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Fasting plasma glucose and HbA 1c as risk factors for Type 2 diabetes
Author(s) -
Inoue Kazuo,
Matsumoto Masatoshi,
Akimoto Kimihiko
Publication year - 2008
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2008.02572.x
Subject(s) - medicine , diabetes mellitus , impaired fasting glucose , hazard ratio , cumulative incidence , type 2 diabetes , incidence (geometry) , confidence interval , endocrinology , confounding , glycated hemoglobin , impaired glucose tolerance , cohort , physics , optics
Aims We examined the value of combining fasting plasma glucose (FPG) and glycated haemoglobin (HbA 1c ) as a predictor of diabetes, using the new American Diabetes Association (ADA) criteria of FPG and lower cut‐off point of HbA 1c . Methods A retrospective cohort study was conducted from 1998 to 2006, inclusive, in 10 042 persons (55 884 person‐years), with a mean age of 53.0 years at baseline. The cumulative incidence of diabetes (defined either as an FPG ≥ 7.0 mmol/l or as clinically diagnosed diabetes) was measured. Results The cumulative incidence and incidence density of diabetes were 3.7% (368 cases) and 6.6/1000 person‐years over a mean follow‐up period of 5.5 years. The cumulative incidence of diabetes in subjects with impaired fasting glucose (IFG) and HbA 1c 5.5–6.4% was 24.8% (172/694 persons) compared with 0.4% (25/6698 persons), 2.5% (15/605 persons), 7.6% (156/2045 persons) in those with normal fasting glucose (NFG) and HbA 1c < 5.5%, NFG and HbA 1c 5.5–6.4% and IFG and HbA 1c < 5.5%, respectively. The hazard ratio for diabetes, adjusted for possible confounders, was 7.4 (95% confidence interval, 4.70 to 11.74) for those with NFG and HbA 1c 5.5–6.4%, 14.4 (11.93 to 27.79) for those with IFG and HbA 1c < 5.5% and 38.4 (24.63 to 59.88) for those with IFG and HbA 1c 5.5–6.4%. Conclusions The combination of FPG and HbA 1c identifies individuals who are at risk of progression to Type 2 diabetes at the new ADA criteria of FPG and a lower cut‐off point of HbA 1c than previous studies.