Michael P. Stern, MD; Ken Williams, MS; Steven M. Haffner, MD, MPH
Acknowledgment: The authors thank Dr. Agustin Escalante for providing helpful advice on the evaluation of ROC curves.
Grant Support: By the National Heart, Lung, and Blood Institute (grants RO1 HL24799 and RO1 HL36820).
Requests for Single Reprints: Michael P. Stern, MD, Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Stern and Haffner and Mr. Williams: Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900.
Author Contributions: Conception and design: M.P. Stern, S.M. Haffner.
Analysis and interpretation of the data: M.P. Stern, K. Williams, S.M. Haffner.
Drafting of the article: M.P. Stern, K. Williams.
Critical revision of the article for important intellectual content: M.P. Stern, K. Williams, S.M. Haffner.
Final approval of the article: M.P. Stern, K. Williams, S.M. Haffner.
Statistical expertise: K. Williams.
Obtaining of funding: M.P. Stern.
Administrative, technical, or logistic support: M.P. Stern.
Collection and assembly of data: M.P. Stern, S.M. Haffner.
Stern MP, Williams K, Haffner SM. Identification of Persons at High Risk for Type 2 Diabetes Mellitus: Do We Need the Oral Glucose Tolerance Test?. Ann Intern Med. 2002;136:575-581. doi: 10.7326/0003-4819-136-8-200204160-00006
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Published: Ann Intern Med. 2002;136(8):575-581.
In 1979, the National Diabetes Data Group defined an entity called impaired glucose tolerance, which reflects a degree of glucose tolerance that, although abnormal, is considered insufficient to merit a diagnosis of diabetes mellitus (1). This entity, which was later endorsed by the World Health Organization (WHO) (2, 3) and the American Diabetes Association (4), requires a 2-hour oral glucose tolerance test for its detection. It is important to emphasize that impaired glucose tolerance is by itself entirely asymptomatic and unassociated with any functional disability. Indeed, insulin secretion is typically greater in response to a mixed meal than in response to a pure glucose load (5); as a result, most persons with impaired glucose tolerance are rarely, if ever, hyperglycemic in their daily lives (5, 6), except when they undergo diagnostic glucose tolerance tests. Thus, the importance of impaired glucose tolerance resides exclusively in its ability to identify persons at increased risk for future disease.
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Cardiology, Endocrine and Metabolism, Diabetes, Coronary Risk Factors.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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