Plasma glucose in screening for diabetes and pre-diabetes: how much is too much? Analysis of fasting plasma glucose and oral glucose tolerance test in Sri Lankans

Katulanda, Gaya; Katulanda, Prasad; Dematapitiya, Chinthana; Dissanayake, Harsha; Wijeratne, Sumedha; Sheriff, M H Rezvi

doi:10.1186/s12902-019-0343-x

Cited by 18 publications

(24 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies conducted in Asian and Caucasian populations have revealed similar findings (6,19). One recent study was conducted to compare the sensitivity and specificity of FPG with OGTT in the diagnosis of pre-diabetes in the local setting and it showed FPG has low sensitivity to detect pre-diabetes similar to our findings (20). Use of OGTT or alternative screening tools such as glycosylated hemoglobin in addition to FPG to diagnose individuals with the pre-diabetes have been recommended to improve the diagnostic yield of pre-diabetes (5).…”

Section: Discussionsupporting

confidence: 89%

Community screening for undiagnosed dysglycaemia in a semi-urban locality in Sri Lanka

et al. 2020

View full text Add to dashboard Cite

Introduction: Previous studies on the prevalence of pre-diabetes and diabetes in Sri Lanka have shown conflicting results. We studied the prevalence of pre-diabetes and diabetes using fasting plasma glucose (FPG) and 75g oral glucose tolerance (OGTT) test among a representative sample of adults in a semi-urban locality in Southern Sri Lanka. Sensitivity and specificity of FPG over OGTT in diagnosing pre-diabetes and diabetes were calculated. Methods: Healthy adults, aged 20-75 years, selected by multi-stage random sampling from one medical officer of health area in Southern Sri Lanka were screened with FPG and 75g OGTT. Subjects known to have diabetes were excluded. Results: Mean (SD) age of men (n=234) and women (n=593) were 44 (10.1) and 43(10.8) years, respectively. With OGTT, 157 (19.0%) subjects had impaired glucose tolerance while another 60(7.3%) had diabetes. With FPG, 270 (32.6%) had impaired fasting glycaemia while another 51(6.2%) had diabetes. Prevalence of prediabetes or diabetes was not different among men and women by OGTT; 55 (23.5%) vs 162 (27.3%), p=0.293 while it was significantly different by FPG; 107 (45.7%) vs 214 (36.1%), p=0.011. Prevalence of pre-diabetes or diabetes was significantly higher in age group ≥45 yrs compared to age <45 yrs by both tests. FPG showed low sensitivity (44.7%) but higher (76.1%) specificity of detecting dysglycaemia. FPG showed sensitivity of 53.3% and specificity of 97.5% in detecting undetected diabetes. Conclusions: Prevalence of pre-diabetes is higher than in previous studies in Sri Lanka. Significantly higher proportion of males compared to females, had pre-diabetes or diabetes by FPG test. Compared to subjects age <45 years, the prevalence of pre-diabetes or diabetes was significantly higher among those ≥ 45 years. FPG lacks adequate sensitivity and specificity to detect those with diabetes or dysglycaemia.

show abstract

Section: Discussionsupporting

confidence: 89%

Community screening for undiagnosed dysglycaemia in a semi-urban locality in Sri Lanka

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Diabetes can result in regulatory alterations in the hemostasis of calcium, phosphorus and magnesium ending with serious complications including cardiovascular disease and neurological disorders ( 7 , 8 ). According to the American Diabetes Association (ADA), pre-diabetes can be defined as either impairment of fasting glucose (5.6–6.9 mmol/L) or impairment of oral glucose tolerance test (2-h OGTT glucose 7.8–11.0 mmol/L) ( 9 ). Other studies showed that the pre-diabetic state is characterized by a reduction of glucose tolerance and delayed insulin secretion ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Urtica Pilulifera in Treating Pre-diabetic Rat Model to Control the Blood Glucose, Lipids and Oxidative Stress

