Endocrine Abstracts

Objective: To determine the progression rate to impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes (DM2) and risk factors of progression to diabetes in normal glucose tolerant (NGT) people during 8 years follow up study using WHO 1999 criteria and new criteria of IFG (IFG 5.6-fasting glucose 5.6–6.9 mmol/l).

Research design and methods: This is an 8 year prospective observation in a randomly selected urban population aged ≥40 years living in Krakow, Poland. 1752 persons had NGT.based on WHO 1999 criteria. 564 of invited person (209 men and 355 women, aged mean 60.7, S.D.=9.2) attended the follow-up assessment. Subjects underwent a physical examination including weight/height, waist circumference, biochemical examination including OGTT glucose/insulin and questionnaire examination concerning CVD health history and family history of type 2 diabetes. Multiple logistic regression was used to assess the risk factors of progression to diabetes.

Results: The prevalence of DM2, IFG and IGT according to WHO 1999 criteria in examined population with baseline NGT was 4.43, 3.37 and 9.93% respectively. The prevalence of IFG (IFG 5.6) using new criteria, was 13.48%. Lowering cutoff point for IFG caused 10.11% increase in the prevalence of IFG. Risk factors of the conversion to diabetes in NGT WHO 1999 were age, 120’OGTT glucose, insulin and hyperinsulinaemia. Risk factors of the convertion to diabetes in NGT 5.6 mmol/l were 120’OGTT glucose. Risk factors of the convertion to diabetes in IGT WHO 1999 were 120’OGTT glucose.

Conclusion: In the studied baseline NGT population after 8 years of follow up high progression rate to impaired glucose metabolism was found. The implementation of new IFG diagnostic criteria increased the prevalence of IFG by 10.1%. Fasting glucose and OGTT glucose should be measured for early identification of people with impaired glucose metabolism.