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Abstract
Introduction The major challenge for diabetes prevention is early identification of individuals at risk to allow for implementation of measures to delay the onset of future disease. Measures such as fasting plasma glucose (FPG), 2-hour plasma glucose (2hPG), and glycosylated hemoglobin (HbA1c) are equally appropriate for identifying pre-diabetes and diabetes, but do not all identify the disease in the same individual. We tested the utility of a diagnostic method combining FPG, 2hPG and HbA1c for early evaluation and easy identification of pre-diabetes.
Research design and methods 531 subjects underwent skin autofluorescence (SAF) and glycemia analyses. We created two classification groups based on the American Diabetes Association diagnosis guidelines: (1) based on 2hPG and (2) based on a new combination of three glycemia parameters (the three-criteria strategy (3-c)). Logistic regression modeling was used to estimate the associations.
Results SAF showed high associations for both 3-c definition and 2hPG definition alone. These associations appeared stronger in 3-c than those in 2hPG. The non-invasive SAF measurement outperformed 2hPG in the detection of dysglycemia or pre-diabetes. Stepwise selections identified 1-hour postload glucose (1hPG) as variable identifying pre-diabetes using the 2hPG criterion, and the model based on 1hPG plus SAF appeared to be the best association using the 3-c strategy.
Conclusions 1hPG coupled with SAF showed a strong association in the evaluation of pre-diabetes using the 3-c method.
- epidemiology
- prediabetic phenotype
- dysglycemia
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Footnotes
Contributors LLS contributed to conception and design of the study, analysis and interpretation of data, and wrote the manuscript. LLS and ET performed statistical analyses. FP and PC critically revised the manuscript. AC contributed to conception and provided critical revision of the paper for important intellectual content. All authors read and approved the manuscript submission. LLS takes responsibility for the content of the article.
Funding This work has been supported by EFSD/Sanofi 2017 (to LLS), Fondazione ‘Romeo ed Enrica Invernizzi’ (Milan, Italy), Italian Ministry of Health ‘Ricerca Corrente’ to IRCCS MultiMedica and ‘RF2016 – 02364513’ (to AC).
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The DIAPASON protocol was approved by the institutional review boards/independent ethics committee of the IRCCS MultiMedica (protocol number 24/2012(153)).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. Our data are not in a repository. We have permission from the participants in terms of informed consent.