A major debate is currently taking place on the world diabetes scene on the
merits of fasting versus 2-hour postprandial glucose concentrations as a r
eference point for the diagnosis of diabetes. Other time points of the oral
glucose tolerance test on the other hand, seem to attract little attention
. In Saudi Arabia however, we have been intrigued by the scale and severity
of hyperglycemia observed at one-hour following glucose load. Plasma gluco
se concentration one-hour postprandially is strikingly abnormal amongst nat
ive Saudis and interestingly, is associated with insulin resistance and fea
tures of syndrome X. Such observations have prompted us to call into questi
on the wisdom of current practices, namely of excluding the one-hour plasma
glucose concentration in the diagnosis of diabetes. In the proceeding arti
cle therefore, we describe in detail our local observations and debate the
wider scientific and historical issues surrounding the place of one-hour gl
ucose concentration as a potentially useful diagnostic point in the detecti
on and classification of glucose intolerance.