Skip to main content

Advertisement

SpringerLink
Log in

Reducing the prevalence of dysglycemia: is the time ripe to test the effectiveness of intervention in high-risk individuals with elevated 1 h post-load glucose levels?

  • Viewpoint
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Identifying the earliest time point on the prediabetic continuum is critical to avoid progressive deterioration in β-cell function. Progressively rising glucose levels even within the “normal range” occur considerably late in the evolution to diabetes thus presenting an important opportunity for earlier diagnosis, treatment, and possible reversal. An elevated 1 h postprandial glucose level, not detected by current diagnostic standards, may provide an opportunity for the early identification of those at risk. When the 1 h post-load glucose level is elevated, lifestyle intervention may have the greatest benefit for preserving β-cell function and prevent further progression to prediabetes and diabetes. In view of the considerable consistent epidemiologic data in large disparate populations supporting the predictive capacity of the1 h post-load value for predicting progression to diabetes and mortality, the time is therefore ripe to evaluate this hypothesis in a large, prospective multicenter randomized trial with lifestyle intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. IDF Atlas, 7th Edition. Online version of IDF Diabetes Atlas: www.diabetesatlas.org, ISBN: 978-2-930229-81-2 (2015)

  2. Xiaohui Zhuo, P. Zhang, T.J. Hoerger, Lifetime direct medical costs of treating type 2 diabetes and diabetic complications. Am. J. Prev. Med. 45(3), 253–261 (2013)

    Article  PubMed  Google Scholar 

  3. Tabak GA, Herder C, Rathmann W, Brunner EJ, Kivimaki M. Prediabetes: A high-risk state for developing diabetes. Lancet.379(9833), 2279–2290 (2012)

    Article  PubMed  Google Scholar 

  4. https://www.cdc.gov/diabetes/pubs/statsreport14/prediabetes-infographic.pdf

  5. G. Li et al., The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes prevention study: a 20-year follow-up study. Lancet. 371(9626), 1783–1789 (2008)

    Article  PubMed  Google Scholar 

  6. R.T. Ackermann et al., Translating the diabetes prevention program into the community. the deploy pilot study. Am. J. Prev. Med. 35(4), 357–363 (2008)

    Article  PubMed  PubMed Central  Google Scholar 

  7. R.T. Ackermann, D.G. Marrero, Adapting the Diabetes Prevention Program lifestyle intervention for delivery in the community: the YMCA model. Diabetes Educ. 33(1), 69, 74–75, 77–78 (2007)

    Article  Google Scholar 

  8. J. Tuomilehto et al., Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N. Engl. J. Med. 344(18), 1343–50 (2001)

    Article  CAS  PubMed  Google Scholar 

  9. W.C. Knowler et al., Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N. Engl. J. Med. 346(6), 393–403 (2002)

    Article  CAS  PubMed  Google Scholar 

  10. M.K. Baker et al., Behavioral strategies in diabetes prevention programs: a systematic review of randomized controlled trials. Diabetes Res. Clin. Pract. 91(1), 1–12 (2011)

    Article  PubMed  Google Scholar 

  11. L. Perreault et al., Regression from pre-diabetes to normal glucose regulation in the diabetes prevention program. Diabetes Care. 32(9), 1583–1588 (2009)

    Article  PubMed  PubMed Central  Google Scholar 

  12. E. Schellenberg et al., Lifestyle interventions for patients with and at risk for type 2 diabetes: a systematic review and meta-analysis. Ann. Intern. Med. 159(8), 543–551 (2013)

    Article  PubMed  Google Scholar 

  13. Diabetes Prevention Program Research Group, 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 374, 1677–1686 (2009)

    Article  PubMed Central  Google Scholar 

  14. J. Lindström, P. Ilanne-Parikka, M. Peltonen et al. on behalf of the Finnish Diabetes Prevention Study Group, Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the finnish diabetes prevention study. Lancet. 368, 1673–1679 (2006)

    Article  PubMed  Google Scholar 

  15. G. Li, P. Zhang, J. Wang et al., The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes prevention study: a 20-year follow-up study. Lancet. 371, 1783–1789 (2008)

    Article  PubMed  Google Scholar 

  16. Diabetes Prevention Program Research Group. Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the diabetes prevention program outcomes study, Lancet Diabetes Endocrinol. (2015). doi:10.1016/S2213-8587(15)00291-0

  17. R. Jagannathan, M.A. Sevick, L. Huilin, D. Fink, R. Dankner, A. Chetrit, J. Roth, M. Bergman. Elevated 1-hour plasma glucose levels are associated with dysglycemia, impaired beta-cell function and insulin sensitivity: pilot study from a real world health care setting. Endocrine. (2015). doi:10.1007/s12020-015-0746-z

