Random Plasma Glucose Tests Predict Diabetes Diagnosis

Random blood tests could be used to predict the development of diabetes and lead to earlier treatment and better outcomes, suggests a study published online in PLoS One.

“Although screening for prediabetes and diabetes could permit earlier detection and treatment, many in the at-risk population do not receive the necessary screening,” said study lead author Mary Rhee, MD, a physician-researcher with the Atlanta Veterans Affairs (VA) Health Care System and Emory University, in a VA press release.

For the study, Dr Rhee and researchers from several VA systems looked at data for 942,446 VA patients to see whether random plasma glucose tests, taken “opportunistically” during regular visits not specifically related to diabetes screening, could signal who would go on to develop diabetes. At baseline, none of the patients had been diagnosed with diabetes. All underwent at least three random plasma glucose tests within the year.

Over 5 years of follow-up, 10% of the patients had developed diabetes. Elevated random plasma glucose levels, researchers found, predicted which patients would develop diabetes—even when levels were less than 200 mg/dL, which is the typical diagnostic threshold for diabetes.

Specifically, patients with two random plasma glucose measurements of 115 mg/dL
or higher were highly likely to receive a diabetes diagnosis, according to the study. Even more predictive of a diabetes diagnosis were random plasma glucose measurements of 130 mg/dL or higher.

The study recommended patients with two random plasma glucose measurements of 115 mg/dL or higher within 12 months receive follow-up testing for diabetes, such as a fasting glucose test or HbA1c test.

“These findings have the potential to impact care in the VA and in the general US population,” said Dr Rhee, “as random plasma glucose levels—which are convenient, low-cost, and ‘opportunistic’—could appropriately prompt high-yield, focused diagnostic testing and improve recognition and treatment of prediabetes and early diabetes.” —Jolynn Tumolo