Diabetes & Metabolism Journal

Original Article

Genetics
Genetic and Lifestyle Factors Influence High 1-Hour Plasma Glucose, a Predictor of Type 2 Diabetes Mellitus: Soobin Cho, Hyunsuk Lee, Joon Ha, Yeonsoo Park, Joon Ho Moon, Hak Chul Jang, Kyong Soo Park, Nam H. Cho, Michael Bergman, Soo Heon Kwak; Received April 25, 2025 Accepted February 3, 2026 Published online April 22, 2026; DOI: https://doi.org/10.4093/dmj.2025.0362 [Epub ahead of print]

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Abstract PDF Supplementary Material PubReader ePub: Background
High 1-hour plasma glucose (1-h PG) level has been proposed by the International Diabetes Federation to identify high-risk individuals and diagnose type 2 diabetes mellitus (T2DM). In a longitudinal cohort, we examined T2DM risk, β-cell function, and the genetic and lifestyle effects associated with the high 1-h PG.
Methods
We analyzed 6,588 participants without baseline T2DM from a community-based prospective cohort in Korea. Participants underwent biennial 2-hour 75-g oral glucose tolerance tests over 14 years. We assessed incident T2DM risk across 1-h PG groups: <155, 155–208, and ≥209 mg/dL. T2DM polygenic risk scores (PRS) were stratified into low (1st quintile), intermediate (2nd–4th quintiles), and high (5th quintile). Lifestyle was evaluated using Life’s Essential 8.
Results
Compared to the <155 mg/dL group, hazard ratios for T2DM were 3.34 (95% confidence interval [CI], 2.99 to 3.74; P<0.001) for 155–208 mg/dL, and 6.81 (95% CI, 5.81 to 7.98; P<0.001) for ≥209 mg/dL. Both groups had lower baseline disposition index compared to the <155 mg/dL group (57.3% and 72.7%, respectively; both P<0.001). Higher T2DM PRS was associated with elevated baseline 1-h PG (low: 131 mg/dL, intermediate: 141 mg/dL, high: 151 mg/dL) and faster increase in 1-h PG (1.36 vs. 1.85 vs. 2.21 mg/dL/year; all P<0.001). Importantly, healthy lifestyle attenuated the increase in rate across all PRS groups.
Conclusion
High 1-h PG predicts T2DM risk and is associated with β-cell dysfunction. The 1-h PG level is influenced by genetic risk and can be modified with a healthy lifestyle.

Review

Basic and Translational Research
Redefining β-Cell Function in Type 2 Diabetes Mellitus: From Comprehensive Assessment to Precision Medicine: YongKyung Kim, Joon Ha, Jun Sung Moon; Diabetes Metab J. 2026;50(2):235-252. Published online March 1, 2026; DOI: https://doi.org/10.4093/dmj.2026.0034

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Abstract PDF PubReader ePub: The global surge in type 2 diabetes mellitus (T2DM) requires a thorough understanding of pancreatic β-cell dysfunction, which remains a central determinant of the disease. However, the evaluation of β-cell insulin secretory capacity is often challenging in clinical practice due to its inherent complexity. This review presents a comprehensive technical overview of diverse assessment methodologies, ranging from conventional fasting-based indices and glucose tolerance tests to advanced mathematical modeling and artificial intelligence-driven approaches. A detailed examination of the methodological strengths and limitations of these various tools is provided to guide their appropriate clinical application. Furthermore, we explore the clinical implications of these assessments in enhancing diagnostic accuracy and tailoring therapeutic strategies. Particular emphasis is placed on the pivotal role of β-cell function evaluation in predicting and achieving diabetes remission—an emerging clinical priority. By integrating the technical landscape of β-cell assessment with practical applications, this review provide a structured framework for optimizing T2DM management and improving long-term patient outcomes.

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