Somannavar Suresh, Ganesan Anbazhagan, Deepa Mohan, Datta Manjula, Mohan Viswanathan
Madras Diabetes Research Foundation and Dr Mohan's Diabetes Specialities Centre, World Health Organization Collaborating Centre for Noncommunicable Diseases Prevention and Control, Chennai, India.
Diabetes Care. 2009 Apr;32(4):641-3. doi: 10.2337/dc08-0403. Epub 2008 Dec 10.
To determine random capillary blood glucose (RCBG) cut points that discriminate diabetic and pre-diabetic subjects from normal individuals.
RCBG was performed in 1,333 individuals randomly chosen from 63,305 individuals who had participated in an opportunistic screening program. An oral glucose tolerance test was also performed by venous plasma glucose on an autoanalyzer. RCBG cut points that discriminate diabetes, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) were determined using receiver operating characteristic curves.
Using 2-h plasma glucose >or=200 mg/dl (11.1 mmol/l) criterion, the RCBG cut point of 140 mg/dl (7.7 mmol/l) gave the highest sensitivity and specificity. For 2-h plasma glucose >or=200 mg/dl (11.1 mmol/l) and fasting plasma glucose (FPG) >or=126 mg/dl (7.0 mmol/l) criteria, either 2-h plasma glucose >or=200 mg/dl (11.1 mmol/l) or FPG >or=126 mg/dl (7.0 mmol/l) criterion, and the FPG >or=126 mg/dl (7.0 mmol/l) criterion, RCBG cut point was 143 mg/dl (7.9 mmol/l). RCBG cut points for IGT, IFG according to World Health Organization criterion, and IFG according to American Diabetes Association criterion were 119 mg/dl (6.6 mmol/l), 118 mg/dl (6.6 mmol/l), and 113 mg/dl (6.3 mmol/l), respectively.
Asian Indians with RCBG >110 mg/dl at screening can be recommended to undergo definitive testing.
确定能区分糖尿病患者、糖尿病前期患者与正常个体的随机毛细血管血糖(RCBG)切点。
对从63305名参加机会性筛查项目的个体中随机选取的1333名个体进行了RCBG检测。还通过自动分析仪对静脉血浆葡萄糖进行了口服葡萄糖耐量试验。使用受试者工作特征曲线确定区分糖尿病、糖耐量受损(IGT)和空腹血糖受损(IFG)的RCBG切点。
采用2小时血浆葡萄糖≥200mg/dl(11.1mmol/l)的标准时,RCBG切点为140mg/dl(7.7mmol/l)时具有最高的敏感性和特异性。对于2小时血浆葡萄糖≥200mg/dl(11.1mmol/l)且空腹血浆葡萄糖(FPG)≥126mg/dl(7.0mmol/l)的标准、2小时血浆葡萄糖≥200mg/dl(11.1mmol/l)或FPG≥126mg/dl(7.0mmol/l)的标准以及FPG≥126mg/dl(7.0mmol/l)的标准,RCBG切点均为143mg/dl(7.9mmol/l)。根据世界卫生组织标准的IGT、IFG以及根据美国糖尿病协会标准的IFG的RCBG切点分别为119mg/dl(6.6mmol/l)、118mg/dl(6.6mmol/l)和113mg/dl(6.3mmol/l)。
筛查时RCBG>110mg/dl的亚洲印度人可被建议进行确定性检测。