Oral glucose-tolerance tests and the diagnosis of diabetes: results of a prospective study based on the Whitehall survey

Lancet. 1979 Sep 1;2(8140):431-3. doi: 10.1016/s0140-6736(79)91489-2.


Men who participated in the Whitehall survey and were found to be glucose intolerant have been studied 6--8 years later, together with a control group of men with normal screening blood-sugar levels. Ophthalmoscopically visible microvascular retinal disease was confined to men diagnosed as probably diabetic after the survey because their 2 h blood-sugar level (after a 50 g oral glucose load) in the survey examination or during a subsequent standard oral glucose-tolerance test was greater than or equal to 200 mg/dl (11.1 mmol/l). The lowest blood-sugar in a "diabetic" subsequently found to have retinopathy was 229 mg/dl. Men with lesser degrees of glucose intolerance, including 34 who had "worsened to diabetes", did not have visible retinovascular disease at follow-up. If diabetes implies a risk of specific microvascular complications in the medium term, then the findings in this study support proposals for the revision of diagnostic criteria based on glucose-tolerance tests.

MeSH terms

  • Aged
  • Albuminuria / urine
  • Blood Glucose / analysis*
  • Blood Pressure
  • Diabetes Mellitus / diagnosis*
  • Diabetes Mellitus / physiopathology
  • Diabetic Retinopathy / diagnosis*
  • Diabetic Retinopathy / etiology
  • England
  • Follow-Up Studies
  • Glucose Tolerance Test*
  • Humans
  • Hyperglycemia / complications
  • Male
  • Middle Aged
  • Population Surveillance
  • Prospective Studies
  • Time Factors


  • Blood Glucose