Endocrine Abstracts (2011) 26 P720

Diagnostic criteria for glucose homeostasis abnormalities in obese patients: are there any differences?

J Mesquita1,2, P Rodrigues1,2, C Nogueira1, S Belo1, C Esteves1, M J Matos1,2, A Varela1,2, P Freitas1,2, Joana Queirós1, Flora Correia1,3, Bruno Oliveira3, Manuel Ferreira de Almeida1, João Tiago Guimarães1,2, José Luís Medina1,2 & Davide Carvalho1,2

1Hospital São João, Porto, Portugal; 2Faculty of Medicine, Porto University, Porto, Portugal; 3Faculty of Nutrition and Food Science, Porto University, Porto, Portugal.

Introduction: The course of type 2 diabetes mellitus (DM) is insidious and, before its development, other glucose homeostasis abnormalities can be detected: impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and elevation of HbA1c.

Aims: To compare the prevalence of glucose homeostasis abnormalities in obese patients, using diagnostic criteria of American Diabetes Association (ADA) 2009, ADA 2010 and International Diabetes Federation (IDF) 2005.

Methods: Patients were 39.9 (10.6) years old and had a body mass index (BMI) of 45.5 (5.4) kg/m2. Mean fasting glycaemia was 99.1 (20.1) mg/dl, mean glycaemia at 120′ of OGTT was 147.5 (52.0) mg/dl and mean A1c was 5.8 (0.8)%. Considering ADA 2009 criteria, prevalence of isolated IFG was 8.4%, isolated IGT was 17.5%, IFG associated with IGT was 4.9% and DM was 20.3%. When the criteria A1c≥6.5% was added to the previous criteria, the percentage of DM rose to 23.1%. On the other hand, when considering each criteria of DM alone, prevalence of DM was 10.5% by fasting plasma glucose≥126 mg/dl, 18.9% by plasma glucose at 120′ of OGTT≥200 mg/dl and 14.0% by A1c≥6.5%. Finally, using the criteria of IDF 2005, prevalence of IFG decreased to 2.1% and IFG combined with IGT decreased to 3.5%.

Conclusions: OGTT alone was the best method for diagnosing diabetes in obese patients. Criterion A1c≥6.5% increased the prevalence of diagnosed DM.