Diagnostic criteria for diabetes mellitus and other categories of glucose intolerance: 1997 criteria by the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (ADA), 1998 WHO Consultation criteria, and1985 WHO criteria

To compare 1997 ADA diagnostic criteria for diabetes mellitus and other cat egories of glucose intolerance/1998 WHO Consultation criteria versus 1985 W HO criteria, we analyzed data from a 75-g oral glucose tolerance test (OGTT ) performed on 1051 high-risk subjects without medical history of diabetes at Diabetes Screening Clinic, Ramathibodi Hospital, Thailand. There were 37 2 males and 679 females, aged (mean +/- S.D.) = 50.3 +/- 12.55 years, BMI = 25.62 +/- 4.39 kg/m(2). If fasting plasma glucose (FPG) was used as recent ly recommended then 54.1, 20.3, and 25.5% of cases were classified as norma l, impaired fasting glucose (IFG), and diabetic, respectively. In diagnosin g diabetes using a full OGTT based on the 1985 WHO criteria as the referenc e test, FPG greater than or equal to 7 mmol/l had a sensitivity of 57.7%, s pecificity of 97.4%, positive predictive value of 94.0%, and negative predi ctive value of 76.4% 53.7%, of subjects with IFG had 2-h plasma glucose gre ater than or equal to 11.1 mmol/l. The 1997 ADAI/1998 WHO Consultation crit eria and 1985 WHO criteria for a full OGTT yield similar overall results. F PG (greater than or equal to 7 mmol/l) was not sensitive for diagnosing dia betes. Moreover, about half of the subjects with IFG were actually diabetic . Therefore, OGTT remains a valuable test in diagnosing diabetes and classi fying various categories of glucose intolerance. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.