Although many drugs are now available, a large effort is still needed to prevent diabetes. The STOP DIABETES study evaluated individuals at risk for type 2 diabetes (T2D) by a 2-h 75-g oral glucose tolerance test (OGTT). Based on the three main defective physiological responses, subjects were stratified as at low, intermediate, or high risk, and treated accordingly with lifestyle modifications and drugs. Participants at intermediate and high risk experienced the greatest reduction of T2D conversion. Interestingly, a group of individuals developing T2D presented a normal glucose tolerance at baseline, but a 1-h plasma glucose concentration > 155 mg/dL. These results are critical as prediabetes can increase the incidence of cardiovascular disease. Considering the timeframe between the first defects in glucose metabolism and the manifestation of diabetes complications, the effort to tackle the glycemic impairment as soon as possible represents an outstanding task to reduce the incidence of diabetes. Ideally, the earlier glycemic alterations are recognized, the lesser armamentarium needs to be used, and the lower is the expense in terms of drugs, complications, and related events and costs. Finally, a wealth of studies clearly demonstrated the importance of 1-h plasma glucose concentration, which has been proposed as an adjunctive diagnostic tool to detect prediabetes earlier. In conclusion, by an OGTT, a lot of individuals at risk for T2D may be detected when the central role for the 1-h plasma glucose concentration is also considered. Consequently, these subjects would be treated early and with less drugs and delay T2D complications.
Perreault L, Kahn SE, Christophi CA, Knowler WC, Hamman RF, Diabetes Prevention Program Research G (2009) Regression from pre-diabetes to normal glucose regulation in the diabetes prevention program. Diabetes Care 32(9):1583–1588. https://doi.org/10.2337/dc09-0523CrossRefGoogle Scholar
Lind M, Tuomilehto J, Uusitupa M et al (2014) The association between HbA1c, fasting glucose, 1-hour glucose and 2-hour glucose during an oral glucose tolerance test and cardiovascular disease in individuals with elevated risk for diabetes. PLoS One 9(10):e109506. https://doi.org/10.1371/journal.pone.0109506CrossRefGoogle Scholar
Abdul-Ghani MA, Puckett C, Triplitt C et al (2015) Initial combination therapy with metformin, pioglitazone and exenatide is more effective than sequential add-on therapy in subjects with new-onset diabetes. Results from the Efficacy and Durability of Initial Combination Therapy for type 2 diabetes (EDICT): a randomized trial. Diabetes Obes Metab 17(3):268–275. https://doi.org/10.1111/dom.12417CrossRefGoogle Scholar
Unwin N, Shaw J, Zimmet P, Alberti KG (2002) Impaired glucose tolerance and impaired fasting glycaemia: the current status on definition and intervention. Diabet Med J Br Diabet Assoc 19(9):708–723CrossRefGoogle Scholar
Manco M, Panunzi S, Macfarlane DP et al (2010) One-hour plasma glucose identifies insulin resistance and beta-cell dysfunction in individuals with normal glucose tolerance: cross-sectional data from the Relationship between Insulin Sensitivity and Cardiovascular Risk (RISC) study. Diabetes Care 33(9):2090–2097. https://doi.org/10.2337/dc09-2261CrossRefGoogle Scholar
Fiorentino TV, Succurro E, Andreozzi F, Sciacqua A, Perticone F, Sesti G (2019) One-hour post-load hyperglycemia combined with HbA1c identifies individuals with higher risk of cardiovascular diseases: cross-sectional data from the CATAMERI study. Diabetes Metab Res Rev 35(2):e3096. https://doi.org/10.1002/dmrr.3096CrossRefGoogle Scholar
Liu K, Dyer AR, Vu TH et al (2005) One-hour postload plasma glucose in middle age and Medicare expenditures in older age among nondiabetic men and women: the Chicago Heart Association Detection Project in Industry. Diabetes Care 28(5):1057–1062CrossRefGoogle Scholar