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Impaired fasting glucose as a treatment target in diabetes management

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Abstract

Impaired fasting glucose (IFG) contributes to microvascular and macrovascular complications and increased cardiovascular disease risk. Although type 2 diabetes is largely considered to occur as a result of IFG, understanding of physiologic and associated management targets is uniformly lacking among health care professionals. Once definitions are standardized, diagnostic criteria and screening tools may help to identify individuals at risk sooner, thereby minimizing the rapid deterioration that often results. To counter the rising pandemic of obesity and diabetes, it is important to understand the vascular risk of IFG and impaired glucose tolerance in patients at risk.

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References and Recommended Reading

  1. American Diabetes Association: Diagnosis and Classification of Diabetes Mellitus. American Diabetes Association 2008 Position Statement. Diabetes Care 2009, 32:S13–S61.

    Article  Google Scholar 

  2. World Health Organization/International Diabetes Federation: 2006 Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia: report of a WHO/IDF Consultation. Available at http://www.who.int/diabetes/publications/Definition%20and%20diagnosis%20of%20diab etes_new.pdf. Accessed April 28, 2008.

  3. Cherrington AD: Banting Lecture 1997: control of glucose uptake and release by the liver in vivo. Diabetes 1999, 48:1198–1214.

    Article  CAS  PubMed  Google Scholar 

  4. DeFronzo RA, Ferrannini E: Regulation of hepatic glucose metabolism in humans. Diabetes Metab Rev 1987, 3:415–459.

    Article  CAS  PubMed  Google Scholar 

  5. DeVegt F, Dekker JM, Jager A, et al.: Relations of impaired fasting and postload glucose with incident type 2 diabetes in a Dutch populations: the Hoorn Study. JAMA 2001, 285:2109–2113.

    Article  CAS  Google Scholar 

  6. Tuomilehto J, Lindstrom J, Eriksson JG, et al.: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. The Finnish Diabetes Prevention Study group. N Engl J Med 2001, 344:1343–1350.

    Article  CAS  PubMed  Google Scholar 

  7. Cowie CC, Rust KF, Ford ES, et al.: Full accounting of diabetes and pre-diabetes in the U.S. population in 1988–1994 and 2005–2006. Diabetes Care 2009, 32:287–294.

    Article  PubMed  Google Scholar 

  8. Unwin N, Shaw J, Zimmet P, Alberti KG: Impaired glucose tolerance and impaired fasting glycemia: the current status on definition and intervention. Diabetes Med 2002, 19:708–723.

    Article  CAS  Google Scholar 

  9. Abdul-Ghani MA, Tripathy D, DeFronzo RA: Contributions of cell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose. Diabetes Care 2006, 29:1130–1139.

    Article  CAS  PubMed  Google Scholar 

  10. Larsson H, Berglund G, Lindgarde F, Ahren B: Comparison of ADA and WHO criteria for diagnosis of diabetes and glucose intolerance. Diabetologia 1998, 41:1124–1125.

    Article  CAS  PubMed  Google Scholar 

  11. Abdul-Ghani MA, Jenkinson C, Richardson DK, et al.: Insulin secretion and insulin action in subjects with impaired fasting glucose and impaired glucose tolerance: results from the Veterans Administration Genetic Epidemiology Study (VEGAS). Diabetes 2006, 55:1430–1435.

    Article  CAS  PubMed  Google Scholar 

  12. Wasada T, Kuroki H, Katsumori K, et al.: Who are more insulin resistant, people with IFG or people with IGT? Diabetologia 2004, 47:758–759.

    Article  CAS  PubMed  Google Scholar 

  13. Ferrannini E, Gastaldelli A, Miyazaki Y, et al.: Predominant role of reduced beta-cell sensitivity to glucose over insulin resistance in impaired glucose tolerance. Diabetologia 2003, 46:1211–1219.

