Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
, 42 (6), 647-54

Is Fasting Glucose Sufficient to Define Diabetes? Epidemiological Data From 20 European Studies. The DECODE-study Group. European Diabetes Epidemiology Group. Diabetes Epidemiology: Collaborative Analysis of Diagnostic Criteria in Europe

No authors listed
Clinical Trial

Is Fasting Glucose Sufficient to Define Diabetes? Epidemiological Data From 20 European Studies. The DECODE-study Group. European Diabetes Epidemiology Group. Diabetes Epidemiology: Collaborative Analysis of Diagnostic Criteria in Europe

No authors listed. Diabetologia.

Abstract

Aims/hypothesis: The World Health Organisation Consultation recommended new diagnostic criteria for diabetes mellitus including: lowering of the diagnostic fasting plasma glucose to 7.0 mmol/l and introduction of a new category: impaired fasting glycaemia. The diagnostic 2-h glucose concentrations for diabetes and for impaired glucose tolerance were unchanged. This study identifies fasting plasma glucose concentrations predicting a diabetic 2-h plasma glucose of 11.1 mmol/l or more, analyses the sensitivity and specificity of different screening strategies for diabetes and describes the cardiovascular risk profile in people with impaired fasting glycaemia.

Methods: European population based studies (n = 17) or large, representative samples of employees (n = 3) with both fasting and 2-h post load glucose concentrations following 75-g oral glucose tolerance tests were included (18,918 men and 10,190 women). The Iceland study (8881 men and 9407 women) is presented separately as a 50-g glucose load was used.

Results: The fasting plasma glucose predicting a 2-h plasma glucose of 11.1 mmol/l or more with optimal sensitivity and specificity was a) 5.8 mmol/l in women and 6.4 mmol/l in men; b) independent of age; c) increased with obesity. Fasting plasma glucose of 7.0/7.8 mmol/l or more predicted a diabetic 2-h plasma glucose with sensitivities of 49.0/29.8% and specificities of 98.2/99.7%, respectively.

Conclusion/interpretation: If fasting glucose is used alone, the 31% of diabetic subjects with a non-diabetic fasting glucose but a diabetic 2-h glucose, will not be diagnosed; impaired fasting glycaemia and impaired glucose tolerance do not identify the same people; the risk profile of people with impaired fasting glycaemia depends on 2-h glucose concentrations. Obesity is the main confounder in the association between fasting and 2-h glucose.

Comment in

Similar articles

See all similar articles

Cited by 39 PubMed Central articles

See all "Cited by" articles

Publication types

LinkOut - more resources

Feedback