Random capillary blood glucose cut points for diabetes and pre-diabetes derived from community-based opportunistic screening in India

Abstract

Objective: To determine random capillary blood glucose (RCBG) cut points that discriminate diabetic and pre-diabetic subjects from normal individuals. Rssearch design and methods: RCBG was performed in 1,333 individuals randomly chosen from 63,305 individuals who had participated in an opportunistic screening program. An oral glucose tolerance test was also performed by venous plasma glucose on an autoanalyzer. RCBG cut points that discriminate diabetes, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) were determined using receiver operating characteristic curves. Results: Using 2-h plasma glucose ≥200 mg/dl (11.1 mmol/l) criterion, the RCBG cut point of 140 mg/dl (7.7 mmol/l) gave the highest sensitivity and specificity. For 2-h plasma glucose ≥200 mg/dl (11.1 mmol/l) and fasting plasma glucose (FPG) ≥126 mg/dl (7.0 mmol/l) criteria, either 2-h plasma glucose ≥200 mg/dl (11.1 mmol/l) or FPG ≥126 mg/dl (7.0 mmol/l) criterion, and the FPG ≥126 mg/dl (7.0 mmol/l) criterion, RCBG cut point was 143 mg/dl (7.9 mmol/l). RCBG cut points for IGT, IFG according to World Health Organization criterion, and IFG according to American Diabetes Association criterion were 119 mg/dl (6.6 mmol/l), 118 mg/dl (6.6 mmol/l), and 113 mg/dl (6.3 mmol/l), respectively. Conclusions: Asian Indians with RCBG >110 mg/dl at screening can be recommended to undergo definitive testing.