RSSDI endorses the IDF Position Statement on 1 h post load plasma glucose for diagnosis of intermediate hyperglycemia and type 2 diabetes

Abstract

The Oral Glucose Tolerance Test (OGTT) remains a gold standard for diagnosis of diabetes and prediabetes all over the world and also in India. The original OGTT was a five sample test which included fasting, 30, 60, 90, and 120 min. Later, the test was modified in the US to two sample test 0 and 120 min, i.e., fasting and 2 h after 75 g glucose and this has been in practice all over the world. Traditional diabetologists continue to measure some of the intermediate samples, particularly the 60 min or 1 h value which identifies individuals even before the fasting or 2 h value becomes abnormal. Thus, even before the stage of prediabetes when one has a normal fasting and 2 h value, a raised 1 h value above 155 mg/dl has been shown to predict who will progress to diabetes. A group of 22 international experts recently got together and the IDF Position Statement on the 1 h value was published which shows why the 1 h value in the OGTT should be reintroduced in the routine lab testing of OGTT. This article is an endorsement of the IDF Position Statement on the 1 h value. Introducing the 1 h value in the OGTT is particularly relevant to India which has one of the fastest conversions of prediabetes to diabetes and also a very rapid loss of beta cell function. Identifying early stages of intermediate hyperglycemia can help to prevent diabetes and also reverse the condition.