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One-hour hyperglycemia predicts type 2 diabetes better than IFG
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Adults with normal glucose tolerance and a high 1-hour postload plasma glucose level have a higher risk for developing type 2 diabetes than those with impaired fasting glucose or a low 1-hour postload plasma glucose level, according to research in The Journal of Clinical Endocrinology & Metabolism.
Teresa Vanessa Fiorentino, MD, of the University of Magna Graecia of Catanzaro, Italy, and colleagues performed a cross-sectional analysis with data from 595 white adults without diabetes who had one parent with type 2 diabetes and who were participating in the EUGENE2 project, which included a 75-g oral glucose tolerance test and a euglycemic hyperinsulinemic clamp.
Researchers performed a longitudinal analysis with data from 392 adults without diabetes at baseline enrolled in the CATAMERI study. Participants were re-examined for type 2 diabetes after an average follow-up of 5.2 years.
In the cross-sectional analysis, researchers found that participants with a normal glucose tolerance and a high 1-hour postload plasma glucose level had a significant reduction in peripheral insulin sensitivity and beta-cell function when compared with participants who had a normal glucose tolerance and a low 1-hour postload plasma glucose level or with participants who had IFG.
In the longitudinal analysis, researchers found a 2.9% incidence rate for type 2 diabetes for participants who at baseline had had normal glucose tolerance and a low 1-hour postload plasma glucose level; 16.7% incidence rate for type 2 diabetes for participants with normal glucose tolerance and a high 1-hour postload plasma glucose level; a 12.5% incidence rate for participants with IFG; and a 31.4% incidence rate for those with impaired glucose tolerance.
Researchers found the risk for developing diabetes for high 1-hour participants was 4.02 (95% CI, 1.06-15.26); the risk was 6.67 (95% CI, 2.09-21.24) for participants with IGT. The risk was 1.91 (95% CI, 0.44-8.29) in the isolated IFG group.
“Our analysis of longitudinal data from the CATAMERI study showed that subjects with [normal glucose tolerance and a high 1-hour postload plasma glucose level], who would otherwise be considered as a group at low risk of type 2 diabetes by current definitions, have an increased risk to develop type 2 diabetes,” the researchers wrote. “In fact, although as a whole, individuals with [normal glucose tolerance] had a relatively low incidence rate of type 2 diabetes (6.4%), subjects with [normal glucose tolerance and a high 1-hour postload plasma glucose level] exhibited a significantly higher incidence rate of type 2 diabetes (16.7%) compared with subjects with a 1-hour low (2.9%).” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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