Area under the curve during OGTT in first degree relatives of diabetic patients as an efficient indicator of future risk of type 2 diabetes and pre-diabetes

Abstract

Objective

To establish whether the area under the curve of an OGTT has a predictive role in identifying pre-diabetic and diabetic subjects amongst first-degree relatives (FDR) of patients with diabetes mellitus type 2 (DM).

Design, patients and measurements

In a population-based cohort study, 766 FDR of diabetic patients with a normal glucose tolerance test (NGT) completed a 2-h OGTT. They were followed up for 7 years and classified according to the American Diabetes Association criteria into: NGT, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and DM. Relative risk (RR) and 95% confidence intervals (95%CI) were calculated based on logistic regression. Receiver-Operator Characteristic (ROC) analysis along with AUC at different intervals and at time points during the OGTT was used to evaluate the risk of pre-diabetes and diabetes.

Results

Twenty-three subjects (3%) developed type 2 DM, 118 (29.3%) IFG, 81 (11.5%) IGT and 544 (71%) subjects remained NGT. AUC and mean difference of glucose in all high-risk groups demonstrated significant differences both in intervals and time points when compared with the NGT group. The cutoff values during OGTT to predict pre-diabetes and diabetes was determined as blood glucose more than 7.2 and 7.8mmol/l at 30 and 60 minutes, respectively. The time point 60 has the highest predictive role for the development of diabetes, alone, and improved the performance of a prediction model containing multiple important clinical risk factors.

Conclusion

The data suggests that the glycaemic response to an OGTT may predict the risk of development of diabetes in first-degree relatives of DM patients.

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