Lowering the Criterion for Impaired Fasting Glucose Will Not Provide Clinical Benefit
- Mayer B. Davidson, MD1,
- Pamela B. Landsman, MPH2 and
- Charles M. Alexander, MD2
- 1Clinical Trials Unit, Charles R. Drew University, Los Angeles, California
- 2Outcomes Research & Management, U.S. Medical & Scientific Affairs, Merck & Co., West Point, Pennsylvania
- Address correspondence and reprint requests to Mayer B. Davidson, MD, Director, Clinical Trials Unit, Charles R. Drew University, 1731 East 120th St., Los Angeles, CA 90059. E-mail: madavids{at}cdrewu.edu
In 1997, the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus lowered the fasting criterion for diabetes from ≥140 (7.8 mmol/l) to ≥126 mg/dl (7.0 mmol/l) (1). This decision was made to allow the prevalence of diabetes diagnosed by fasting plasma glucose (FPG) concentrations to equal the prevalence of diabetes diagnosed by 2-h values on a glucose tolerance test. The fact that 60% of the new cohort of people with diabetes, i.e., those diagnosed by FPG concentrations of 126–139 mg/dl, would have normal A1C levels (2) did not seem to trouble the committee.
Using the same rationale of equalizing outcomes achieved by utilizing two different criteria, in last month’s issue of Diabetes Care (3) the Expert Committee decreased the lower limit of normal for FPG concentrations. The definition of impaired …
