Evaluation of Fasting Plasma Glucose as a Screening for Diabetes Mellitus in Middle-aged Adults of Naju Country.
10.4093/kdj.2008.32.4.328
- Author:
Jin Hwa KIM
1
;
Mi Ah HAN
;
Chol Jin PARK
;
Il Goo PARK
;
Ji Hye SHIN
;
Sang Yong KIM
;
So Yeon RYU
;
Hak Yeon BAE
Author Information
1. Division of Endocrinology, Chosun University Hospital, Korea.
- Publication Type:Original Article
- Keywords:
Diagnostic criteria;
Fasting plasma glucose;
Type 2 Diabetes Mellitus
- MeSH:
Adult;
Aged;
Diabetes Mellitus;
Diabetes Mellitus, Type 2;
Fasting;
Glucose;
Glucose Tolerance Test;
Humans;
Male;
Mass Screening;
Plasma;
Prevalence;
Sensitivity and Specificity
- From:Korean Diabetes Journal
2008;32(4):328-337
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The criteria for the diagnosis of diabetes mellitus have been modified by the American Diabetes Association (ADA) in 1997. The ADA proposed that the diagnosis of diabetes be defined by a fasting plasma glucose (FPG) of 7.0 mmol/L. Disagreement has been reported between criteria based on FPG and postchallenge 2-h plasma glucose (2-h PG). The aim of the present study is to assess the FPG criteria as the diagnostic screening test for diabetes in Korean middle-aged adults in comparison to the 2-h PG criteria. METHODS: Randomly selected 1,731 subjects (679 men and 1,052 women) aged 40~70 years (mean age: 58.4 +/- 7.89 years) without previously diagnosed diabetes completed 75 g oral glucose tolerance test (OGTT). We assessed the prevalence of diabetes mellitus and the level of agreement (kappa statistics) according to the different diagnostic glucose categories. RESULTS: The frequency of newly diagnosed diabetes was 2.7% (n = 51) using the FPG criteria only; 6.4% (n = 120) using the 2-h PG criteria only; and 6.9% (n = 130) using concentrations of > or = 7.0 mmol/L for FPG or > or = 11.1 mmol/L for 2-h PG. Of the 120 subjects with diabetes by the 2-h PG criteria, 65.8% (n = 79) were not diagnosed with diabetes according to FPG concentration. The level of agreement between two diagnostic criteria was low (kappa = 0.268). The receiver operating characterstic (ROC) curve analysis determined FPG of 5.6 mmol/L to yield optimal sensitivity and specificity corresponding to 2-h PG 11.1 mmol/L. CONCLUSION: The findings in this study demonstrate that the discordance between the FPG and 2-h PG criteria in the diagnosis of diabetes in Korean middle-aged adults is large. We suggest that IFG group (FPG 5.6~6.9 mmol/L) were performed 75 g OGTT for diagnosing diabetes mellitus in Korean middle-aged adults.
