Pubertal Stage–Based One‐hour Postload Glucose Thresholds Improve Identification of Prediabetes and Type 2 Diabetes in Children With Overweight or Obesity
Authors' conclusion
Elevated 1h-PG proved to be a practical marker for identifying early metabolic dysfunction in children and adolescents with euglycemia. Given that widely used adult-derived cut-offs (8.6 and 11.6 mmol/L) are suboptimal for pediatric populations, we established pubertal stage-specific thresholds that outperformed both age-specific and adult-derived cut-offs.
Study context
- Population
- Children and adolescents with overweight or obesity undergoing OGTT
- Participants
- 4,344 children
- Exposure
- Pubertal stage-specific vs age-based and adult 1h-PG thresholds
- Outcome
- Age- and pubertal stage-specific 1h-PG thresholds for identifying prediabetes and T2D
Methodological detailsvalidated in two independent cohorts
- Validated in two independent cohorts
Main finding
As reported in the abstract
Diagnostic performance of 1h-PG thresholds
| Strategy | Sensitivity for prediabetes | Sensitivity for T2D |
|---|---|---|
| Prepubertal cut-off | 75.40% | — not stated in the abstract |
| Pubertal cut-off | — not stated in the abstract | 89.47% |
| Adult thresholds | 56.68% | 73.68% |
Sensitivity for prediabetes
Prepubertal cut-off75.40%
Pubertal cut-off— not stated in the abstract
Adult thresholds56.68%
Sensitivity for T2D
Prepubertal cut-off— not stated in the abstract
Pubertal cut-off89.47%
Adult thresholds73.68%
— not stated in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | NGT with elevated 1h-PG | NGT with normal 1h-PG | P value |
|---|---|---|---|
| Insulin AUC in NGT: elevated vs normal 1h-PG | 29 916 | 23 524 | P < 0.001 |
Insulin AUC in normal glucose tolerance (NGT): elevated vs normal 1h-PG
- Elevated 1h-PG: greater insulin resistance, impaired β-cell function
1h-PG by pubertal stage
- 1h-PG levels increased with pubertal progression
Original publication
Pubertal Stage–Based One‐hour Postload Glucose Thresholds Improve Identification of Prediabetes and Type 2 Diabetes in Children With Overweight or Obesity. Diabetes Obes Metab. Published 30 June 2026. doi:10.
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