A 2-Hour Postprandial Glucose of 8.3 mmol/L Indicates Prediabetes

A 2-hour postprandial glucose level of 8.3 mmol/L (149 mg/dL) indicates impaired glucose tolerance (IGT), which is classified as prediabetes. 1

Diagnostic Classification

According to the World Health Organization (WHO) criteria, a 2-hour postprandial glucose level between 7.8 mmol/L (140 mg/dL) and 11.0 mmol/L (199 mg/dL) is diagnostic of impaired glucose tolerance (IGT), which is considered prediabetes 1
The value of 8.3 mmol/L falls within this range, clearly indicating impaired glucose tolerance 1
This classification applies when the 2-hour value is measured during a standardized 75g oral glucose tolerance test (OGTT) 1
For a normal glucose regulation classification, the 2-hour postprandial glucose should be <7.8 mmol/L (140 mg/dL) 1

Impaired glucose tolerance represents an intermediate metabolic state between normal glucose homeostasis and diabetes 1
This finding indicates increased risk for progression to type 2 diabetes 1
Individuals with IGT also have an approximately 2-fold increased risk of cardiovascular disease compared to those with normal glucose tolerance 2
Postprandial hyperglycemia is an independent risk factor for cardiovascular disease even when fasting glucose and HbA1c values are normal 2

A complete diabetes risk assessment should be performed, including evaluation of fasting plasma glucose (FPG) 1
If not already done, HbA1c measurement should be considered to assess overall glycemic control 1
Screening for other cardiovascular risk factors is recommended, including blood pressure measurement and lipid profile 1
Lifestyle modifications should be initiated immediately to prevent progression to diabetes 1

For individuals with prediabetes, the goal is to achieve a 2-hour postprandial glucose <7.8 mmol/L (140 mg/dL) 1
If the individual is pregnant, stricter targets apply: 2-hour postprandial glucose should be <7.8 mmol/L (140 mg/dL) for gestational diabetes management 1
For those with established diabetes, the 2-hour postprandial target is typically <10.0 mmol/L (180 mg/dL) for most non-pregnant adults 3
In patients with diabetes who have difficulty achieving HbA1c targets despite normal fasting glucose, focusing on postprandial glucose control becomes particularly important 3, 4

A single elevated postprandial glucose reading should be confirmed with repeat testing before making a definitive diagnosis 1
The 2-hour glucose value after a mixed meal may differ from the value after a pure glucose load (OGTT), so the context of measurement is important 1, 5
Postprandial glucose levels can vary based on time of day, with some individuals showing higher values in the evening compared to morning measurements 1
When evaluating glycemic status, it's important to consider both fasting and postprandial glucose values, as some individuals may have isolated postprandial hyperglycemia despite normal fasting levels 4, 6

Lifestyle interventions including weight loss (if overweight/obese), increased physical activity, and dietary modifications are first-line approaches 1
Regular monitoring of both fasting and postprandial glucose is recommended to track progress 7
If lifestyle interventions fail to normalize glucose levels, pharmacological therapy may be considered, particularly if other cardiovascular risk factors are present 1
Follow-up testing should be performed at least annually to monitor for progression to diabetes 1