Pre-Type 1 Diabetes Dysmetabolism: Maximal Sensitivity Achieved with Both Oral and Intravenous Glucose Tolerance Testing - 12/08/11
, Kim McFann, PhD, Leonard C. Harrison, MD, DSc, Spiros Fourlanos, MD, Jeffrey Krischer, PhD, David Cuthbertson, MS, H. Peter Chase, MD, George S. Eisenbarth, MD, PhDDPT-1 Study Group
Reprint requests: Dr Jennifer M. Barker, Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, 4200 E. 9th Avenue B140, Denver CO 80262.Résumé |
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 Trial—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.
Le texte complet de cet article est disponible en PDF.Abbreviations : BMI, DPT-1, FPIR, HOMA-R, ICA, IFG, IGT, IVGTT, OGTT, T1D
Plan
| Supported by NIH AI 39213, DK32083. Dr Barker is supported by JDRF 11-2005-15. |
Vol 150 - N° 1
P. 31 - janvier 2007 Retour au numéro
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