Summary
Subjects selected from a centre specializing in diabetes detection have been classified using nine different methods of diagnosis including the recent criteria of the National Diabetes Data Group and the World Health Organization. The applicability of these two new criteria have been evaluated and compared with seven other previous criteria. The agreements and discrepancies between these criteria have been assessed. Application of the new criteria result in a major redistribution of subjects with abnormal glucose tolerance into a rare category of diabetes mellitus and a large category of ‘impaired glucose tolerance’. An important percentage of our population (33%) is excluded from the three clinical classes circumscribed by the criteria of the National Diabetes Data Group. Among these subjects, two-thirds correspond to the subjects named ‘non-diagnostic’ by these authors and one-third are not classifiable. The need to allow for all possible oral glucose tolerance test responses is emphasized.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
West KM (1978) Epidemiology of diabetes and its vascular lesions. Elsevier, New York, pp 93–102
National Diabetes Data Group (1979) Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 28: 1039–1057
Expert Committee on Diabetes Mellitus, World Health Organization (1980) WHO Technical Report Series 646
Valleron AJ, Eschwege E, Papoz L, Rosselin GE (1965) Agreement and discrepancy in the evaluation of normal and diabetic oral glucose tolerance test. Diabetes 24: 585–593
McDonald GW, Hoet JP, Butterfield WJH (1965) Diabetes mellitus: report of a WHO expert committee. WHO Technical Report Series 310
Committee on Statistics of the American Diabetes Association (1969) Standardization of the oral glucose tolerance test. Diabetes 18: 299–310
Schwartz D, Lellouch J, Anguera FG, Beaumont JL, Lenegre J (1966) Tobacco and other factors in the aetiology of ischaemic heart disease in man. Results of a retrospective survey. J Chron Dis 19: 35–56
West KM (1979) Standardization of definition, classification and reporting in diabetes-related epidemiologic studies. Diabetes Care 2: 65–76
Fajans SS, Conn JS (1965) Prediabetes, subclinical diabetes and latent clinical diabetes. Interpretation, diagnosis and treatment. In: Leibel BS, Wrenshall GA (eds) On the nature and treatment of diabetes. Excerpta Medica Foundation, New York, International Congress Series 84: 641–665
Wilkerson HLC (1964) Diagnosis, oral glucose tolerance tests. In: Danowski TS (ed) Diabetes mellitus, diagnosis and treatment. American Diabetes Association, New York, pp 31–34
Fitzgerald MG, Keen H (1964) Diagnostic classification of diabetes. Br Med J 1: 1568
Klimt CR, Meinert CL, Knowles HC (1967) University Group Diabetes Program. A study of the relationship of therapy to vascular and other complications of diabetes. In: Butterfield WJH, Westering V (eds) Tolbutamide after ten years. Brook Lodge Symposium of the International Diabetes Federation, August 1967. Excerpta Medica Foundation, New York, International Congress Series 149: 261–269
European Association for the Study of Diabetes (1970) A brief account of the European Diabetes Epidemiology Study Group: recommendations and research. Diabetologia 6: 453–454
O'Sullivan JM, Mahan CM (1964) Criteria for the oral glucose tolerance test in pregnancy. Diabetes 13: 278–285
Remein QR, Wilkerson HCL (1961) The efficiency of screening tests for diabetes. J Chron Dis 13: 6–21
Bennett PH, Rushforth NB, Miller M, Le Compte PM (1976) Epidemiologic studies of diabetes in the Pima Indians. Rec Prog Horm Res 32: 333–376
Zimmet P, Whitehouse S (1978) Bimodality of fasting and two hour glucose tolerance distributions in a Micronesian population. Diabetes 27: 793–800
O'Sullivan JB, Mahan CM (1968) Prospective study of 352 young patients with chemical diabetes. N Eng J Med 278: 1038–1041
Birmingham Diabetes Survey Working Party (1970) Five year follow up report on the Birmingham diabetes survey of 1962. Br Med J 3: 301–305
Fitzgerald MG, Malins JM (1976) Ten years follow up report on the Birmingham diabetes survey of 1961. Br Med J 2: 35–37
Jarrett RJ, Keen H (1976) Diabetes and atherosclerosis. In: Keen H, Jarrett RJ (eds) Complications of diabetes. Edward Arnold, London, pp 179–204
Jarrett RJ, Keen H, Fuller JH, Mc Cartney M (1979) Worsening to diabetes in men with impaired glucose tolerance. Diabetologia 16: 25–30
Al Sayegh H, Jarrett RJ (1979) Oral glucose tolerance tests and diagnosis of diabetes: Results of a prospective study based on the Whitehall survey. Lancet 1: 31–33
Rushforth NB, Miller M, Bennett PH (1979) Fasting and two hour post load glucose levels for the diagnosis of diabetes. The relationship between glucose levels and complications of diabetes in Pima Indians. Diabetologia 16: 373–379
Köbberling J, Creutzfeldt W (1979) Diabetes mellitus: a new look at diagnostic criteria. Diabetologia 17: 263–264
Pettitt DJ, Knowler WC, Lisse JR, Bennett PH (1980) Development of retinopathy and proteinuria in relation to plasma glucose concentrations in Pima Indians. Lancet 2: 1050–1052
Bennett PH (1979) Recommendations on the standardization of methods and reporting of tests for diabetes and its microvascular complications in epidemiologic studies. Diabetes Care 2: 98–104
Keen H, Jarrett RJ, Alberti KGMM (1979) Diabetes mellitus: a new look at diagnostic criteria. Diabetologia 16: 283–285
O'Sullivan JB, Fajans SS (1980) Selecting criteria for the diagnosis of diabetes mellitus. Diabetes Care 3: 565–566
Jarrett RJ, Keen H (1981) Classification of diabetes. Diabetes Care 4: 137–138
Alberti KGMM (1980) Impaired glucose tolerance. Lancet 2: 211
Watkins PJ (1979) Diabetes mellitus: a new look at diagnostic criteria. Diabetologia 17: 127–128
Dix D, Cohen P (1980) Interpretation of the glucose tolerance test. Diabetologia 19: 488
Ganda OP, Day JL, Soeldner JS, Connon JJ, Gleason RE (1978) Reproducibility and comparative analysis of repeated intravenous and oral glucose tolerance tests. Diabetes 27: 715–725
O'Sullivan JB, Mahan CM (1966) Glucose tolerance test, variability in pregnant and non-pregnant women. Am J Clin Nutr 19: 345–350
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Massari, V., Eschwège, E. & Valleron, A.J. Imprecision of new criteria for the oral glucose tolerance test. Diabetologia 24, 100–106 (1983). https://doi.org/10.1007/BF00297390
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00297390