Utility of Casual Postprandial Glucose Levels in Type 2 Diabetes Management

Imad M. El-Kebbi, David C. Ziemer, Curtiss B. Cook, Daniel L. Gallina, Catherine S. Barnes, Lawrence S. Phillips

Research output: Contribution to journalArticle

52 Scopus citations

Abstract

OBJECTIVE - Because readily available glycemic indicators are needed to guide clinical decision-making for intensification of diabetes therapy, our goals were to define the relationship between casual postprandial plasma glucose (cPPG) levels and HbA1c in patients with type 2 diabetes and to determine the predictive characteristics of a convenient glucose cutoff. RESEARCH DESIGN AND METHODS - We examined the relationship between cPPG levels (1-4 h post meal) and HbA1c levels in 1,827 unique patients who had both determinations during a single office visit. RESULTS - The population studied was predominantly African American and middle-aged, with average cPPG of 201 mg/dl and HbA1c of 8.4%. The prevalence of HbA1c ≥7.0% was 67% and HbA1c >6.5% was 77%. Overall, cPPG and HbA1c were linearly correlated (r = 0.63, P < 0.001). The correlation between cPPG and HbA1c was strongest in patients treated with diet alone (n = 348, r = 0.75, P < 0.001) and weaker but still highly significant for patients treated with oral agents (n = 610, r = 0.64, P < 0.001) or insulin (n = 869, r = 0.56, P < 0.001). A cutoff cPPG >150 mg/ dl predicted an HbA1c level ≥7.0% in the whole group, with a sensitivity of 78%, a specificity of 62%, and an 80% positive predictive value. The same cPPG cutoff of 150 mg/dl predicted an HbA1c level >6.5%, with a sensitivity of 74%, a specificity of 66%, and an 88% positive predictive value. CONCLUSIONS - When rapid-turnaround HbA1c determinations are not available, a single cPPG level >150 mg/dl may be used during a clinic visit to identify most inadequately controlled patients and allow timely intensification of therapy.

Original languageEnglish (US)
Pages (from-to)335-339
Number of pages5
JournalDiabetes Care
Volume27
Issue number2
DOIs
StatePublished - Feb 2004
Externally publishedYes

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ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

El-Kebbi, I. M., Ziemer, D. C., Cook, C. B., Gallina, D. L., Barnes, C. S., & Phillips, L. S. (2004). Utility of Casual Postprandial Glucose Levels in Type 2 Diabetes Management. Diabetes Care, 27(2), 335-339. https://doi.org/10.2337/diacare.27.2.335