Evaluation of Fasting Plasma Glucose as a Screening for Diabetes Mellitus in Middle-aged Adults of Naju Country

Background: The criteria for the diagnosis of diabetes mellitus have been modified by the American Diabetes Association (ADA) in 1997.The ADA proposed that the diagnosis of diabetes be defined by a fasting plasma glucose (FPG) of 7.0 mmol/L.Disagreement has been reported between criteria based on FPG and postchallenge 2-h plasma glucose (2-h PG).The aim of the present study is to assess the FPG criteria as the diagnostic screening test for diabetes in Korean middle-aged adults in comparison to the 2-h PG criteria. Methods:Randomly selected 1,731 subjects (679 men and 1,052 women) aged 40~70 years (mean age: 58.4 ± 7.89 years) without previously diagnosed diabetes completed 75 g oral glucose tolerance test (OGTT).We assessed the prevalence of diabetes mellitus and the level of agreement (ĸ statistics) according to the different diagnostic glucose categories.Results: The frequency of newly diagnosed diabetes was 2.7% (n = 51) using the FPG criteria only; 6.4% (n = 120) using the 2-h PG criteria only; and 6.9% (n = 130) using concentrations of ≥ 7.0 mmol/L for FPG or ≥ 11.1 mmol/L for 2-h PG.Of the 120 subjects with diabetes by the 2-h PG criteria, 65.8% (n = 79) were not diagnosed with diabetes according to FPG concentration.The level of agreement between two diagnostic criteria was low (ĸ = 0.268).The receiver operating characterstic (ROC) curve analysis determined FPG of 5.6 mmol/L to yield optimal sensitivity and specificity corresponding to 2-h PG 11.1 mmol/L. Conclusion:The findings in this study demonstrate that the discordance between the FPG and 2-h PG criteria in the diagnosis of diabetes in Korean middle-aged adults is large.We suggest that IFG group (FPG 5.6~6.9mmol/L) were performed 75 g OGTT for diagnosing diabetes mellitus in Korean middle-aged adults.