Impaired Fasting Glucose and the Risk of Incident Diabetes Mellitus and Cardiovascular Events in an Adult Population
Open accessAbstract
Objectives The purpose of the study was to assess the cardiovascular risk of impaired fasting glucose (IFG).Background The associations between IFG, incident type 2 diabetes mellitus (T2DM), and cardiovascular (CV) events remains unclear.Methods The MESA (Multi-Ethnic Study of Atherosclerosis) study included participants who were 45 to 84 years or age and free of clinical CV disease at baseline (2000 to 2002). Type 2 DM was defined as fasting glucose >125 mg/dl or receiving antidiabetes medication at baseline and follow-up examinations; IFG was defined as no T2DM and fasting glucose 100 to 125 mg/dl. Cox proportional hazards analysis was used to assess the association between IFG and incident DM and also between IFG and incident CV events.Results Of 6,753 participants included in these analyses, 840 (12.7%) had T2DM and 940 (13.8%) had IFG at the baseline examination. During 7.5 years of follow-up, there were 418 adjudicated CV events. Type 2 DM was associated with an increased CV incidence in the univariate model (hazard ratio [HR]: 2.83, 95% confidence interval [CI]: 2.25 to 3.56, p < 0.0001) and multivariate model adjusted for demographics and traditional risk factors (HR: 1.87, 95% CI: 1.47 to 2.37, p < 0.0001) compared with subjects not having T2DM (IFG plus normal fasting glucose). Impaired fasting glucose was associated with increased incidence of T2DM (HR: 13.2, 95% CI: 10.8 to 16.2, p < 0.001) that remained after adjusting for demographics, highest educational level, physical activity, and body mass index (HR: 10.5, 95% CI: 8.4 to 13.1, p < 0.001) compared with normal fasting glucose. Impaired fasting glucose was associated with incident CV events in the univariate model (HR: 1.64, 95% CI: 1.26 to 2.14, p < 0.001) but not in the full multivariate model (HR: 1.16, 95% CI: 0.88 to 1.52, p = 0.3) compared with normal fasting glucose.Conclusions Having IFG was not independently associated with an increased short-term risk for incident CV events. These data reiterate the importance of intervention for persons with IFG to reduce their incidence of T2DM.
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Because the annual progression rate from prediabetes to type 2 diabetes can be as high as 11% in certain populations, delays in metformin prescription represent missed opportunities to delay or prevent progression to type 2 diabetes among higher risk adults.
“Since the annual progression rate from prediabetes to type 2 diabetes can be as high as 11% in certain populations, these delays represent missed opportunities to delay or prevent progression to type 2 diabetes among adults who are at higher risk. 5,6”
From Metformin Prescription Rates for Patients with Prediabetes (2022) · cites this paper as [6]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredAdults with prediabetes are at an increased risk of developing type 2 diabetes.
“Adults with prediabetes are at an increased risk of developing type 2 diabetes.”
From Metformin Prescription Rates for Patients with Prediabetes (2022) · cites this paper as [6]
Recent major studies found annualised diabetes incidence of 11% in the DPP Outcomes Study, 6% among MESA participants with IFG, 9% among Japanese participants with IFG, and 7% among those with A1c 5.7-6.4%.
“In more recent major studies, progression estimates have been similar: the annualised incidence was 11% in the Diabetes Prevention Program (DPP) Outcomes Study,15 6% among participants with IFG in the US Multi-Ethnic Study of Atherosclerosis (MESA),16 9% among participants with IFG and 7% among those with an A1c 5.7–6.4% in a Japanese population-based study.17”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [16]
In the Multi-Ethnic Study of Atherosclerosis, the incidence of diabetes was 4% in individuals with IFG.
“In the Multi-Ethnic Study of Atherosclerosis the incidence of diabetes was 4% in individuals with IFG.”
From The Vasculature in Prediabetes (2018) · cites this paper as [19]
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- Authors
- Yeboah, J., Bertoni, A. G., Herrington, D. M., Post, W. S., & Burke, G. L.
- Affiliations
- University of Virginia Medical Center (US)
- Wake Forest University Health Sciences (US)
- Johns Hopkins University (US)
- Corresponding author
- Yeboah, Joseph
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2011-07
- Volume
- 58
- Issue
- 2
- Pages
- 140-146
- ISSN
- 0735-1097 (ISSN-L)
- PMC
- PMC3146297
- OpenAlex
- W197779105
- Cited by
- 120
- References
- 21
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 12 · 2023: 14 · 2022: 5 · 2021: 7 · 2020: 7 · 2019: 9 · 2018: 8 · 2017: 6 · 2016: 10 · 2015: 11 · 2014: 12 · 2013: 1 · 2012: 5
- FWCI
- 5.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32 HL076132)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- impaired fasting glucose, type 2 diabetes, cardiovascular events, cardiovascular risk, new-onset diabetes, prediabetes, Multi-Ethnic Study of Atherosclerosis, fasting blood glucose, adults without diabetes, body mass index, physical activity, educational attainment, cardiovascular risk stratification, diabetes screening, diabetes prevention, cardiovascular disease prevention
- MeSH terms
- Aged, Aged, 80 and over, Blood Glucose, Cardiovascular Diseases, Diabetes Mellitus, Ethnicity, Female, Humans, Male, Middle Aged, Risk, Body Mass Index, Proportional Hazards Models, Diabetes Complications, Atherosclerosis
About these checks
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