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Background <p>The incidence of type 2 diabetes (T2D) in children is rising rapidly, yet many cases remain undetected. Conventional diagnostic tools, including fasting glucose, HbA1c, and the gold-standard oral glucose tolerance test (OGTT), have limitations and often show low compliance in pediatric populations. This study aimed to evaluate a simplified OGTT (s-OGTT) with adjusted capillary glucose cut-off values as a novel approach for screening and diagnosing T2D in children and adolescents.</p> Methods <p>A total of 468 children from four clinical centers in China underwent s-OGTT with capillary glucose testing. Capillary glucose values were compared with venous glucose levels using Bland-Altman analysis. Sensitivity and specificity for diagnosing diabetes and prediabetes were assessed using receiver operating characteristic (ROC) curves.</p> Results <p>Capillary glucose levels showed a strong correlation with venous measurements. Based on gold-standard criteria, 37 children were diagnosed with diabetes, 41 with impaired fasting glucose (IFG), and 74 with impaired glucose tolerance (IGT). Using optimized capillary cut-offs tailored for point-of-care testing, the s-OGTT demonstrated excellent diagnostic performance and improved specificity compared with applying conventional venous-based thresholds directly: for diabetes based on fasting glucose (sensitivity 97.56%, specificity 98.40%), diabetes based on 2&#xa0;h postload glucose (sensitivity 100.00%, specificity 99.67%), IFG (sensitivity 97.60%, specificity 98.30%), and IGT (sensitivity 88.89%, specificity 92.04%). Validation analyses confirmed high agreement between s-OGTT and venous results.</p> Conclusion <p>The s-OGTT provides a reliable, accurate, and child-friendly approach for diagnosing diabetes and abnormal glucose tolerance. These optimized thresholds enhance diagnostic specificity and support its use for large-scale pediatric screening.</p>

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A High-accuracy and compliance-driven paradigm for pediatric type 2 diabetes screening based on simplified OGTT --- a multicenter study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月24日

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  • Zhaoyuan Wu,
  • Jianwei Zhang,
  • Minghao Chen,
  • Rahim Ullah,
  • Ruimin Chen,
  • Haiyan Wei,
  • Jianfang Zhu,
  • Dandan Peng,
  • Ke Huang,
  • Wei Wu,
  • Guanping Dong,
  • Jianbing Wang,
  • Junfen Fu

摘要

Background

The incidence of type 2 diabetes (T2D) in children is rising rapidly, yet many cases remain undetected. Conventional diagnostic tools, including fasting glucose, HbA1c, and the gold-standard oral glucose tolerance test (OGTT), have limitations and often show low compliance in pediatric populations. This study aimed to evaluate a simplified OGTT (s-OGTT) with adjusted capillary glucose cut-off values as a novel approach for screening and diagnosing T2D in children and adolescents.

Methods

A total of 468 children from four clinical centers in China underwent s-OGTT with capillary glucose testing. Capillary glucose values were compared with venous glucose levels using Bland-Altman analysis. Sensitivity and specificity for diagnosing diabetes and prediabetes were assessed using receiver operating characteristic (ROC) curves.

Results

Capillary glucose levels showed a strong correlation with venous measurements. Based on gold-standard criteria, 37 children were diagnosed with diabetes, 41 with impaired fasting glucose (IFG), and 74 with impaired glucose tolerance (IGT). Using optimized capillary cut-offs tailored for point-of-care testing, the s-OGTT demonstrated excellent diagnostic performance and improved specificity compared with applying conventional venous-based thresholds directly: for diabetes based on fasting glucose (sensitivity 97.56%, specificity 98.40%), diabetes based on 2 h postload glucose (sensitivity 100.00%, specificity 99.67%), IFG (sensitivity 97.60%, specificity 98.30%), and IGT (sensitivity 88.89%, specificity 92.04%). Validation analyses confirmed high agreement between s-OGTT and venous results.

Conclusion

The s-OGTT provides a reliable, accurate, and child-friendly approach for diagnosing diabetes and abnormal glucose tolerance. These optimized thresholds enhance diagnostic specificity and support its use for large-scale pediatric screening.