  18. R. Jagannathan, M.A. Sevick, D. Fink, R. Dankner, A. Chetrit, J. Roth, M. Buysschaert, M. Bergman. The 1-hour post-load glucose level is more effective than HbA1c for screening dysglycemia. On-line. Acta. Diabetol. 1–8 (2016). doi:10.1007/s00592-015-0829-6

  19. J.H. Ohn, S.H. Kwak, Y.M. Cha, S. Lim, H.C. Jang, K.S. park, N.H. Cho, 10-year trajectory of β-cell function and insulin sensitivity in the development of type 2 diabetes: a community-based prospective cohort study. Lancet Diabetes Endocrinol. (15)00336-8 (2015). doi:10.1016/s2213-8587

  20. M.M. Priya, A. Amutha, T.A. Pramodkumar, et al., β-cell function and insulin sensitivity in normal glucose-tolerant subjects stratified by 1-hour plasma glucose values. Diabetes. Technol. Ther. 18 (2016). doi:1089/dia.2015.0065

  21. M. Buysschaert, M. Bergman, D. Yanogo, R. Jagannathan, B. Buysschaert, V. Preumont. An elevated 1-hour post- load glucose level during the oral glucose tolerance test detects prediabetes. Diabetes Metab. Syndr: Clin. Res. Rev. (2016). doi:10.1016/j.dsx.2016.12.002

  22. M. Bergman, R. Dankner, J. Roth, K.M.Venkat Narayan, Are current diagnostic guidelines delaying diagnosis of dysglycemic states? Time for new approaches. Endocrine. 44, 66–69 (2013)

    Article  CAS  PubMed  Google Scholar 

  23. M. Bergman, Inadequacies of Absolute Threshold Levels for Diagnosing Prediabetes. Diabetes Metab. Res. Rev. 26, 3–6 (2010)

    Article  PubMed  Google Scholar 

  24. M. Bergman, “The early diabetes intervention program—is early actually late?” commentary. Diabetes Metab. Res. Rev. 30, 654–658 (2014)

    Article  PubMed  Google Scholar 

  25. M. Buysschaert, J.L. Medina, M. Bergman, A. Shah, J. Lonier, Prediabetes and associated disorders. Endocrine. 48(2), 371–393 (2015)

    Article  CAS  PubMed  Google Scholar 

  26. M.A. Abdul-Ghani, V. Lyssenko, T. Tuomi, R.A. DeFronzo, L. Groop, Fasting versus postload plasma glucose concentration and the risk for future type 2 diabetes: results from the Botnia study. Diabetes Care. 32(2), 281–286 (2009)

    Article  PubMed  PubMed Central  Google Scholar 

  27. M.A. Abdul-Ghani, K. Williams, R.A. DeFronzo, M. Stern What is the best predictor of future type 2 diabetes? Diabetes Care. 30(207), 1544–1548 (2007)

  28. M.A. Abdul-Ghani, T. Abdul-Ghani, N. Ali, R.A. DeFronzo, One-hour plasma glucose concentration and the metabolic syndrome identify subjects at high risk for future type 2 diabetes. Diabetes Care. 31(8), 1650–1655 (2008)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. M.A. Abdul-Ghani, R.A. DeFronzo, plasma glucose concentration and prediction of future risk of type 2 diabetes. Diabetes Care. 32(Suppl 2), S194–S198 (2009)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. C. Bianchi, R. Miccoli, M. Trombetta, F. Giorgino, S. Frontoni, E. Faloia, G. Marchesini, M.A. Dolci, F. Cavalot, G. Cavallo, F. Leonetti, R.C. Bonadonna, S. Del Prato, Elevated 1-hour postload plasma glucose levels identify subjects with normal glucose tolerance but impaired beta-cell function, insulin resistance, and worse cardiovascular risk profile: the GENFIEV study. J. Clin. Endocrinol. Metab. 98(5), 2100–2105 (2013)

    Article  CAS  PubMed  Google Scholar 

  31. A. Alyass, P. Almgren, M. Akerlund, J. Dushoff, B. Isomaa, P. Nilsson, T. Tuomi, V. Lyssenko, L. Groop, D. Meyre, Modelling of OGTT curve identifies 1 h plasma glucose level as a strong predictor of incident type 2 diabetes: results from two prospective cohorts. Diabetologia. 58, 87–97 (2015)

