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The metabolic deterioration that antedates diabetes: personal trajectories of HbA 1c and fasting glucose as early indicators and possible triggers for intervention
Author(s) -
Dankner Rachel,
Bergman Michael,
Danoff Ann,
Qureshi Sana,
Whitford Ian,
Kaviani Nargess,
Dynkevich Yevgeniya,
Roth Jesse
Publication year - 2013
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2373
Subject(s) - diabetes mellitus , medicine , intervention (counseling) , fasting glucose , population , disease , endocrinology , environmental health , insulin resistance , psychiatry
Summary HbA 1c testing has become an accepted means of diagnosing diabetes as an alternative to blood glucose levels. However, population‐based norms of glucose and of HbA 1c levels do not enable the detection of diabetes at an early enough stage to thwart complications. Personal trajectories of glucose levels show steep increases a number of years prior to diabetes diagnosis. Here, we hypothesize that a comparable time‐dependent deviation in an individual's HbA 1c level may be an early manifestation of disease that should prompt lifestyle modifications. We predict that analysis of personal trajectories of glucose and of HbA 1c will promote earlier intervention and a greater reduction in disease complications than current standards, which are based on population‐based norms. Copyright © 2012 John Wiley & Sons, Ltd.