Author(s): Inoue K, Matsumoto M, Kobayashi Y
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Abstract OBJECTIVES: We examined the usefulness of the combined use of fasting plasma glucose (FPG) and hemoglobin Alc (HbA1c) levels to predict the progression of diabetes in a Japanese population. METHODS: A retrospective cohort study was conducted from 1995 to 2002 among 449 non-diabetic Japanese workers, ages 23-65, in whom baseline FPG levels and HbA1c were measured. Subjects were classified into six groups according to their baseline FPG level: low normal fasting glucose (NFG) (<5.55 mmol/l); high NFG (5.55-6.09 mmol/l); or impaired fasting glucose (IFG) (6.10-6.99 mmol/l), in combination with baseline HbA1c level: low HbA1c (<5.8\%) and high HbA1c (> or =5.8\%). The cumulative incidence of diabetes in 2002, as defined by the 1997 American Diabetes Association (ADA) diagnostic criteria, was compared between groups. RESULTS: The overall cumulative incidence of diabetes was 3.8\% (17/449). The cumulative incidence of diabetes was 0.6\% (2/339) in those with low NFG/normal HbA1c; 0\% (0/24) with low NFG/high HbA1c; 6.4\% (3/47) with high NFG/normal HbA1c; 23.1\% (3/13) with high NFG/high HbA1c; 17.6\% (3/17) with IFG/normal HbA1c; and 66.7\% (9/17) with IFG/high HbA1c. The odds ratios for diabetes, adjusted for age, sex, body mass index (BMI) and family history of diabetes, were 5.3 (95\% CI, 3.0-9.3) and 3.0 (1.7-5.3), per 0.56 mmol/l increase in FPG and 0.5\% increase in HbA1c, respectively. CONCLUSIONS: The combined use of FPG and HbA1c levels predicts the progression to diabetes in individuals with no apparent risk. In particular, the combination is recommended for individuals with a FPG > or =5.55 mmol/l.
This article was published in Diabetes Res Clin Pract
and referenced in Journal of Gerontology & Geriatric Research