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Author Notes:

Corresponding author: Lawrence S. Phillips, MD, Endocrinology, Emory University, 101 Woodruff Circle, WMRB Room 1027, Atlanta, GA 30322. medlsp@emory.edu

Subject:

Research Funding:

This work was supported in part by grants DK07298, DK062668, RR017643, DK066204, and RR00039 from NIDDK and the National Center for Research Resources.

Age, BMI, and Race Are Less Important Than Random Plasma Glucose in Identifying Risk of Glucose Intolerance

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Journal Title:

Diabetes Care

Volume:

Volume 31, Number 5

Publisher:

, Pages 884-886

Type of Work:

Article | Post-print: After Peer Review

Abstract:

OBJECTIVE Age, BMI, and race/ethnicity are used in National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and American Diabetes Association (ADA) guidelines to prompt screening for pre-diabetes and diabetes, but cutoffs have not been evaluated rigorously. RESEARCH DESIGN AND METHODS Random plasma glucose (RPG) was measured and 75-g oral glucose tolerance tests were performed in 1,139 individuals without known diabetes. Screening performance was assessed by logistic regression and area under the receiver operating characteristic curve (AROC). RESULTS NIDDK/ADA indicators age >45 years and BMI >25 kg/m2 provided significant detection of both diabetes and dysglycemia (both AROCs 0.63), but screening was better with continuous-variable models of age, BMI, and race and better still with models of age, BMI, race, sex, and family history (AROC 0.78 and 0.72). However, screening was even better with RPG alone (AROCs 0.81 and 0.72). RPG >125 mg/dl could be used to prompt further evaluation with an OGTT. CONCLUSIONS Use of age, BMI, and race/ethnicity in guidelines for screening to detect diabetes and pre-diabetes may be less important than evaluation of RPG. RPG should be investigated further as a convenient, inexpensive screen with good predictive utility.

Copyright information:

© 2008 by the American Diabetes Association.

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