EVALUATION OF THE NEW FASTING PLASMA-GLUCOSE CUTPOINT OF 7.0 MMOL L IN DETECTION OF DIABETES-MELLITUS IN THE THAI POPULATION/

To determine whether a fasting plasma glucose (FPG) cutpoint of 7.0 mm ol/l can be appropriately used for detection of diabetes mellitus (DM) in the Thai population, different FPG cutpoints were evaluated for th eir efficacy in the diagnosis of DM. A plasma glucose level of greater than or equal to 11.1 mmol/l at 2 h after a 75-g oral glucose toleran ce test (OGTT) was used as the gold standard criterion for diagnosis o f DM. OGTT was performed in 496 subjects who were at risk of developin g diabetes. They were 120 males and 376 females, 14-76 years old (mean +/- S.D. = 45.0 +/- 12.2 years). Plasma glucose level was determined in NaF preserved plasma using the glucose oxidase method. Diagnosis of DM was made in 22.8% of cases by the gold standard criterion as compa red to 4.2% by using FPG values of greater than or equal to 7.8 mmol/l . The sensitivity of the FPG cutpoint of 7.8 mmol/l was 18.6%. Diagnos is of DM using FPG greater than or equal to 7.0 mmol/l improved the se nsitivity to 33.6% with a positive predictive Value of 100% and highes t Youden's index of 0.836. The receiver operating characteristic curve of FPG revealed the best cutpoint to lie between 5.6-6.0 mmol/l. A FP G cutpoint of < 6.0 mmol/l over-estimated the prevalence of diabetes. DM and impaired glucose tolerance were noted in 65.6 and 29.5% of the subjects who had FPG values between 6.0 and 6.9 mmol/l, respectively. We conclude that FPG cutpoint of 7.0 mmol/l is applicable to a high ri sk Thai population for detection of DM. OGTT is recommended for defini tive determination of glucose tolerance status in those individuals wi th FPG values between 6.0 and 6.9 mmol/l. (C) 1998 Elsevier Science Ir eland Ltd. All rights reserved.