Optimal threshold level of fasting blood sugar and HbA1c to detect pre-diabetes and diabetes based on 75 g OGTT among at-risk Filipino subjects
- Author:
Charmia Kim G. Balansag
1
;
Ceryl Cindy Tan
1
Author Information
- Publication Type:Journal Article
- MeSH: Human; Diabetes Mellitus; Prediabetic State; Glycated Hemoglobin; Glucose Tolerance Test
- From: Philippine Journal of Internal Medicine 2025;63(4):51-60
- CountryPhilippines
- Language:English
-
Abstract:
BACKGROUND:The prevalence of pre-diabetes and diabetes mellitus type 2 (DMT2) among Filipinos exceeds 20%. Progressive loss of insulin sensitivity can occur with fasting blood sugar (FBS) ≥90 mg/dL. Studies among Asians with pre- diabetes show a higher prevalence of DMT2 diagnosed by 75 g oral glucose tolerance test (OGTT), the gold standard, which remains underutilized.
OBJECTIVE:This prospective, observational, single-center study included adult patients admitted between January 2022 to August 2022 who were diagnosed with ARF type 1 and/or 2 and who were hooked to NIV as oxygen supplementation.
METHODOLOGY:This cross-sectional analysis was conducted in the outpatient departments of two hospitals in Cebu City. Ninety-five adult Filipino patients with FBS < 126 mg/dL but with risk factors for DMT2 had HbA1c and 75 g OGTT taken. Test performance and receiver operating characteristic curves were computed for the optimal FBS and HbA1c threshold.
RESULTS:Pre-diabetes or DMT2 was prevalent among 66% of participants. Using 75 g OGTT, 23% reached levels indicative of DMT2 but had normal or impaired fasting glucose, while this was found in 20% with pre-diabetic glycated hemoglobin (HbA1c) levels. HbA1c was more accurate than FBS.
CONCLUSION:Performing 75 g OGTT for high-risk Filipinos with FBS ≥94.2 mg/dL or HbA1c ≥5.6% is highly predictive of a change in glucose tolerance status to pre-diabetes, while an FBS ≥106 mg/dL or HbA1c ≥5.8% is predictive of DMT2. Lower cut-off levels promote earlier detection and intervention. Hypertension and age ≥35 years old were significantly associated with such conditions. - Full text:20260630152758500659-2024-340.pdf
