federation Position Statement on the 1-hour post-load plasma glucose for the diagnosis of intermediate hyperglycaemia and type 2 diabetes
    Michael Bergman, Melania Manco, Ilhan Satman, Juliana Chan, Maria Inês Schmidt, Giorgio Sesti, Teresa Vanessa Fiorentino, Muhammad Abdul-Ghani, Ram Jagannathan, Pramod Kumar Thyparambil Aravindakshan, Rafael Gabriel, Viswanathan Mohan, Martin Buysschaert,
    Diabetes Research and Clinical Practice.2024; 209: 111589.     CrossRef
  • Development and validation of a machine learning‐based model to predict isolated post‐challenge hyperglycemia in middle‐aged and elder adults: Analysis from a multicentric study
    Rui Hou, Jingtao Dou, Lijuan Wu, Xiaoyu Zhang, Changwei Li, Weiqing Wang, Zhengnan Gao, Xulei Tang, Li Yan, Qin Wan, Zuojie Luo, Guijun Qin, Lulu Chen, Jianguang Ji, Yan He, Wei Wang, Yiming Mu, Deqiang Zheng
    Diabetes/Metabolism Research and Reviews.2024;[Epub]     CrossRef
  • A unified technique for entropy enhancement based diabetic retinopathy detection using hybrid neural network
    Fatima, Muhammad Imran, Anayat Ullah, Muhammad Arif, Rida Noor
    Computers in Biology and Medicine.2022; 145: 105424.     CrossRef
  • In-silico identification of peroxisome proliferator-activated receptor (PPAR)α/γ agonists from Ligand Expo Components database
    Xiao-Yan Feng, Ting-Ting Ding, Ya-Ya Liu, Wei-Ren Xu, Xian-Chao Cheng
    Journal of Biomolecular Structure and Dynamics.2021; 39(5): 1853.     CrossRef

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