确认糖尿病预防计划中的血糖状态：对高危成年人诊断糖尿病的影响。
Confirming glycemic status in the Diabetes Prevention Program: implications for diagnosing diabetes in high risk adults.
机构信息
Biostatistics Center, George Washington University, Rockville, MD, USA.
出版信息
J Diabetes Complications. 2013 Mar-Apr;27(2):150-7. doi: 10.1016/j.jdiacomp.2012.09.012. Epub 2012 Nov 7.
AIMS
To examine the ability of fasting plasma glucose (FPG) and/or 2-h glucose to confirm diabetes and to determine the proportion of participants with HbA1c ≥6.5%.
METHODS
Diabetes confirmation rates were calculated after a single elevated FPG and/or 2-h glucose on an oral glucose tolerance test (OGTT) using a confirmatory OGTT performed within 6 weeks.
RESULTS
772 (24%) participants had elevated FPG or 2-h glucose on an OGTT that triggered a confirmation visit. There were 101 triggers on FPG alone, 574 on 2-h glucose alone, and 97 on both. Only 47% of participants who triggered had confirmed diabetes. While the confirmation rate for FPG was higher than that for 2-h glucose, the larger number of 2-h glucose triggers resulted in 87% of confirmed cases triggering on 2-h glucose. Confirmation rates increased to 75% among persons with FPG ≥126 mg/dl and HbA1c ≥6.5%.
CONCLUSIONS
Only half of the persons with elevated FPG and IGT were subsequently confirmed to have diabetes. At current diagnostic levels, more persons trigger on 2-h glucose than on FPG, but fewer of these persons have their diagnoses confirmed. In individuals with FPG ≥126 mg/dl and HbA1c ≥6.5%, the confirmation rate was increased.
目的
检验空腹血糖（FPG）和/或 2 小时血糖确诊糖尿病的能力，并确定糖化血红蛋白（HbA1c）≥6.5%的参与者比例。
方法
采用在 6 周内进行的确认性口服葡萄糖耐量试验（OGTT），对单次 OGTT 中 FPG 和/或 2 小时血糖升高者进行糖尿病确诊率的计算。
结果
772（24%）名参与者的 OGTT 出现 FPG 或 2 小时血糖升高，触发了确认性就诊。单纯 FPG 升高触发 101 例，单纯 2 小时血糖升高触发 574 例，两者均升高触发 97 例。仅有 47%的触发者被确诊患有糖尿病。FPG 的确诊率高于 2 小时血糖，但 2 小时血糖触发者更多，导致 87%的确诊病例是由 2 小时血糖触发的。FPG≥126mg/dl 和 HbA1c≥6.5%的人群中，确诊率上升至 75%。
结论
仅有一半 FPG 和 IGT 升高者随后被确诊为糖尿病。在当前的诊断标准下，更多的人因 2 小时血糖而触发，但这些人中只有较少的人得到确诊。在 FPG≥126mg/dl 和 HbA1c≥6.5%的个体中，确诊率增加。
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