1283-P: Pilot Study Reveals Excellent Agreement between the Newly Developed Pastry Sugar Tolerance Test and the OGTT in the Diagnosis of Diabetes

Abstract

Achieving early diagnosis of type 2 diabetes (T2D) in Africans is challenging. The Glucola used in the OGTT is expensive and unavailable in most African countries. Alternatives to the OGTT are fasting plasma glucose (FPG) and A1C, but they have a low diagnostic sensitivity in Africans. As an alternative to the Glucola (75g glucose) used in the OGTT, we developed the Pastry Sugar Tolerance Test (PSTT) with pastry sugar (75g glucose powder) dissolved in hot water. Pastry sugar is inexpensive and widely available in Africa. Hence, our aim was to determine the diagnostic agreement between (1) OGTT and PSTT; (2) OGTT and A1C; (3) OGTT and FPG in the detection of T2D in 48 African-born Blacks living in America (male: 67%; age: 41±10y (mean±SD)). At Visit 1, an OGTT, A1C and FPG were performed. At Visit 2, which occurred 8±3 days later, a PSTT was performed (Fig). ADA criteria were used for the OGTT, A1C≥6.5% and FPG≥126 mg/dL. Agreement between tests was determined by κ-statistic. T2D, prediabetes and normal glucose tolerance occurred in 8% (4/48), 31% (15/48) and 61% (29/48), resp. All individuals with T2D were detected by both the OGTT and PSTT (κ=0.99). Yet, A1C only detected 50% (2/4) (κ=0.65), and FPG only detected 25% (1/4) (κ=0.38) of Africans with T2D. This pilot study suggests that in the detection of T2D, agreement between the PSTT and the OGTT may be both excellent and superior to A1C and FPG. Disclosure B.R.Schenk: None. A.E.Sumner: None. J.Hurston: None. J.Gatete: None. C.Dubose: None. L.Mabundo: None. S.Yang: None. C.Worthy: None. A.B.Courville: None. R.Jagannathan: None.