    Article  CAS  PubMed  Google Scholar 

  32. M. Bergman, A. Chetrit, J. Roth, R. Dankner, Dysglycemia and long-term mortality: observations from the Israel study of glucose intolerance, obesity and hypertension. Diabetes Metab. Res. Rev. 31(4), 368–375 (2015)

    Article  CAS  PubMed  Google Scholar 

  33. A.G. Tabak, M. Jokela, T.N. Akbaraly, E.J. Brunner, M. Kivimaki, D.R. Witte, Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall study. Lancet. 2009. doi:10.1016/s0140-6736(09)60619-x

  34. C.C. Mason, R.L. Hanson, W.C. Knowler, Progression to type 2 diabetes characterized by moderate then rapid glucose increases. Diabetes. 56, 2054–2061 (2007)

    Article  CAS  PubMed  Google Scholar 

  35. E. Laspa, A. Christen, Z. Efstathiadou, D.G. Johnston, I.F. Godsland, Long-term changes and variability in diabetes risk factors prior to the development of impaired glucose homeostasis. Diabetic Med. 24, 1269–1278 (2007)

    Article  CAS  PubMed  Google Scholar 

  36. E. Ferrannini, M. Nannipieri, K. Williams, C. Gonzales, S.M. Haffner, M.P. Stern, Mode of onset of type 2 diabetes from normal or impaired glucose tolerance. Diabetes 53, 160–165 (2004)

    Article  CAS  PubMed  Google Scholar 

  37. N. Unwin, J. Shaw, P. Zimmet, K.G.M.M. Alberti, Impaired glucose tolerance and impaired fasting glycaemia: the current status on definition and intervention. Diabetic Med. 19, 708–723 (2002)

    Article  CAS  PubMed  Google Scholar 

  38. M.A. Abdul-Ghani, K. Williams, R.A. DeFronzo, M. Stern, What is the best predictor of future type 2 diabetes? Diabetes Care. 30(6), 1544–1548 (2007)

    Article  PubMed  Google Scholar 

  39. M.A. Abdul-Ghani, R.A. DeFronzo, Plasma glucose concentration and prediction of future risk of type 2 diabetes. Diabetes Care. 32(Suppl 2), S194–S198 (2009)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. C. Bianchi, R. Miccoli, M. Trombetta, F. Giorgino, S. Frontoni, E. Faloia, G. Marchesini, M.A. Dolci, F. Cavalot, G. Cavallo, F. Leonetti, R.C. Bonadonna; on behalf of the GENFIEV Investigators, Elevated 1-hour postload plasma glucose levels identify subjects with normal glucose tolerance but impaired β-cell function, insulin resistance, and worse cardiovascular risk profile: the genfiev study. J. Clin. Endocrinol. Metab. 98(5), 2100–2105 (2013)

    Article  CAS  PubMed  Google Scholar 

  41. M. Manco, E.M. Del Giudice, M.R. Spreghini, M. Cappa, L. Perrone, C. Brufani, C. Rustico, G. Morino, S. Caprio, 1-Hour plasma glucose in obese youth. Acta. Diabetol. 49, 435–443 (2012)

    Article  CAS  PubMed  Google Scholar 

  42. A. Alyass, P. Almgren, M. Akerlund, J. Dushoff, B. Isomaa, P. Nilsson, T. Tuomi, V. Lyssenko, L. Groop, D. Meyre, Modelling of OGTT curve identifies 1 h plasma glucose level as a strong predictor of incident type 2 diabetes: results from two prospective cohorts. Diabetologia. 58, 87–97 (2015)

    Article  CAS  PubMed  Google Scholar 

  43. R. Oka, T. Aizawa, S. Miyamoto, T. Yondea, M. Yamagashi, One-hour plasma glucose as a predictor of the development of type 2 diabetes in Japanese adults. Diabetic Med. (2016). doi:10.1111/dme.12994

  44. M. Bergman, A. Chetrit, J. Roth, R. Jagannathan, M. Sevick, R. Dankner, One-hour post-load plasma glucose level during the OGTT predicts dysglycemia. Observations from the 24 year follow-up of Israel study of glucose intolerance, obesity and hypertension. Diabetes Res. Clin. Pract. 120(10), 221–228 (2016). doi:10.1016/j.diabres.2016.08.013

    Article  CAS  PubMed  Google Scholar 

  45. T.J. Oh, S. Lim, K.M. Kim, J.H. Moon, S.H. Choi, Y.M. Cho, K.S. Park, H. Jang, N.H. Cho, One-hour postload plasma glucose concentration in people with normal glucose homeostasis predicts future diabetes mellitus: a 12- year community-based cohort study. Clin. Endocrinol. (Oxf). (2016) doi:10.1111/cen.13280

