Pre-type 1 diabetes dysmetabolism: Maximal sensitivity achieved with both oral and intravenous glucose tolerance testing

被引:28
作者
Barker, Jennifer M.
Harrison, Leonard C.
Fourlanos, Spiros
Krischer, Jeffrey
Cuthbertson, David
Chase, H. Peter
Eisenbarth, George S.
机构
[1] Univ Colorado, Hlth Sci Ctr, Barbara Davis Ctr Childhood Diabet, Denver, CO 80262 USA
[2] Walter & Eliza Hall Inst Med Res, Autoimmun & Transplant Div, Parkville, Vic 3050, Australia
[3] Univ S Florida, Dept Pediat, Tampa, FL 33612 USA
关键词
D O I
10.1016/j.jpeds.2006.09.033
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective. To determine the relationship of intravenous (IVGTT) and oral (OGTT) glucose tolerance tests abnormalities to diabetes development in a high-risk pre-diabetic cohort and to identify an optimal testing strategy for detecting preclinical diabetes. Study design. Diabetes Prevention Ttial-Type 1 Diabetes (DPT-1) randomized subjects to oral (n = 372) and parenteral (n = 339) insulin prevention trials. Subjects were followed with IVGTTs and OGTTs. Factors associated with progression to diabetes were evaluated. Results. Survival analysis revealed that higher quartiles of 2-hour glucose and lower quartiles of first phase insulin response (FPIR) at baseline were associated with decreased diabetes-free survival. Cox proportional hazards modeling showed that baseline body mass index (BMI), FPIR, and 2-hour glucose levels were significantly associated with an increased hazard for diabetes. On testing performed within 6 months of diabetes diagnosis, 3% (1/32) had normal FPIR and normal 2-hour glucose on OGTT. The sensitivities for impaired glucose tolerance (IGT) and low FPIR performed within 6 months of diabetes diagnosis were equivalent (76% vs 73%). Conclusions. Most (97%) subjects had abnormal IVGTTs and/or OGTTs before the development of diabetes. The highest sensitivity is achieved using both tests.
引用
收藏
页码:31 / 36
页数:6
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