Review of methods for detecting glycemic disorders

Michael Bergman, Muhammad Abdul-Ghani, Ralph A. DeFronzo, Melania Manco, Giorgio Sesti, Teresa Vanessa Fiorentino, Antonio Ceriello, Mary Rhee, Lawrence S. Phillips, Stephanie Chung, Celeste Cravalho, Ram Jagannathan, Louis Monnier, Claude Colette, David Owens, Cristina Bianchi, Stefano del Prato, Mariana P. Monteiro, João Sérgio Neves, Jose Luiz MedinaMaria Paula Macedo, Rogério Tavares Ribeiro, João Filipe Raposo, Brenda Dorcely, Nouran Ibrahim, Martin Buysschaert

Research output: Contribution to journalReview articlepeer-review

89 Citations (Scopus)


Prediabetes (intermediate hyperglycemia) consists of two abnormalities, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) detected by a standardized 75-gram oral glucose tolerance test (OGTT). Individuals with isolated IGT or combined IFG and IGT have increased risk for developing type 2 diabetes (T2D) and cardiovascular disease (CVD). Diagnosing prediabetes early and accurately is critical in order to refer high-risk individuals for intensive lifestyle modification. However, there is currently no international consensus for diagnosing prediabetes with HbA1c or glucose measurements based upon American Diabetes Association (ADA) and the World Health Organization (WHO) criteria that identify different populations at risk for progressing to diabetes. Various caveats affecting the accuracy of interpreting the HbA1c including genetics complicate this further. This review describes established methods for detecting glucose disorders based upon glucose and HbA1c parameters as well as novel approaches including the 1-hour plasma glucose (1-h PG), glucose challenge test (GCT), shape of the glucose curve, genetics, continuous glucose monitoring (CGM), measures of insulin secretion and sensitivity, metabolomics, and ancillary tools such as fructosamine, glycated albumin (GA), 1,5- anhydroglucitol (1,5-AG). Of the approaches considered, the 1-h PG has considerable potential as a biomarker for detecting glucose disorders if confirmed by additional data including health economic analysis. Whether the 1-h OGTT is superior to genetics and omics in providing greater precision for individualized treatment requires further investigation. These methods will need to demonstrate substantially superiority to simpler tools for detecting glucose disorders to justify their cost and complexity.

Original languageEnglish
Article number108233
JournalDiabetes Research and Clinical Practice
Publication statusPublished - Jul 2020


  • Biomarkers
  • Cardiovascular disease
  • Continuous glucose monitoring
  • Glycemic variability
  • HbA1c
  • Metabolomics
  • Oral glucose tolerance test
  • Prediabetes
  • Type 2 diabetes


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