Introduction and Objective: The International Diabetes Federation suggests replacing the 2-h plasma glucose (PG) ≥200 mg/dL with a 1-h PG ≥209 mg/dL for diagnosing type 2 diabetes (T2D). However, in the Africans in America cohort, the sensitivity of the 1-h PG ≥209 mg/dL threshold was only 67%. Additionally, fasting plasma glucose (FPG) >126 mg/dL alone captured few cases, as most individuals had abnormal 2-h PG values. To enhance T2D detection with 1-h PG in Africans, we evaluated the sensitivity and specificity of three criteria: (a) 1-h PG ≥209 mg/dL, (b) FPG ≥100 mg/dL, and (c) FPG ≥100 mg/dL with 1-h PG ≥209 mg/dL.Methods: OGTT were performed in 641 African-born Blacks enrolled in the Africans in America cohort (male: 62% (396/641), age: 39±11y (mean±SD), BMI: 27.8±4.6 kg/m2. African regions of birth: West 49%, East 32%, Central 17%, Southern Africa 2%). Glucose tolerance status of the participants was previously unknown. T2D was diagnosed based on 2-h PG of ≥200 mg/dL.Results: Prevalence of newly diagnosed T2D, prediabetes and normal glucose tolerance were: 7% (45/641), 32% (204/641) and 61% (392/641), respectively. The sensitivity and specificity of the 1-h PG≥209 mg/dL-alone criterion were 67% and 89%, respectively. Using the FPG≥100 mg/dL alone, the sensitivity increased to 76%, while specificity remained at 89%. Combining FPG≥100 mg/dL and 1-h PG≥209 mg/dL, further improved sensitivity to 84%, with specificity of 87%. The combined approach demonstrated significantly higher sensitivity compared to 1-h PG ≥209 mg/dL-alone (P=0.008); whereas the difference between FPG -alone and the combined tests approached significance (P=0.125).Conclusion: Combining 1-h PG and FPG enhances the detection of T2D in Africans and supports reducing the OGTT from 2-h to 1-h.
K. Lakhani: None. E.A. Huefner: None. M. Sayed: None. G.G. Smith: None. K. Ntabadde: None. C. DuBose: None. M. Bergman: None. R. Jagannathan: None. A.E. Sumner: None.
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