Reproducibility of the Oral Glucose Tolerance Test in Overweight Children

Libman, Ingrid; Barinas‐Mitchell, Emma; Bartucci, Andrea; Robertson, Robert J.; Arslanian, Silva

doi:10.1210/jc.2008-0801

Cited by 158 publications

(148 citation statements)

References 24 publications

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“…Of note, however, is that the OGTT-derived indices of insulin resistance (WBISI) and secretion (IGI) employed in the current study were validated by our group and were found to correlate relatively well with clamp-derived insulin sensitivity and secretion measures in obese children and adolescents [15,19]. Reproducibility of the OGTT as a tool to detect glucose regulation is known to be poor, particularly for 2 h plasma glucose [20]. Such variability of the OGTT is not surprising, given that basal and postprandial measures of glucose and insulin are highly variable, reflecting changes in nutrition and physical activity, and are influenced by seasonal and diurnal factors.…”

Section: Discussionmentioning

confidence: 67%

High normal fasting glucose level in obese youth: a marker for insulin resistance and beta cell dysregulation

et al. 2010

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Aims/hypothesis A high but normal fasting plasma glucose level in adults is a risk factor for future development of type 2 diabetes mellitus and cardiovascular disease. We investigated whether normal fasting plasma glucose levels (<5.60 mmol/l) are associated with decreases in insulin sensitivity and beta cell function, as well as an adverse cardiovascular profile in obese youth. Methods We performed a cross-sectional analysis in a multiethnic sample of 1,020 obese youth (614 girls and 406 boys; mean age 12.9 years [CI 95% 12.7-13.1], BMI z score 2.34 [CI 95% 2.31-2.38]) with normal fasting plasma glucose. All participants had a standard OGTT, with calculation of indices of insulin sensitivity and beta cell function. For the analysis, prepubertal and pubertal participants were stratified into quartiles of normal fasting plasma glucose. Results We observed a significant increase in fasting insulin and AUC 2 h glucose across quartiles. Pronounced changes were observed in insulin sensitivity and secretion, particularly in the pubertal group. Moreover, the odds of presenting with impaired glucose tolerance increased by 4.5% with each 0.06 mmol/l increase in fasting plasma glucose. No significant differences in cardiovascular indices were seen across quartiles. Conclusions/interpretation These data suggest that in obese youth, independent of age, BMI z score, sex, family history and ethnicity, insulin sensitivity and secretion decline when moving from low to high normal fasting plasma glucose. The simple measure of fasting plasma glucose could assist clinicians in identifying children for targeted diabetes screening and subsequent lifestyle management.

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Section: Discussionmentioning

confidence: 67%

High normal fasting glucose level in obese youth: a marker for insulin resistance and beta cell dysregulation

et al. 2010

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“…Since fasting blood glucose failed to diagnose diabetes mellitus in one fourth of children with type 2 diabetes mellitus in the European cohort [3] , oGTT seems to be a better screening tool even if fasting glucose is preferred because of its lower costs and greater convenience. However, the low reproducibility of an oGTT has to be kept in mind [48] . Using the criteria (1) type 2 diabetes mellitus in the first or second degree relatives, (2) onset of puberty, and (3) extreme obesity allows to identify the great majority of overweight European children, which should be screened by oGTT, when two of this three criteria are fulfilled [49] .…”

Section: Screening For Type 2 Diabetes Mel-litus In Children and Adolmentioning

confidence: 99%

Type 2 diabetes mellitus in children and adolescents

Reinehr¹

2013

WJD

295

173

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“…TRT reliability was evaluated by Libman et al 176 in a study that compared measurement of glucose via fasting and 2-hour samples in 60 overweight/obese adolescents. Results indicated that fasting glucose (r = 0.73) had higher reliability than 2-hour glucose (r = 0.37) testing.…”

Section: Onlymentioning

confidence: 99%