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Cited by 189Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and ResearchDiabetes Treatment and Management

The Relation of Fasting and 2-h Postchallenge Plasma Glucose Concentrations to Mortality

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Sorkin, John D., Muller, Denis C., Fleg, Jerome L., Andres, Reubin·2005·Diabetes Care
DOI 10.2337/diacare.28.11.2626
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Abstract

OBJECTIVE—Under the auspices of the National Institutes of Health, American Diabetes Association, and World Health Organization, expert committees lowered the fasting plasma glucose (FPG) concentration diagnostic for diabetes from 7.8 to 7.0 mmol/l and defined 6.1–6.9 mmol/l as impaired fasting glucose (IFG) and <6.1 mmol/l as normal fasting glucose. In 2003, IFG was lowered to 5.6–6.9 mmol/l and normal fasting glucose to <5.6 mmol/l. Reports of the relationship between glucose concentration and all-cause mortality have been inconsistent. It is not known if the 2-h plasma glucose (2hPG) concentration from an oral glucose tolerance test (OGTT) adds to the predictive power of FPG. RESEARCH DESIGN AND METHODS—We followed 1,236 men for an average of 13.4 years to determine the relationship between both FPG and 2hPG and all-cause mortality. RESULTS—Risk for mortality did not increase until the FPG exceeded 6.1 mmol/l. Risk increased by ∼40% in the 6.1–6.9 mmol/l range and doubled when FPG ranged from 7.0 to 7.7 mmol/l. A combination of the 2hPG and FPG allowed better estimation of risk than the FPG alone. Within any category of FPG, risk generally increased as the 2hPG increased, and within any category of 2hPG, risk generally increased as the FPG increased. CONCLUSIONS—These data support the decision to lower the FPG diagnostic for diabetes from 7.8 to 7.0 mmol/l, show that both IFG and impaired glucose tolerance have risks between the normal and diabetic ranges, and show that the OGTT adds predictive power to that of FPG alone and should not be abandoned. The lowering of IFG to 5.6 mmol/l from 6.1 mmol/l, at least for mortality, is, however, not supported by our results.

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Authors
Sorkin, J. D., Muller, D. C., Fleg, J. L., & Andres, R.
Affiliations
  • National Institute on Aging (US)
  • National Heart, Lung, and Blood Institute (US)
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2005-11-01
Volume
28
Issue
11
Pages
2626-2632
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.28.11.2626
OpenAlex
W2096688728
Cited by
189
References
26
Citations by year
2026: 1 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 7 · 2021: 6 · 2020: 3 · 2019: 5 · 2018: 6 · 2017: 5 · 2016: 10 · 2015: 11 · 2014: 13 · 2013: 18 · 2012: 10
FWCI
7.45
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • U.S. Department of Veterans Affairs
  • National Institutes of Health
  • Geriatric Research Education and Clinical Center
  • National Institute on Aging (K01AG001054)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
fasting blood glucose, oral glucose tolerance test, all-cause mortality, impaired fasting glucose, impaired glucose tolerance, risk prediction, men
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Blood Glucose, Diabetes Mellitus, Fasting, Glucose Tolerance Test, Humans, Longitudinal Studies, Male, Middle Aged, Mortality, Reference Values, Risk, Time Factors, Baltimore

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