Minimal Contribution of Fasting Hyperglycemia to the Incidence of Type 2 Diabetes in Subjects With Normal 2-h Plasma Glucose

• Published in: Diabetes care Vol. 33; no. 3; pp. 557 - 561
• Main Authors: Abdul-Ghani, Muhammad A, Stern, Michael P, Lyssenko, Valeriya, Tuomi, Tiinamaija, Groop, Leif, DeFronzo, Ralph A
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.03.2010
• Subjects: Adult; analysis; Biological and medical sciences; blood; blood glucose; Blood Glucose - analysis; Blood pressure; Clinical Medicine; complications; Dextrose; Diabetes; Diabetes Mellitus, Type 2; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - etiology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinology and Diabetes; Endocrinopathies; Endokrinologi och diabetes; epidemiology; etiology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; fasting; Fasting - blood; Female; Follow-Up Studies; Glucose; Glucose Tolerance Test; heart; Humans; Hyperglycemia; Hyperglycemia - complications; Hyperglycemia - epidemiology; Incidence; Klinisk medicin; logit analysis; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Metabolic diseases; Middle Aged; Miscellaneous; noninsulin-dependent diabetes mellitus; Original Research; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Statistical methods; Studies; Time Factors; Type 2 diabetes; Variables; Endocrinopathy; Type 2 diabetes; Human; Fasting; Nutrition; Metabolic diseases; Glucose; Normal; Epidemiology; Incidence; Hyperglycemia; Fast; Endocrinology; Glycemia
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc09-1145

OBJECTIVE: To assess the relative contribution of increased fasting and postload plasma glucose concentrations to the incidence of type 2 diabetes in subjects with a normal 2-h plasma glucose concentration. RESEARCH DESIGN AND METHODS: A total of 3,450 subjects with 2-h plasma glucose concentration <140 mg/dl at baseline were followed up in the San Antonio Heart Study (SAHS) and the Botnia Study for 7-8 years. The incidence of type 2 diabetes at follow-up was related to the fasting, 1-h, and 2-h plasma glucose concentrations. RESULTS: In subjects with 2-h plasma glucose <140 mg/dl, the incidence of type 2 diabetes increased with increasing fasting plasma glucose (FPG) and 1-h and 2-h plasma glucose concentrations. In a multivariate logistic analysis, after adjustment for all diabetes risk factors, the FPG concentration was a strong predictor of type 2 diabetes in both the SAHS and the Botnia Study (P < 0.0001). However, when the 1-h plasma glucose, but not 2-h plasma glucose, concentration was added to the model, FPG concentration was no longer a significant predictor of type 2 diabetes in both studies (NS). When subjects were matched for the level of 1-h plasma glucose concentration, the incidence of type 2 diabetes markedly increased with the increase in 1-h plasma glucose, but the increase in FPG was not associated with a significant increase in the incidence of type 2 diabetes. CONCLUSIONS: An increase in postload glycemia in the normal range is associated with an increase in the incidence of type 2 diabetes. After controlling for 1-h plasma glucose concentration, the increase in FPG concentration is not associated with an increase in the incidence of type 2 diabetes.