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Not performing an OGTT results in underdiagnosis, inadequate risk assessment and probable cost increases of (pre)diabetes in Han Chinese over 40 years: a population based prospective cohort study.

07:00 EST 1st December 2018 | BioPortfolio

Summary of "Not performing an OGTT results in underdiagnosis, inadequate risk assessment and probable cost increases of (pre)diabetes in Han Chinese over 40 years: a population based prospective cohort study."

Screening for (pre)diabetes is recommended in China using fasting blood glucose as routine strategy currently but not oral glucose tolerance test (OGTT) in high-risk population. We aimed to explore the impact by not performing an OGTT in Han Chinese over 40 years. 6682 participants were included in the prospective cohort study followed up for 3 years. Fasting plasma glucose (FPG), 2-h post-load plasma glucose (2h-PG), FPG and 2h-PG (in OGTT), and HbA1c testing using WHO or ADA Criteria were employed for strategy analysis. The prevalence of diabetes is 12.4% (95%
CI:
11.6-13.3), while the prevalence of prediabetes is 34.1% (95%
CI:
32.9-35.3) and 56.5% (95%
CI:
55.2-57.8) using WHO and ADA Criteria respectively. 2h-PG determined more diabetes individuals than FPG and HbA1c. The testing cost per true positive case of OGTT is close to FPG and less than 2h-PG or HbA1c. FPG, 2h-PG and HbA1c strategies would increase costs from complications for FP or FN results compared with OGTT. Moreover, the least individuals identified as normal by OGTT at baseline developed (pre)diabetes, and the most prediabetes individuals identified by HbA1c or FPG using ADA criteria developed diabetes. We concluded that the prevalence of isolated IGT and isolated 2h post-load diabetes were high and the majority of individuals with (pre)diabetes were undetected in Chinese Han population. Additionally, not performing an OGTT results in underdiagnosis, inadequate developing risk assessment and probable cost increases of (pre)diabetes in Han Chinese over 40 years and great consideration should be given to OGTT in detecting (pre)diabetes in this population. Further population-based prospective cohort study of longer-term effects is necessary to investigate the risk assessment and cost of (pre)diabetes.

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This article was published in the following journal.

Name: Endocrine connections
ISSN: 2049-3614
Pages:

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