Random Plasma Glucose in Serendipitous Screening for Glucose Intolerance: Screening for Impaired Glucose Tolerance Study 2
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With positive results from diabetes prevention studies, there is interest in convenient ways to incorporate screening for glucose intolerance into routine care and to limit the need for fasting diagnostic tests.
The aim of this study is to determine whether random plasma glucose (RPG) could be used to screen for glucose intolerance.
This is a cross-sectional study.
The participants of this study include a voluntary sample of 990 adults not known to have diabetes.
RPG was measured, and each subject had a 75-g oral glucose tolerance test several weeks later. Glucose intolerance targets included diabetes, impaired glucose tolerance (IGT), and impaired fasting glucose110 (IFG110; fasting glucose, 110–125 mg/dl, and 2 h glucose < 140 mg/dl). Screening performance was measured by area under receiver operating characteristic curves (AROC).
Mean age was 48 years, and body mass index (BMI) was 30.4 kg/m2; 66% were women, and 52% were black; 5.1% had previously unrecognized diabetes, and 24.0% had any “high-risk” glucose intolerance (diabetes or IGT or IFG110). The AROC was 0.80 (95% CI 0.74–0.86) for RPG to identify diabetes and 0.72 (0.68–0.75) to identify any glucose intolerance, both highly significant (p < 0.001). Screening performance was generally consistent at different times of the day, regardless of meal status, and across a range of risk factors such as age, BMI, high density lipoprotein cholesterol, triglycerides, and blood pressure.
RPG values should be considered by health care providers to be an opportunistic initial screening test and used to prompt further evaluation of patients at risk of glucose intolerance. Such “serendipitous screening” could help to identify unrecognized diabetes and prediabetes.
KEY WORDStype 2 diabetes prediabetes impaired glucose intolerance impaired fasting glucose screening
Atherosclerosis Risk in Communities
National Health and Nutrition Examination Survey III
any glucose intolerance110 (dysglycemia)
type 2 diabetes mellitus
area under the ROC curve
impaired glucose tolerance
impaired fasting glucose
- IFG110 or IFG110–125
IFG with fasting plasma glucose 110–125 mg/dl
type 2 diabetes or IGT or IFG110
World Health Organization
National Cholesterol Education Program
high density lipoprotein
This work was supported in part by DK07298, DK062668, RR017643, DK066204, and RR00039. We thank Jane Caudle, Jack Kaufman, Eileen Osinski, Elizabeth Barrera, Jade Irving, and Aisha Bobcombe for their assistance. Portions of this work were presented at the Scientific Sessions of the American Diabetes Association in Washington, DC (2006).
Conflict of interest Statement
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