Running Title: Identification of subjects at high risk for future diabetes

Identification of subjects at high risk for future diabetes Objective: To assess the efficacy of 1 hour plasma glucose concentration and the metabolic syndrome in predicting future risk of T2DM. Research Design and Methods: 1611 subjects from the San Antonio Heart Study, who were free of T2DM at baseline, who had plasma glucose and insulin concentrations measured at time 0, 30, 60 and 120 minutes during the OGTT, and who had their diabetes status determined with an OGTT after 7-8 years of follow-up, were evaluated. Two models, based on glucose tolerance status, 1-h plasma glucose (1h-PG) concentration and presence of the metabolic syndrome, were tested in predicting the risk for T2DM at 7-8 years of follow-up Results: A cut off point of 155 mg/dl for the 1h-PG concentration during the OGTT was used to stratify subjects in each glucose tolerance group into low, intermediate and high risk for future T2DM. A model based upon 1h-PG concentration, ATP III criteria for the metabolic syndrome, and FPG, independent of 2-h plasma glucose, performed equally well in stratifying non-diabetic subjects into low, intermediate and high risk for future T2DM and identified a group of NGT subjects who were at very high risk for future T2DM. Conclusion: The plasma glucose concentration at 1 hour during the OGTT is a strong predictor of future risk for T2DM. A plasma glucose cut off point of 155 mg/dl and the ATP III criteria for the metabolic syndrome can be used to stratify non-diabetic subjects into 3 risk groups: low, intermediate and high risk 2 Identification of subjects at high risk for future diabete