Criteria for Oral Glucose Tolerance Testing of Obese Minority Youth

Puri, Mala; Freeman, Katherine; Garcia, Mireya; Nussbaum, Hadassa; DiMartino-Nardi, Joan

doi:10.1515/jpem.2007.20.6.703

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…The number of studies suggesting HbA1c as a predictive parameter for IGT in childhood is limited (8,9,20). Tsay et al (9), who evaluated some parameters (FG, fasting insulin, triglyceride, cholesterol, blood pressure, BMI-Z score and HbA1c) as predictors of IGT, found that only HbA1c is a significant predictor of IGT.…”

Section: Discussionmentioning

confidence: 99%

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Can HbA1c and One-Hour Glucose Concentration in Standard OGTT Be Used for Evaluation of Glucose Homeostasis in Childhood?

G¹,

Özsu²,

Fm³

et al. 2013

Jcrpe

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Objective: To investigate whether glycosylated hemoglobin (HbA1c) and 1-hour glucose level in oral glucose tolerance test (OGTT) are useful parameters for evaluation of glucose homeostasis in childhood.Methods: The medical records of 106 obese/overweight children aged from 7 to 18 years who underwent OGTT were evaluated retrospectively. The subjects were divided into 2 groups according to their one-hour glucose concentration. Group 1 consisted of subjects whose one-hour glucose level was <155 mg/dL, and Group 2 consisted of subjects whose one-hour glucose level was ≥155mg/dL. The fasting and 2-hour glucose concentrations of the groups werecompared. The sensitivity and specificity levels were determined using the ROC curve to assess the predictive value of HbA1c for impaired glucose tolerance (IGT).Results: The mean 2-hour glucose concentration of the subjects in Group 2 was significantly higher than that of the subjects in Group 1 (137.8±35.5 mg/dL versus 113.1±21.2 mg/dL, p<0.05). If a 5.5% cut-off value for HbA1c was accepted as predictor of IGT, the sensitivity was 63% and specificity was 70%. 31% of the subjects with HbA1c levels at or above 5.5% had IGT. This rate was significantly lower in subjects who had HbA1c levels below 5.5% (p<0.05).Conclusions: Obese/overweight children and adolescents whose 1-hourglucose level is ≥155 mg/dL in the standard OGTT carry a high risk for IGT. Obese/overweight children and adolescents whose HbA1c level is at or above 5.5% may have IGT even though their fasting glucose level is normal, thus, OGTT is necessary to evaluate the glucose tolerance.Conflict of interest:None declared.

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Section: Discussionmentioning

confidence: 99%

“…Studies in children and adolescents suggesting that HbA1c is more predictive of glucose intolerance than 2-hour glucose concentration in OGTT are limited (8,9). In this study, we therefore aimed to investigate whether HbA1c and 1-hour glucose in OGTT are useful parameters for evaluation of glucose homeostasis in children and adolescents.…”

Section: Introductionmentioning

confidence: 99%

Can HbA1c and One-Hour Glucose Concentration in Standard OGTT Be Used for Evaluation of Glucose Homeostasis in Childhood?

G¹,

Özsu²,

Fm³

et al. 2013

Jcrpe

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“…One U.S. study of obese minority youth evaluated a variety of risk factors for dysglycemia (20). Their criteria for determining risk consisted of a measure of insulin resistance [homeostasis model assessment (HOMA-IR)] for both girls and boys and cholesterol and HbA1c for boys.…”

Section: Discussionmentioning

confidence: 99%

A risk score for identifying overweight adolescents with dysglycemia in primary care settings1)

Lee

Woolford

Tarini

et al. 2013

Journal of Pediatric Endocrinology and Metabolism

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Objective To develop a clinical risk scoring system for identifying adolescents with dysglycemia (prediabetes or diabetes) who need further confirmatory testing and to determine whether the addition of non-fasting tests would improve the prediction of dysglycemia. Study Design A sample of 176 overweight and obese adolescents (10 – 17 years) had a history/physical exam, a 2-h oral glucose tolerance test, and non-fasting tests [hemoglobin A1c, 1-h glucose challenge test (GCT), and random glucose test] performed. Given the low number of children with diabetes, we created several risk scoring systems combining the clinical characteristics with non-fasting tests for identifying adolescents with dysglycemia and compared the test performance. Results Sixty percent of participants were white and 32% were black; 39.2% had prediabetes and 1.1% had diabetes. A basic model including demographics, body mass index percentile, family history of diabetes, and acanthosis nigricans had reasonable test performance [area under the curve (AUC), 0.75; 95% confidence interval (95% CI), 0.68 – 0.82]. The addition of random glucose (AUC, 0.81; 95% CI, 0.75 – 0.87) or 1-h GCT (AUC, 0.82; 95% CI, 0.75 – 0.88) to the basic model significantly improved the predictive capacity, but the addition of hemoglobin A1c did not (AUC, 0.76; 95% CI, 0.68 – 0.83). The clinical score thresholds to consider for the basic plus random glucose model are total score cutoffs of 60 or 65 (sensitivity 86% and 65% and specificity 60% and 78%, respectively) and for the basic plus 1-h GCT model are total score cutoffs of 50 or 55 (sensitivity 87% and 73% and specificity 59% and 76%, respectively). Conclusions Pending a validation in additional populations, a risk score combining the clinical characteristics with non-fasting test results may be a useful tool for identifying children with dysglycemia in the primary care setting.

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Which obese youth are at increased risk for type 2 diabetes? Latent class analysis and comparison with diabetic youth

et al. 2011

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Currently recommended screening of obese youth by FPG is normal in 91.5%, but lacks further information to detect increased risk for youth-onset T2D. Evaluation of obese youth by LCA identified one third (class 3) in whom the combination of higher levels of BMIz, HOMA-IR, and family history suggests the greatest risk for T2D and targets them for further evaluation and intensive preventative management.

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Criteria for Oral Glucose Tolerance Testing of Obese Minority Youth

Cited by 4 publications

References 6 publications

Can HbA1c and One-Hour Glucose Concentration in Standard OGTT Be Used for Evaluation of Glucose Homeostasis in Childhood?

Can HbA1c and One-Hour Glucose Concentration in Standard OGTT Be Used for Evaluation of Glucose Homeostasis in Childhood?

A risk score for identifying overweight adolescents with dysglycemia in primary care settings1)

Which obese youth are at increased risk for type 2 diabetes? Latent class analysis and comparison with diabetic youth

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