The 1-h post-load plasma glucose as a novel biomarker for diagnosing dysglycemia

• Type of Material: Article
• Authors: Ram Jagannathan, Emory University; Martin Buysschaert, Université Catholique de Louvain; José Luis Medina, Oporto University, Portugal; Karin Katz, NYU School of Medicine; Sarah Musleh, NYU School of Medicine; Brenda Dorcely, NYU School of Medicine; Michael Bergman, NYU School of Medicine
• Language: English
• Date: 2018-06-01
• Publisher: SPRINGER-VERLAG ITALIA SRL
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018, Springer-Verlag Italia S.r.l., part of Springer Nature
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1007/s00592-018-1105-3
• Title of Journal or Parent Work: ACTA DIABETOLOGICA
• Volume: 55
• Issue: 6
• Start Page: 519
• End Page: 529
• Keywords: BETA-CELL FUNCTION; FOLLOW-UP; DIABETES-MELLITUS; RISK; Prediabetes; MORTALITY; TOLERANCE; INDIVIDUALS; Oral glucose tolerance test; ONE-HOUR GLUCOSE; Endocrinology & Metabolism; INSULIN SENSITIVITY; Diabetes; LEVEL; Life Sciences & Biomedicine; Dysglycemia; Science & Technology

Abstract

Identifying the earliest moment for intervention to avert progression to prediabetes and diabetes in high-risk individuals is a substantial challenge. As β-cell function is already compromised in prediabetes, attention should therefore be focused on identifying high-risk individuals earlier in the so-called pre-prediabetes stage. Biomarkers to monitor progression and identify the time point at which β-cell dysfunction occurs are therefore critically needed. Large-scale population studies have consistently shown that the 1-h plasma glucose (1-h PG) ≥ 155 mg/dl (8.6 mmol/l) during the oral glucose tolerance test detected incident type 2 diabetes and associated complications earlier than fasting plasma glucose or 2-h plasma glucose levels. An elevated 1-h PG level appears to be a better alternative to HbA1c [5.7–6.4% (37–47 mmol/mol)] or traditional glucose criteria for identifying high-risk individuals at a stage when ß-cell function is substantially more intact than in prediabetes. Diagnosing high-risk individuals earlier proffers the opportunity for potentially reducing progression to diabetes, development of microvascular complications and mortality, thereby advancing benefit beyond that which has been demonstrated in global diabetes prevention programs.