Criteria for oral glucose tolerance testing of obese minority youth.

Aim: To identify those obese minority youth at greatest risk for having an abnormal oral glucose tolerance test (OGTT) indicating impaired glucose tolerance (IGT) or type 2 diabetes mellitus (DM2). Study Design and Methods: 167 children, who met the ADA criteria for T2DM screening, underwent an OGTT. Logistic regression models were derived for girls, boys, and both. Based on significant variables, algorithms yielding 100% sensitivity were derived to identify candidates for screening. Results: 12% of children screened had an abnormal OGTT. Girls who met the algorithm criteria for screening (HOMA >4.5) had an abnormal OGTT with a sensitivity of 100% (95% confidence interval [CI] 0.988-1.0) and specificity of 53.7% (95% CI 0.41-0.648). Boys who met the algorithm screening criteria (HOMA >13, or HbA 1c >5.8%, or total cholesterol >200 mg/dl) had an abnormal OGTT with a sensitivity of 100% (95% CI 0.979-1.000) and specificity of 76.6% (95% CI 0.632-0.849). The model was validated using a large patient sample, yielding similar results. Conclusions: In obese pubertal minority youth meeting the ADA criteria for DM2 screening, these algorithm screening criteria can be useful in identifying those at risk youth who should undergo an OGTT.