Optimizing Prediabetes Detection in Primary Care: Evaluating the Glucose Challenge Test

https://doi.org/10.22146/rpcpe.106233

Yaltafit Abror Jeem(1*), Rahma Yuantari(2), Hajar Admira Widiatninda(3), Russy Novita Andriani(4), Linda Rosita(5), Erlina Marfianti(6)

(1) Department of Public Health; Faculty of Medicine; Universitas Islam Indonesia
(2) Department of Clinical Pathology; Faculty of Medicine; Universitas Islam Indonesia
(3) Faculty of Medicine; Universitas Islam Indonesia
(4) Faculty of Medicine; Universitas Islam Indonesia
(5) Department of Clinical Pathology; Faculty of Medicine; Universitas Islam Indonesia
(6) Department of Internal Medicine; Faculty of Medicine; Universitas Islam Indonesia
(*) Corresponding Author

Abstract


Background: The rising incidence of prediabetes necessitates effective early detection strategies in primary care settings. While the Glucose Challenge Test (GCT) is well-established for gestational diabetes screening, its validity for prediabetes screening in the general non-pregnant population remains inadequately explored. Objective: This study aimed to evaluate the diagnostic validity of GCT as a screening tool for prediabetes in adults within the primary care context compared to the Oral Glucose Tolerance Test (OGTT) as the gold standard. Methods: An observational-analytical study with a cross-sectional diagnostic test design was conducted in three community health centers in Yogyakarta, Indonesia,from April to November 2018. . Participants aged 35-64 years were recruited using cluster sampling. Of 213 initially recruited participants, 65 completed the full diagnostic protocol. Data were analyzed using 2×2 contingency tables and Receiver Operating Characteristic (ROC) curve analysis. Results: The prevalence of prediabetes in the study population was 30.76%. The GCT demonstrated an Area Under the Curve (AUC) of 63.6% (95% CI: 47.8%–79.4%), indicating poor to fair diagnostic accuracy. At the optimal cut-off point, the GCT showed a sensitivity of 40% and a specificity of 80%. The positive predictive value (PPV) and negative predictive value (NPV) were 47.06% and 75%, respectively. Conclusion: Although the GCT is feasible for "any-time" screening in primary care due to its non-fasting nature, its low sensitivity suggests it may not be sufficient as a standalone screening tool for prediabetes in its current protocol. Further optimization of cut-off values or its use as an opportunistic tool in high-risk populations may be considered. 

Keywords


Glucose Challenge Test (GCT); Oral Glucose Tolerance Test (OGTT); prediabetes screening; primary health care,diagnostic validity

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DOI: https://doi.org/10.22146/rpcpe.106233

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