Detecting Type 2 Diabetes by a Single Post-Challenge Blood Sample
-
Rainer Haeckel
Abstract
In the recent American Diabetes Association (ADA)/WHO recommendations, the oral glucose tolerance test (OGTT) was replaced by the measurement of a single fasting glucose concentration with a decision limit for the detection of type 2 diabetes mellitus (DM) reduced. This proposal, however, misses all cases of isolated post-prandial hyperglycaemia. Therefore, a study was undertaken to develop a post-challenge, one-sample mode of diagnosis.
OGTT was performed in 240 high-risk subjects who were suspected to suffer from type 2 DM. Glucose concentrations were determined at 30 min intervals in the capillary blood, venous blood and plasma, and insulin was determined in venous plasma only. The test results were classified in non-disease and disease group according to the decision limits recommended by ADA/WHO. Furthermore, the early insulin response and an insulin sensitivity index were used to determine new cut-off values. These were identified as the concentrations demonstrating the highest diagnostic efficiency and were lower than the WHO limits. The 2 h post-load plasma concentration led to higher efficiency at a cut-off value of 9.0 mmol/l glucose (162 mg/dl) compared to concentrations of samples taken in the fasting state, at an earlier time of the OGTT, or in venous and capillary blood. Under this condition, 72 diabetic patients (35%) were detected in the study group (n = 207), whereas only 36 (17%) were found with one sample in the fasting state and 53 (26%) with two samples using the ADA/WHO criteria. Therefore, a single venous plasma sample taken after 2 h post-glucose challenge appeared to be most efficient for the early detection of DM.
Copyright © 2003 by Walter de Gruyter GmbH & Co. KG
Artikel in diesem Heft
- Editors' Introduction: Welcome to the Special Issue on Diabetes Mellitus
- Linking Research and Innovative Clinical Practice: The Story of Diabetes Mellitus
- Insulin Resistant States and Insulin Signaling
- Diabesity: An Inflammatory Metabolic Condition
- Plasma Adiponectin and Hyperglycaemia in Diabetic Patients
- Platelet Function and Acetyl-Coenzyme A Metabolism in Type 1 Diabetes Mellitus
- Oxidative Stress in Diabetes
- Carbonyl Stress and Diabetic Complications
- Chemical Modification of Proteins by Lipids in Diabetes
- Glyoxal and Methylglyoxal Levels in Diabetic Patients: Quantitative Determination by a New GC/MS Method
- Dyslipidemia in Patients with Type 2 Diabetes. Relationships between Lipids, Kidney Disease and Cardiovascular Disease
- Haemoglobin A1c – A Marker for Complications of Type 2 Diabetes: The Experience from the UK Prospective Diabetes Study (UKPDS)
- Glycated Hemoglobin Standardization – National Glycohemoglobin Standardization Program (NGSP) Perspective
- Haemoglobin A1c: Analysis and Standardisation
- Point-of-Care Testing in Diabetes Mellitus
- Evaluation of Portable Blood Glucose Meters. Problems and Recommendations
- Measurements of Glucose on the Skin Surface, in Stratum Corneum and in Transcutaneous Extracts: Implications for Physiological Sampling
- Biological Variability of Albumin Excretion Rate and Albumin-to-Creatinine Ratio in Hypertensive Type 2 Diabetic Patients
- Clinical and Laboratory Evaluation of Specific Chemiluminescence Assays for Intact and Total Proinsulin
- Clinical Impact of the New Criteria for the Diagnosis of Diabetes Mellitus
- The Effect of the New ADA and WHO Guidelines on the Number of Diagnosed Cases of Diabetes Mellitus
- Detecting Type 2 Diabetes by a Single Post-Challenge Blood Sample
- Laboratory Tests in Diagnosis and Management of Diabetes Mellitus. Practical Considerations
- Obesity, Glucose Intolerance and Diabetes and Their Links to Cardiovascular Disease. Implications for Laboratory Medicine
- Meetings and Awards
Artikel in diesem Heft
- Editors' Introduction: Welcome to the Special Issue on Diabetes Mellitus
- Linking Research and Innovative Clinical Practice: The Story of Diabetes Mellitus
- Insulin Resistant States and Insulin Signaling
- Diabesity: An Inflammatory Metabolic Condition
- Plasma Adiponectin and Hyperglycaemia in Diabetic Patients
- Platelet Function and Acetyl-Coenzyme A Metabolism in Type 1 Diabetes Mellitus
- Oxidative Stress in Diabetes
- Carbonyl Stress and Diabetic Complications
- Chemical Modification of Proteins by Lipids in Diabetes
- Glyoxal and Methylglyoxal Levels in Diabetic Patients: Quantitative Determination by a New GC/MS Method
- Dyslipidemia in Patients with Type 2 Diabetes. Relationships between Lipids, Kidney Disease and Cardiovascular Disease
- Haemoglobin A1c – A Marker for Complications of Type 2 Diabetes: The Experience from the UK Prospective Diabetes Study (UKPDS)
- Glycated Hemoglobin Standardization – National Glycohemoglobin Standardization Program (NGSP) Perspective
- Haemoglobin A1c: Analysis and Standardisation
- Point-of-Care Testing in Diabetes Mellitus
- Evaluation of Portable Blood Glucose Meters. Problems and Recommendations
- Measurements of Glucose on the Skin Surface, in Stratum Corneum and in Transcutaneous Extracts: Implications for Physiological Sampling
- Biological Variability of Albumin Excretion Rate and Albumin-to-Creatinine Ratio in Hypertensive Type 2 Diabetic Patients
- Clinical and Laboratory Evaluation of Specific Chemiluminescence Assays for Intact and Total Proinsulin
- Clinical Impact of the New Criteria for the Diagnosis of Diabetes Mellitus
- The Effect of the New ADA and WHO Guidelines on the Number of Diagnosed Cases of Diabetes Mellitus
- Detecting Type 2 Diabetes by a Single Post-Challenge Blood Sample
- Laboratory Tests in Diagnosis and Management of Diabetes Mellitus. Practical Considerations
- Obesity, Glucose Intolerance and Diabetes and Their Links to Cardiovascular Disease. Implications for Laboratory Medicine
- Meetings and Awards