  46. L. Kuang, Z. Huang, Z. Hong, A. Chen, Y. Li, Predictability of 1-h postload plasma glucose concentration: a 10-year retrospective cohort study. J. Diabetes Invest 6, 647–654 (2015)

    Article  CAS  Google Scholar 

  47. E. Succurro, M.A. Marini, F. Arturi, A. Grembiale, M. Lugara, F. Andreozzi, A. Sciacqua, R. Lauro, M.L. Hribal, F. Perticone, G. Sesti, Elevated one-hour post-load plasma glucose levels identifies subjects with normal glucose tolerance but early carotid atherosclerosis. Atherosclerosis. 207(1), 245–249 (2009). doi:10.1016/j.atherosclerosis.2009.04.006

    Article  CAS  PubMed  Google Scholar 

  48. A. Sciacqua, R. Maio, S. Miceli, A. Pascale, G. Carullo, N. Grillo, F. Arturi, G. Sesti, F. Perticone, Association between One-hour post-load plasma glucose levels and vascular stiffness in essential hypertension. PLoS. ONE. 7, e44470 (2012)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. E. Succurro, F. Arturi, M. Lugara, A. Grembiale, T.V. Fiorentino, V. Caruso, F. Andreozzi, A. Sciacqua, M.L. Hribal, F. Perticone, G. Sesti, One-hour postload plasma glucose levels are associated with kidney dysfunction. Clin J Am Soc Nephrol: CJASN 5(11), 1922–1927 (2010). doi:10.2215/CJN.03240410

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. G. Sesti, T.V. Fiorentino, E. Succurro, M. Perticone, F. Arturi, A. Sciacqua, F. Perticone, Elevated 1-hour post-load plasma glucose levels in subjects with normal glucose tolerance are associated with unfavorable inflammatory profile. Acta. Diabetol. 51, 927–932 (2014)

    Article  CAS  PubMed  Google Scholar 

  51. G. Sesti, M.L. Hribal, T.V. Fiorentino, A. Sciacqua, F. Petricone, Elevated 1 h post-load plasma glucose levels identify adults with normal glucose tolerance but increased risk of non-alcoholic fatty liver disease. BMJ Open Diab. Res. Care. 2, e000016 (2014)

    Article  PubMed  PubMed Central  Google Scholar 

  52. M. Bergman, A. Chetrit, J. Roth, R. Dankner, One-hour post-load plasma glucose level during the OGTT predicts mortality: observations from the Israel Study of Glucose Intolerance, Obesity and Hypertension. Diabetic Med. (2016). doi:10.1111/dme.13116

  53. B. Warren, J.S. Pankow, K. Matsushita, N.M. Punjabi, N.R. Daya, M. Grams, M. Woodward, E. Selvin, Comparative prognostic performance of definitions of prediabetes: a prospective cohort analysis of the atherosclerosis risk in communities (ARIC ) study. Lancet Diabetes Endocrinol 5, 34–42 (2017)

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. NYU School of Medicine, Department of Medicine, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, New York, NY, 10016, USA

    Michael Bergman, Karin Katz & Brenda Dorcely

  2. NYU School of Medicine, Department of Population Health, Division of Health Behavior Change, New York, NY, 10016, USA

    Ram Jagannathan & Mary Ann Sevick

  3. Department of Endocrinology and Diabetology, Université Catholique de Louvain, University Clinic Saint-Luc, Brussels, Belgium

    Martin Buysschaert

  4. Oporto Medical School, Oporto University, Oporto, Portugal

    Jose Luis Medina

  5. The Feinstein Institute for Medical Research, Manhasset, North Shore, New York, 11030, USA

    Jesse Roth & Rachel Dankner

  6. Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel

    Angela Chetrit & Rachel Dankner

  7. Sackler Faculty of Medicine, School of Public Health, Department of Epidemiology and Preventive Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel

    Rachel Dankner

Authors
  1. Michael Bergman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ram Jagannathan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martin Buysschaert
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jose Luis Medina
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mary Ann Sevick
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Karin Katz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Brenda Dorcely
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jesse Roth
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Angela Chetrit
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Rachel Dankner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael Bergman.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For retrospective studies, formal consent is not required

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bergman, M., Jagannathan, R., Buysschaert, M. et al. Reducing the prevalence of dysglycemia: is the time ripe to test the effectiveness of intervention in high-risk individuals with elevated 1 h post-load glucose levels?. Endocrine 55, 697–701 (2017). https://doi.org/10.1007/s12020-017-1236-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-017-1236-2

Keywords

Search

Navigation