Take one-hour test to diagnose your diabetes risk: Doctors' body

Chennai: A blood test an hour after a glucose drink will help better assess your risk for diabetes, says latest research by India's largest body of diabetologists. If the value is more than 155mg/dL, the person will quickly progress from prediabetes to diabetes.

The Research Society for Study of Diabetes in India (RSSDI) has recommended the one-hour test for screening diabetes among people whose fasting and two-hour post-load glucose values are normal. "Identifying the early stages of an increase in blood glucose levels (hyperglycemia) can help prevent diabetes and reverse the condition," said first author and RSSDI president Dr Rakesh Sahay.

"Intervening at this stage is primordial prevention," says another author and senior diabetologist Dr V Mohan. "It's easier, less expensive and more effective to act at this stage with lifestyle changes including diet and exercise," he said.

A series of studies abroad showed if the one-hour values exceeded 155 mg/dL among people with normal fasting and two-hour values, there was progression to prediabetes and diabetes. This was supported by studies done in India, where there are 101 million people with diabetes and 136 million people with prediabetes.

Preventing diabetes may have got just a little bit easier with the addition of one more test to the regulation fasting and post-prandial tests. Senior diabetologists say even if the fasting blood sugar and two-hour postload plasma glucose values are normal, the risk of prediabetes and diabetes is high if plasma glucose values are above 155mg/dL one hour after a glucose drink.

In a review article published in the recent edition of the International Journal of Diabetes in Developing Countries, Research Society for Study of Diabetes in India (RSSDI) has recommended one-hour value in tests for screening diabetes among people whose fasting and two-hour post-load glucose are normal. People with elevated values in the one-hour test quickly convert from prediabetes to diabetes,” said the fi rst author and RSSDI president Dr Rakesh Sahay, based out of Hyderabad.

There is also a very rapid loss of beta cell function -- a reduction in the ability of pancreatic beta cells to produce and secrete insulin, he added. RSSDI based its recommendation on several studies conducted abroad and in India. For example, a study published in Diabetes Technology and Therapeutics said that of 30,000 people studied in Chennai, 12.6 per cent who had normal glucose and two-hour oral glucose tolerance tests developed diabetes in less than six years and 32.6 per cent of them developed prediabetes.

Among people with onehour post-glucose tests above 155mg/dL, 19 per cent of people got diabetes and 52 per cent developed pre-diabetes, the study said. The conversion rates were slower in people with lower one-hour post glucose test. That is, in the group that had between 143 mg/dL and 155 mg/dL, 10 per cent got diabetes and in the group that had less than 143 mg/dL in the same test, 6 per cent developed diabetes. Pre-diabetes was seen in 39 per cent and 26 per cent respectively.

In March, the International Diabetes Federation recommended one-hour values to check for diabetes risk. A person with prediabetes either has impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). In IFG fasting blood sugar levels are elevated, but blood sugar levels after the two-hour glucose tolerance test are normal. In IGT, fasting blood sugar levels are normal, but blood sugar levels rise too high after a glucose tolerance test.

Studies from across the globe have shown that individuals with IGT responded more favourably to lifestyle changes aimed at preventing diabetes compared to those with IFG. “This matters for India and Southeast Asia, where IFG is a more prevalent form of prediabetes,” diabetologist Dr R M Anjana said. “It’s important to note that remission doesn’t mean cure, as diabetes can potentially return with lifestyle changes or other medical conditions,” she said.