Document Detail


Pre-type 1 diabetes dysmetabolism: maximal sensitivity achieved with both oral and intravenous glucose tolerance testing.
MedLine Citation:
PMID:  17188609     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jennifer M Barker; Kim McFann; Leonard C Harrison; Spiros Fourlanos; Jeffrey Krischer; David Cuthbertson; H Peter Chase; George S Eisenbarth;
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  150     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2006-12-25     Completed Date:  2007-01-25     Revised Date:  2014-09-14    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  31-36.e6     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adolescent
Blood Glucose / metabolism*
Child
Diabetes Mellitus, Type 1 / blood,  diagnosis*,  etiology
Female
Glucose / administration & dosage,  diagnostic use*
Glucose Tolerance Test / methods
Humans
Male
Metabolic Syndrome X / blood*,  complications
Proportional Hazards Models
Reproducibility of Results
Sweetening Agents / administration & dosage,  diagnostic use*
Grant Support
ID/Acronym/Agency:
AI 39213/AI/NIAID NIH HHS; DK32083/DK/NIDDK NIH HHS; R01 AI039213/AI/NIAID NIH HHS; R01 DK032083/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Sweetening Agents; IY9XDZ35W2/Glucose
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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