Study protocols |
Demographic
characteristics |
Study results
|
Conclusions |
References |
FPG and OGTT
N= 188 >6 mo. postTx,
OGTT performed in patients with FPG < 7.0 mmol/L
(n= 188) |
White > 90% |
ROC analyses
- Optimal FPG predictive of NODAT: 101 mg/dL; 5.6 mmol/L (AUC= 0.70; sensitivity 64; specificity 67, positive predictive 20; negative predictive 93
- Optimal FPG predictive of IGT less well-defined (AUC= 0.54)
- Prevalence of NODAT (OGTT vs. FPG alone 17% vs. 6%, respectively; P<0.0001)
|
FPG may not be the optimal screening or diagnostic tool due to lack of sensitivity & specificity
OGTT should be considered as a routine screening test in all renal transplant recipients |
Armstrong et al. |
FPG and OGTT
N=122 > 6 months postTx
OGTT performed in patients with 2 FPG values between 5.6-6.9 mmol/L |
White 96%
Asian 3%
Afro-Caribbean 1% |
OGTT revealed 10 had overt DM, 9% IGT alone, 18% IFG alone, 14% combined IFG and IGT |
FPG underestimates IGT and NODAT prevalence
Routine use of OGTT is a valuable clinical tool to risk stratify patient for NODAT |
Sharif et al. |
FPG and OGTT
N=359
All pts completed OGTT 5 days potTx
Mean f/u: 42.8 + 16.9 months |
White 91.4%
Blacks 1.4%
Arabic 7.2%
Hispanics 0% |
- A normal (vs. diabetic) OGTT at day 5 postTx associated with↓NODAT risk (OR= 0.003; P=0.0002)
Sensitivity 93.4; Specificity 71.9%
- A normal (vs diabetic) FPG on day 5 associated with ↓NODAT risk (OR= 0.06; P< 0.0001)
Sensitivity 21.6% Specificity 97.6%
|
A normal FPG (vs. diabetic) and a normal OGTT (vs diabetic) at 5 days postTx seems to identify patients at ↓NODAT risk |
Kuypers et al. |
FPG and A1C
N=199 > 3 months postTx
All patients had a history of normal FPG prior to study
Normal A1C defined as < 6.1
% |
African Americans 81.9% |
- Twenty (10.1%) had A1C > 6.1% (6 of whom had both ↑A1C and new onset ↑FPG @ study entry, and 14 had ↑A1C only
- Of the 6 pts with both ↑A1C and new onset ↑FPG, 5 were diagnosed with NODAT
- Of the 14 pts with ↑A1C only, 3 were diagnosed with NODAT and 4 with glucose intolerance
- The odds of African Americans having ↑A1C were 2.8 times higher than other races
- High normal FPG was significantly associated with an ↑A1C (P= 0.003)
- Race effect marginally significant when adjusted for FPG (P=0.08)
|
A1C level was a more sensitive test than FPG in detecting NODAT
A1C testing should be considered as a screening test for NODAT, especially in African Americans |
Hoban et al. |
FPG, A1C , and OGTT
N=929 @ 10-week postTx
Patients who had
both FPG < 7.0mmol/L and A1C levels available were evaluated |
White 95% |
ROC analysis:
FPG: AUC 0.761 (95CI 0.714-0.809)
A1C: AUC 0.817 (95CI 0.758-0.876)
Performing OGTT on patients with FPG > 5.3 mmol/L or A1C > 5.8% predicted NODAT with 81% and 83% sensitivity, requiring 49 and 41 of the patients to be tested, respectively
Combined criterion of FPG > 5.0 mmol/L and A1C > 5.7 provided a sensitivity of 79% from testing 29% of the population
|
OGTT should be considered in patients with FPG between 5.3-6.9 mmol/L or A1C > 5.8%
or
In those with combined FPG > 5 mmol/L and A1C > 5.7% |
Valderhaugh et al. |