Normal Fasting Plasma Glucose and Risk of Prediabetes and Type 2 Diabetes: The Isfahan Diabetes Prevention Study

Abstract

■ Abstract AIM:To determine the association of fasting plasma glucose (FPG) level within normal range and the risk of prediabetes and type 2 diabetes in an Iranian population. METH-ODS: A total of 806 first-degree relatives (FDRs) of patients with type 2 diabetes who had FPG levels less than 5.6 mmol/l (100 mg/dl) in 2003 to 2005, and who did not have diabetes or impaired fasting glucose (IFG), were followed through 2010 for the occurrence of prediabetes or type 2 diabetes. At baseline and through follow-ups, participants underwent a standard 75 g 2-hour oral glucose tolerance test (OGTT). RESULTS: The incidence of type 2 diabetes, impaired glucose tolerance (IGT), and IFG was 9.6 (95% confidence interval (CI): 6.8-12.4), 28.7 (23.8-33.6), and 33.0 (27.7-38.2) per 1,000 person-years based on 4,489 person-years of follow-up, respectively. FPG was associated with the incidence of diabetes, IGT, and IFG. The multivariate-adjusted hazard ratios (95% CI) for diabetes, IGT, and IFG were 1.36 (1.01-1.84), 1.45 (1.10-1.91) and 1.31 (1.00-1.71), for the highest quintile of FPG compared with the lowest quintile, respectively. CONCLUSIONS: An increase in FPG in the normal range is associated with an increase in the incidence of IGT, IFG, and type 2 diabetes. These results prove FPG in the normal range to be useful in identifying apparently healthy FDRs of patients with type 2 diabetes at risk of developing prediabetes and diabetes.

Prevalence of high normal FBS and prediabetes among adolescents in Birjand, East of Iran, 2012

“…Different studies have shown that high FBS, within the normal range, is a risk factor for type-2 diabetes. [ 14 15 16 ] Tirosh et al found that FBS greater than (87 mg/dl) significantly increased diabetes risk among young men with FPG level <100mg/dl. [ 17 ] The prospective study by Nichols et al revealed that people with FBS (90 to 94 mg/dl), even after controlling for a large number of known risk factors, are significantly at the risk of developing diabetes (49% greater risk); compared with individuals, with FBS less than 85 mg/dl.…”

“…[ 12 ] The mechanism by which higher normal FBS increases the risk of diabetes is unknown. [ 14 ] Hypothetical mechanisms include increased hepatic insulin resistance, impaired early insulin response, and decrease in noninsulin-dependent glucose clearance. The main factor of prediabetes and diabetes is progressive beta-cell failure.…”

“…The main factor of prediabetes and diabetes is progressive beta-cell failure. [ 14 ] The presence of islet cell autoantibodies during prediabetic period damages to the beta cells. [ 19 ]…”

Correlates of fasting blood glucose among children living with hiv in a Nigerian tertiary hospital: a cross-sectional study

“…Diabetes was defined as a FBG level of 126 mg per deciliter or higher. Normal blood glucose values were further subdivided into high normal (˃ 87 mg/dl to 99 mg/dl) and moderate normal (87 mg/dl and below) values, the former having been associated with the risk of pre-diabetes [10][11][12]. Children with impaired fasting glucose were referred to the Paediatric Endocrinology Clinic of the Hospital for further evaluation.…”

The product of fasting plasma glucose and triglycerides improves risk prediction of type 2 diabetes in middle-aged Koreans

“…Also, the increase of fasting plasma glucose (FPG) in the normal range is associated with increased incident T2DM [ 17 ]. Of these, serum triglyceride (TG) has been used to identify people at high risk for T2DM, alongside obesity [ 18 ].…”