Prediction of diabetes based on baseline metabolic characteristics in individuals at high risk

Ralph A. DeFronzo, Devjit Tripathy, Dawn C. Schwenke, Mary Ann Banerji, George A. Bray, Thomas A. Buchanan, Stephen C. Clement, Robert R. Henry, Abbas E. Kitabchi, Sunder Mudaliar, Robert E. Ratner, Frankie B. Stentz, Nicolas Musi, Peter D. Reaven, Amalia Gastaldelli

Research output: Contribution to journalArticlepeer-review

53 Scopus citations


OBJECTIVE-Individuals with impaired glucose tolerance (IGT) are at high risk for developing type 2 diabetes mellitus (T2DM).We examined which characteristics at baseline predicted the development of T2DMversus maintenance of IGT or conversion to normal glucose tolerance. RESEARCH DESIGN AND METHODS-We studied 228 subjects at high risk with IGT who received treatment with placebo in ACTNOWand who underwent baseline anthropometric measures and oral glucose tolerance test (OGTT) at baseline and after a mean follow-up of 2.4 years. RESULTS-In a univariate analysis, 45 of 228 (19.7%) IGT individuals developed diabetes. After adjusting for age, sex, and center, increased fasting plasma glucose, 2-h plasma glucose, ΔG0-120 during OGTT, HbA 1c, adipocyte insulin resistance index, ln fasting plasma insulin, and ln ΔI0-120, as well as family history of diabetes and presence of metabolic syndrome, were associated with increased risk of diabetes. At baseline, higher insulin secretion (ln [ΔI0-120/ ΔG0-120]) during the OGTT was associated with decreased risk of diabetes. Higher β-cell function (insulin secretion/insulin resistance or disposition index; ln [ΔI0-120/ΔG0-120 × Matsuda index of insulin sensitivity]; odds ratio 0.11; P<0.0001)was the variablemost closely associated with reduced risk of diabetes. CONCLUSIONS-In a stepwise multiple-variable analysis, only HbA1c and β-cell function (ln insulin secretion/insulin resistance index) predicted the development of diabetes (r = 0.49; P < 0.0001).

Original languageEnglish (US)
Pages (from-to)3607-3612
Number of pages6
JournalDiabetes Care
Issue number11
StatePublished - Nov 2013
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing


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