Evidence map›Paper›PMID 40593903›Full record

ArticleScientific reports2025

Diagnosis of diabetes without oral glucose tolerance test is associated with increased mortality in older adults.

Chia-Hung Lin, Kang-Chih Fan, I-Weng Yen, Szu-Chi Chen, Chih-Yao Hsu, Ya-Pin Lyu, Wan-Chen Wu, Chung-Yi Yang, Mao-Shin Lin, Shyang-Rong Shih and 1 more

Abstract read
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In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Chia-Hung LinDivision of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Kang-Chih FanGraduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
I-Weng YenDivision of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Szu-Chi ChenDivision of Endocrinology and Metabolism, Department of Internal Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan.
Chih-Yao HsuDivision of Endocrinology and Metabolism, Department of Internal Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan.
Ya-Pin LyuDepartment of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
Wan-Chen WuDivision of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Chung-Yi YangDepartment of Medical Imaging, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
Mao-Shin LinDivision of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Shyang-Rong ShihDivision of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Hung-Yuan LiDivision of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. larsli@ntuh.gov.tw.

Funding

National Science and Technology Council MOST 104-2314-B-002-124-MY3National Science and Technology Council NSTC 113-2314-B-002-317National Taiwan University Hospital 114-O0032National Taiwan University Hospital Hsin-Chu Branch 109-HCH051National Taiwan University Hospital Hsin-Chu Branch 113-HCH063
6 · The paper itself

Abstract

The current method of diagnosing diabetes mellitus (DM) using fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) without oral glucose tolerance tests (OGTT) results in inaccuracy and underdiagnosis of diabetes. This study aimed to investigate the mortality of individuals with improperly classified glycemic status and suggest new screening methods for diabetes. A total of 1935 subjects were prospectively followed for 10 years, with vital status obtained through linkage to the National Health Insurance Research Database (NHIRD). Hazard ratios (HR) of all-cause mortality were analyzed. The percentage of all-cause mortality was significantly higher in subjects with improperly classified glycemic status than those correctly classified (8.3% vs. 3.6%, p = 0.004; unadjusted HR 2.537, p = 0.002). The risk of mortality associated with underdiagnosis was highest in those over the age of 60 (adjusted HR 2.043, p = 0.036). Using components of metabolic syndrome, three screening strategies were developed to determine the need for OGTT in elderly subjects with improved sensitivity in diagnosing DM. Diagnosis of diabetes based solely on FPG and HbA1c leads to underdiagnosis of glycemic status and higher all-cause mortality in older adults. Age and the presence of components of metabolic syndrome-based screening strategies can improve diagnostic accuracy and reduce the need for OGTT.

Indexed as

Diabetes MellitusAgedAged, 80 and overBlood GlucoseFastingFemaleGlucose Tolerance TestGlycated HemoglobinHumansMaleMiddle AgedProspective StudiesBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanDiabetes mellitusGlucose tolerance testMetabolic syndromeMortality

Identifiers

PMID40593903
PMCPMC12216346

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.