To analyze the blood glucose screening condition for individuals receiving physical examinations. Specifically, to examine the rates of abnormal postprandial glucose at different levels of fasting blood glucose and the characteristics of people who had normal fasting blood glucose with high postprandial glucose.

Participants were individuals who received physical examinations at the Health Management Centre, Tianjin Medical University General Hospital, from January 2016 to December 2016. Data collection included general information, physical examination, and laboratory tests including fasting blood glucose, HbA1c, postprandial glucose, blood fat, and blood uric acid. The blood glucose indicators for the study population were analyzed. Among participants without diabetes, the rate of abnormal postprandial glucose at different fasting blood glucose levels or with a HbA1c screening were compared. For participants with complete information, chi-square tests and multivariate logistic regressions were used to analyze the characteristics of individuals who had normal fasting blood glucose with high postprandial glucose.

A total of 45 447 participants were included, with 23 001 males (50.61%) and 22 446 females (49.39%). For blood glucose, the most frequently completed indicator was fasting blood glucose (97.04%), then HbA1c (56.17%) followed by postprandial glucose (17.51%). There were 7 351 participants without diabetes who had all three glucose indicators. As fasting blood glucose increased, the abnormal rate of postprandial glucose increased gradually. When fasting blood glucose was lower than 5.6 mmol/L, the rate of abnormal postprandial glucose was 11.59%. When fasting blood glucose was between 5.6 mmol/L and 6.1 mmol/L, the rate was 33.9%. When fasting blood glucose was higher than 6.1 mmol/L, the rate was 68.73%. When the cutoff for fasting blood glucose was 5.6 mmol/L, the rate of abnormal postprandial glucose decreased compared with a cutoff of 6.1 mmol/L (11.59% vs. 14.32%, respectively). Combined with HbA1c screening, the rate of postprandial glucose abnormalities were both reduced (8.83% vs.11.59% for 5.6 mmol/L; 10.08% vs. 14.32% for 6.1 mmol/L). A total of 5 872 individuals had complete information and were included in the analysis. Participants who were men, >45 years old, and were overweight or obese had higher risk for abnormal postprandial glucose [ OR(95%CI): 2.85(2.33-3.48), 2.15(1.76-2.62), 1.82(1.45-2.27), and 2.64(2.04-3.42), respectively, P<0.05]. Hypertension, hyperlipidemia and hyperuricemia were also risk factors [OR(95%CI): 1.80(1.51-2.15) and 1.52(1.27-1.82), respectively, P<0.05]

The completion rate was highest for fasting blood glucose and lowest for postprandial glucose among the study population. The rate of abnormal postprandial glucose was high when fasting blood glucose was normal. Screening combined with HbA1c decreased the rate of postprandial glucose abnormalities. Postprandial glucose testing should be recommended for those who are male, older, overweight or obese, and have other risk factors including hypertension, hyperlipidemia, and hyperuricemia.

Health examination; Screening; Postprandial glucose; Risk factors