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- Title
Impaired Glucose Tolerance Is a More Important Risk Factor for the Development of Diabetes than Impaired Fasting Glucose in Japanese Americans.
- Authors
Tong, Jenny; Utzschneider, Kristina M.; Boyko, Edward J.; Gerchman, Fernando; Carr, Darcy B.; Udayasankar, Jayalakshmi; Zraika, Sakeneh; Leonetti, Donna L.; Fujimoto, Wilfred Y.; Kahn, Steven E.
- Abstract
The relative importance of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) as "prediabetes" conditions is debated. We examined whether subjects with isolated IFG, isolated IGT or combined IFG/IGT carry different risks for the development of diabetes. Prospective analysis was performed in 509 non-diabetic Japanese Americans (262M/247F, mean age 52.1±12.0 y, BM124.1±3.2 kg/m²) with normal glucose tolerance (NGT) (n=253), isolated IFG (n=61), isolated IGT (n=117) and IFG/IGT (n=78) by an oral glucose tolerance test at baseline. Two (0.8%) NGT, 3 (4.9%) isolated IFG, 18 (15.4%) isolated IGT, and 24 (30.8%) IFG/IGT subjects developed diabetes at 5-y follow-up (n=455), while 8 (3.2%), 5 (8.2%), 22 (18.8%) and 31 (39.7%) developed diabetes at 10-y follow-up (n=399), respectively. At baseline, gender was a major determinant of abnormal glucose tolerance with men more likely to have isolated IFG (OR=2.1 [95% CI 1.04-4.1]) and IFG/IGT (OR=2.2 [1.1-4.3]), while women were more likely to have isolated IGT compared to NGT (OR=2.4 [1.4-4.0]) after adjusting for age, BMI, intra-abdominal fat, fasting insulin, and early insulin release (ΔI[sub 0-30]/ΔG[sub 0-30]). Baseline isolated IGT and IFG/IGT predicted the development of diabetes at both 5- (OR=18.9 [3.9-90.4] and OR=41.9 [8.4-208.7] respectively) and 10-y follow-up (OR=7.0 [2.8-17.6] and OR=23.1 [8.3-64.0] respectively) compared to NGT after adjusting for age, gender, BMI, intra-abdominal fat, fasting insulin, and early insulin release. In contrast, isolated IFG did not predict the future development of diabetes (OR=5.3 [0.8-35.3] at 5y and OR=2.2 [0.6-7.5] at 10y respectively). Thus, having isolated IGT at baseline was associated with a higher risk of development of diabetes at 5-y follow-up compared to isolated IFG (OR=5.0 [1.3-19.2]). In conclusion, IGT is a more important risk factor than isolated IFG for the development of diabetes in Japanese Americans, with women being at particular risk for IGT. The 2-hour rather than the fasting glucose provides greater information for the prediction of future diabetes in this population. ADA-Funded Research
- Subjects
GLUCOSE; PREDIABETIC state; DIABETES; GLUCOSE tolerance tests; INSULIN; JAPANESE Americans; DISEASES
- Publication
Diabetes, 2007, Vol 56, pA248
- ISSN
0012-1797
- Publication type
Article