Glucose Patterns and the Future Development of Diabetes

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Four distinct glucose patterns were identified during the oral glucose tolerance test.
Four distinct glucose patterns were identified during the oral glucose tolerance test.

An elevated glucose level at 30 minutes during an oral glucose tolerance test (OGTT), independent of fasting and 2-hour glucose levels, may be associated with an increased risk for diabetes and all-cause mortality, according to a study published in Diabetologia.

Researchers identified 5861 participants without a baseline diagnosis of diabetes and performed a retrospective analysis of data from the Danish Inter99 prospective nonpharmacologic intervention study. Participants underwent OGTT, with blood glucose levels measured at 0 (fasting), 30, and 120 minutes. The primary end point of the study was to characterize heterogeneity of glycemic patterns based on the glucose levels obtained at 3 time points. 

Study results identified 4 glucose patterns, with one pattern characterized by an elevated glucose level at 30 minutes, followed by a low glucose level at 2 hours. Participants with this pattern were identified as having a higher risk for diabetes developing when compared with participants who had low glucose levels at 30 minutes and 2 hours (hazard ratio (HR) 4.1; 95% CI, 2.2-7.6), and those with a low 30-minute glucose level and high 2-hour glucose level (HR 1.5; 95% CI, 1.0, 2.2). Overall, all-cause mortality rates were higher in both groups that demonstrated high

glucose levels

at 30 minutes.

Researchers concluded that, “Elevated 30 min[ute] glucose is associated with increased risk of diabetes and all-cause mortality rate independent of fasting and 2-hour glucose levels.” 

 

Based on the findings in this study, clinicians should monitor closely patients with OGTT results that include an elevated glucose level at 30 minutes because they may be at high risk for diabetes developing in the future.

Reference

Hulman A, Vistisen D, Glümer C, Bergman M, Witte DR, Færch. Glucose patterns during an oral glucose tolerance test and associations with future diabetes, cardiovascular disease and all-cause mortality rate [published online October 6, 2017]. Diabetologia. doi: 10.1007/s00125-017-4468-z

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