Khatib

Amawi

2020

Med Arch

View full text Add to dashboard Cite

Introduction: Pre-diabetic precedes the development of full diabetes. Studying and identification changes in pre-diabetic conditions can give the possibility to decline the development of diabetes and treat conditions associated with diabetes such as cardiovascular diseases. Aim: The main objectives of the present study were to investigate the potential of using Urtica pilulifera in treating the pre-diabetic rat model and to investigate its anti-oxidant impact. Methods: The pre-diabetic model was induced in rats through daily giving high sucrose diet (35%) for 30 days. The extraction of U. pilulifera leaves was made as described by previous studies. Thirty male Wistar rats were randomly divided into three groups, control group (n=10), pre-diabetic group (n=10), and treated group with the extract of U. pilulifera (n=10). Control group rats received standard diet; pre-diabetic group rats received standard diet and high sucrose (35%) in drinking water, treated group rats received the same conditions as a pre-diabetic group, with intra-peritoneal injection of U. pilulifera injection on daily basis. After one month experiment, blood samples were taken from all rats and tested for glucose, triglycerides, cholesterol, GSH, TAC, and MDA. Results: Both glucose and triglycerides levels were significantly increased in pre-diabetic groups, and significantly reduced in the treated group by the extract of U.pilulifera . The cholesterol level was not significantly changed in all groups. The levels of GSH were significantly reduced in the pre-diabetic group compared with the control group. Treatment with the extract of U. pilulifera increased the levels of GSH significantly compared with the pre-diabetic group. The levels of TAC were not significantly changed between the control group and the pre-diabetic group, but significantly increased in the treated group compared with the pre-diabetic group. The levels of MDA significantly increased in the pre-diabetic group compared with the control group, and significantly reduced in the treated group compared with the control group. Conclusion: High sucrose pre-diabetic model is a good model to study diabetes at early stages, and the treatment using U. pilulifera has several benefits in reducing glucose and lipid profile lipids as well as combating oxidative stress.

show abstract

“…HbA1c testing, which costs anywhere between USD22 and USD65 per test, is thus associated with a substantial opportunity cost and most public facilities in rural Sri Lanka lack the financial and human resource capacity to make HbA1c a sustainable marker of glycaemic control. 6 7 Since public subsidisation of diabetes focussed supplies and laboratory services are currently limited to a glucometer, monthly glucometer strips and a CBG measurement at regular appointments, CBG remains the most appropriate method of assessing glycaemic control in this population. Previous studies demonstrate significant concordance between HbA1c and CBG: both FPG and post-prandial blood glucose (PPBG) showed strong positive correlations with HbA1c in numerous clinical settings including Sri Lanka.…”

Section: Introductionmentioning

confidence: 99%

Imputing HbA1c from capillary blood glucose levels in patients with type 2 diabetes in Sri Lanka: a cross-sectional study

et al. 2020

View full text Add to dashboard Cite

ObjectiveTo develop a population-specific methodology for estimating glycaemic control that optimises resource allocation for patients with diabetes in rural Sri Lanka.DesignCross-sectional study.SettingTrincomalee, Sri Lanka.ParticipantsPatients with non-insulin-treated type 2 diabetes (n=220) from three hospitals in Trincomalee, Sri Lanka.Outcome measureCross-validation was used to build and validate linear regression models to identify predictors of haemoglobin A1c (HbA1c). Validation of models that regress HbA1c on known determinants of glycaemic control was thus the major outcome. These models were then used to devise an algorithm for categorising the patients based on estimated levels of glycaemic control.ResultsTime since last oral intake other than water and capillary blood glucose were the statistically significant predictors of HbA1c and thus included in the final models. In order to minimise type II error (misclassifying a high-risk individual as low-risk or moderate-risk), an algorithm for interpreting estimated glycaemic control was created. With this algorithm, 97.2% of the diabetic patients with HbA1c ≥9.0% were correctly identified.ConclusionsOur calibrated algorithm represents a highly sensitive approach for detecting patients with high-risk diabetes while optimising the allocation of HbA1c testing. Implementation of these methods will optimise the usage of resources devoted to the management of diabetes in Trincomalee, Sri Lanka. Further external validation with diverse patient populations is required before applying our algorithm more widely.

show abstract

Plasma glucose in screening for diabetes and pre-diabetes: how much is too much? Analysis of fasting plasma glucose and oral glucose tolerance test in Sri Lankans

Cited by 18 publications

References 26 publications

Community screening for undiagnosed dysglycaemia in a semi-urban locality in Sri Lanka

Community screening for undiagnosed dysglycaemia in a semi-urban locality in Sri Lanka

Urtica Pilulifera in Treating Pre-diabetic Rat Model to Control the Blood Glucose, Lipids and Oxidative Stress

Imputing HbA1c from capillary blood glucose levels in patients with type 2 diabetes in Sri Lanka: a cross-sectional study

Contact Info

Product

Resources

About