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Original Research

Minimal Contribution of Fasting Hyperglycemia to the Incidence of Type 2 Diabetes in Subjects With Normal 2-h Plasma Glucose

  1. Muhammad A. Abdul-Ghani, MD, PHD1,
  2. Michael P. Stern, MD2,
  3. Valeriya Lyssenko, MD, PHD3,
  4. Tiinamaija Tuomi, MD, PHD3,
  5. Leif Groop, MD3 and
  6. Ralph A. DeFronzo, MD3
  1. 1Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, Texas;
  2. 2Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas;
  3. 3Department of Clinical Sciences, Diabetes and Endocrinology and Lund University Diabetes Center, Lund University, Malmö, Sweden.
  1. Corresponding author: Muhammad A. Abdul-Ghani, abdulghani{at}uthscsa.edu.
Diabetes Care 2010 Mar; 33(3): 557-561. https://doi.org/10.2337/dc09-1145
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    Figure 1

    Seven- to 8-year incidence of type 2 diabetes (T2DM) in subjects with normal fasting glucose (FPG <100 mg/dl) and impaired fasting glucose (FPG 100–125 mg/dl). Subjects were divided into six groups according to fixed intervals of 1-h plasma glucose concentration as follows: <100, 100–125, 125–150, 150–175, 175–200, and >200 mg/dl. The mean 1-h plasma glucose concentration (n) in subjects with FPG <100 mg/dl was 85 (652), 113 (732), 139 (634), 165 (206), and 192 (187) mg/dl and in subjects with FPG >110 mg/dl was 91 (104), 114 (224), 140 (333), 165 (158), 193 (169), and 241 (51) mg/dl, respectively. None of the subjects with FPG <100 mg/dl had a 1-h plasma glucose concentration >200 mg/dl.

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  • Table 1

    Baseline patient characteristics in the SAHS and Botnia Study

    SAHSBotnia StudyP
    n1,3902,060<0.0001
    Age (years)43 ± 0345 ± 0.3<0.0001
    Sex (% male)5652.9<0.0001
    BMI27.3 ± 0.225.5 ± 0.1<0.0001
    Systolic blood pressure (mmHg)117 ± 0.4126 ± 0.4<0.0001
    Diastolic blood pressure (mmHg)71 ± 0.394 ± 0.2<0.0001
    FPG (mg/dl)85 ± 0.399 ± 0.2<0.0001
    1-h plasma glucose (mg/dl)125 ± 1133 ± 0.5<0.0001
    2-h plasma glucose (mg/dl)96 ± 0.6104 ± 0.5<0.0001
    HDL (mg/dl)47 ± 0.454 ± 0.6<0.0001
    Triglycerides (mg/dl)132 ± 2108 ± 2<0.0001
    Type 2 diabetes incidence (%)6.333.64<0.0001
  • Table 2

    Multivariate logistic model for the future risk of type 2 diabetes as the dependent variable and FPG, age, sex, BMI, ethnicity, family history for type 2 diabetes, blood pressure, and HDL cholesterol as the independent variables (model 1)

    SAHSBotnia Study
    OR (95%CI)POR (95% CI)P
    Model 1
        Age1.03 (1.004–1.05)0.011.04 (1.02–1.06)0.001
        BMI1.1 (1.06–1.14)<0.00011.1 (1.04–1.18)0.002
    Ethnicity0.53 (0.3–0.930.02NA
        Systolic blood pressure1.01 (0.997–1.03)NS1.02 (1.002–1.03)0.02
        FPG1.06 (1.04–1.08)<0.00011.05 (1.02–1.08)<0.0001
    Model 2
        1-h plasma glucose1.03 (1.02–1.04)<0.00011.02 (1.01–1.03)<0.0001
        Age1.02 (0.99–1.04)NS1.04 (1.01–1.06)0.004
        BMI1.08 (1.04–1.13)<0.00011.07 (1.006–1.14)0.03
        Ethnicity0.46 (0.256–0.83)<0.01NA
        Systolic blood pressure1.0 (0.98–1.02)NS1.01 (0.99–1.03)NS
        FPG1.02 (0.99–1.05)NS1.02 (0.99–1.06)NS
    Model 3
        2-h plasma glucose1.02 (1.004–1.03)0.0071.04 (0.8–1.35)NS
        Age1.02 (1.001–1.05)0.041.04 (1.015–1.06)0.001
        BMI1.09 (1.05–1.13)<0.00011.09 (1.02–1.16)0.01
        Ethnicity0.58 (0.316–0.985)0.04NA
        Systolic blood pressure1.0 (0.98–1.02)NS1.02 (1.01–1.03)0.02
        FPG1.05 (1.03–1.08)<0.00011.05 (1.02–1.08)0.001
    • Data are ORs (95% CI) for the variables that were significant predictors of type 2 diabetes risk. In model 2, the 1-h plasma glucose concentration during the OGTT was added to model 1, and in model 3, the 2-h plasma glucose concentration during the OGTT was added to the model.

  • Table 3

    Incidence of type 2 diabetes in subjects with NGT divided into three groups based on FPG

    FPG (mg/dl)1-h PG (mg/dl)n (% of SAHS participants)FPG (mg/dl)1-h PG (mg/dl)2-h PG (mg/dl)OR (95% CI)
    <90<125894 (72)81 ± 195 ± 2687 ± 111
    125–150286 (73)82 ± 6135 ± 10100 ± 224.7 (2.0–11.1)
    >150219 (72)83 ± 6175 ± 19109 ± 217.4 (3.3–17.1)
    90–100<125489 (29)95 ± 399 ± 1494 ± 181.8 (0.6–5.2)
    125–150255 (30)95 ± 3136 ± 10105 ± 192.7 (1.1–6.9)
    >150265 (34)96 ± 3180 ± 18111 ± 2011.3 (5.0–25.8)
    >100<125329 (7)106 ± 5102 ± 12101 ± 171.7 (0.4–6.7)
    125–150277 (9)107 ± 5137 ± 10108 ± 194.0 (1.3–12.5)
    >150432 (10)109 ± 6188 ± 27114 ± 1817.7 (7.5–41.9)
    • Data are means ± SD unless indicated otherwise. Subjects with NGT were divided into three groups based on FPG <90, 90–100, and >100 mg/dl. Subjects in each group were further subdivided based on a 1-h plasma glucose (PG) concentration <125, 125–155, and >155 mg/dl. Age, BMI, ethnicity, and systolic blood pressure were included as covariates in the model.

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Diabetes Care: 33 (3)

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Minimal Contribution of Fasting Hyperglycemia to the Incidence of Type 2 Diabetes in Subjects With Normal 2-h Plasma Glucose
Muhammad A. Abdul-Ghani, Michael P. Stern, Valeriya Lyssenko, Tiinamaija Tuomi, Leif Groop, Ralph A. DeFronzo
Diabetes Care Mar 2010, 33 (3) 557-561; DOI: 10.2337/dc09-1145

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Minimal Contribution of Fasting Hyperglycemia to the Incidence of Type 2 Diabetes in Subjects With Normal 2-h Plasma Glucose
Muhammad A. Abdul-Ghani, Michael P. Stern, Valeriya Lyssenko, Tiinamaija Tuomi, Leif Groop, Ralph A. DeFronzo
Diabetes Care Mar 2010, 33 (3) 557-561; DOI: 10.2337/dc09-1145
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