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The threshold for definition of impaired fasting glucose in a Japanese population
Author(s) -
Inoue K.,
Matsumoto M.,
Akimoto K.
Publication year - 2009
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.1464-5491.2009.02850.x
Subject(s) - medicine , diabetes mellitus , impaired fasting glucose , glycated haemoglobin , fasting glucose , population , plasma glucose , cohort , impaired glucose tolerance , endocrinology , type 2 diabetes , insulin resistance , environmental health
Aims We examined whether the cut‐off value of fasting plasma glucose (FPG) for diagnosing impaired fasting glucose (IFG) should be lowered, using data from a large Japanese population. Methods A retrospective cohort study was conducted from 1998 to 2006. Follow‐up (2002–2006) data were merged with baseline (1998–2002) data, yielding 11 129 persons who had participated on both occasions. Among these, 10 475 persons who did not have diabetes (known diabetes or defined as FPG ≥ 7.0 mmol/l) or suspected diabetes (glycated haemoglobin ≥ 6.4%) were analysed. Results During follow‐up of an average of 5.4 years, 279 (5.2%) out of 5372 men and 98 (1.9%) out of 5103 women developed diabetes. According to the three baseline FPG categories (< 5.6, 5.6–6.1 and 6.2–6.9 mmol/l), 28/3401 (0.8%), 91/1456 (6.3%) and 160/515 (31.1%), respectively, in men and 13/4231 (0.3%), 30/695 (4.3%) and 55/177 (31.1%), respectively, in women developed diabetes. The optimal cut‐off FPG value to predict diabetes was 5.7 mmol/l for both men (sensitivity 84.2%, specificity 76.9%) and women (81.6%, 91.0%). However, lowering the cut‐off from 6.1 to 5.7 mmol/l increased the prevalence of IFG 2.7‐fold in men and 3.0‐fold in women. Lowering the value further to 5.6 mmol/l increased the prevalence of IFG 3.8‐fold in men and 4.9‐fold in women. Conclusions It may be reasonable to retain the conventional lower FPG limit for IFG and treat FPG values of 5.6–6.1 mmol/l as non‐diabetic hyperglycaemia, considering the four‐ to fivefold increase in individuals classified as IFG when the new cut‐off is applied.