    Article  CAS  PubMed  Google Scholar 

  14. Osei K, Gaillard T, Schuster DP: Pathogenetic mechanisms of impaired glucose tolerance and type II diabetes in African-Americans: the significance of insulin secretion, insulin sensitivity, and glucose effectiveness. Diabetes Care 1997, 20:396–404.

    Article  CAS  PubMed  Google Scholar 

  15. Piche ME, Despres JP, Pascot A, et al.: Impaired fasting glucose vs. glucose intolerance in pre menopausal women: distinct metabolic entities and cardiovascular disease risk? Diabet Med 2004, 21:730–737.

    Article  CAS  PubMed  Google Scholar 

  16. Vauhkonen I, Niskanen L, Vanninen E, et al.: Defects in insulin secretion and insulin action in non-insulin-dependent diabetes mellitus are inherited: metabolic studies on offspring of diabetic probands. J Clin Invest 1998, 101:86–96.

    Article  CAS  PubMed  Google Scholar 

  17. Lloyd-Jones D, Adams R, Carnethon M, et al.: Heart disease and stroke statistic-2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2009, 119:e21–e181.

    Article  PubMed  Google Scholar 

  18. Thorpe LE, Upadhyay UD, Chamany S, et al.: Prevalence and control of diabetes and impaired fasting glucose in New York City. Diabetes Care 2009, 32:57–62.

    Article  PubMed  Google Scholar 

  19. Moog JM, Grootenhuis PA, De Vries H, et al.: Intra-individual variation of glucose, specific insulin and pro-insulin concentrations measured by two oral glucose tolerance tests in a general Caucasian population: the Hoorn Study. Diabetologia 1996, 39:298–305.

    Article  Google Scholar 

  20. Shaw JE, Zimmet PZ, de Courten M, et al.: Impaired fasting glucose or impaired glucose tolerance: what best predicts future diabetes in Mauritius? Diabetes Care 1999, 22:399–402.

    Article  CAS  PubMed  Google Scholar 

  21. Ferrannini E, Massari M, Nannipieri M, et al.: Plasma glucose levels as predictors of diabetes: the Mexico City diabetes study. Diabetologia 2009 Feb 18 (Epub ahead of print).

  22. Abdul-Ghani MA, Lyssenko V, Tuomi T, et al.: Fasting versus postload plasma glucose concentration and the risk for future type 2 diabetes: results from the Botnia Study. Diabetes Care 2009, 32:281–286

    Article  PubMed  Google Scholar 

  23. DREAM (Diabetes Reduction Assessment with ramipril and rosiglitazone Medication) Trial Investigators, Gerstein HC, Yusuf S, et al.: Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomized controlled trial. Lancet 2006, 368:1096–1105.

    Article  CAS  PubMed  Google Scholar 

  24. Meigs JB, Hu FB, Rifai N, Manson JE: Biomarkers of endothelial dysfunction and risk of type 2 diabetes mellitus. JAMA 2004, 291:1978–1986.

    Article  CAS  PubMed  Google Scholar 

  25. Schmidt MI, Duncan BB, Sharrett AR, et al.: Markers of inflammation and prediction of diabetes mellitus in adults (Atherosclerosis Risk in Communities study): a cohort study. Lancet 1999, 353:1649–1652.

    Article  CAS  PubMed  Google Scholar 

  26. Balletshofer BM, Rittig K, Enderle MD, et al.: Endothelial dysfunction is detectable in young normotensive first-degree relatives of subjects with type 2 diabetes in association with insulin resistance. Circulation 2000, 101:1780–1784.

    CAS  PubMed  Google Scholar 

  27. Serne EH, de Jongh RT, Eringa EC, et al.: Microvascular dysfunction: a potential pathophysiological role in the metabolic syndrome. Hypertension 2007, 50:204–211.

    Article  CAS  PubMed  Google Scholar 

  28. Kifley A, Wang JJ, Cugati S, et al.: Retinal vascular caliber and the long-term risk of diabetes and impaired fasting glucose: the Blue Mountains Eye Study. Microcirculation 2008, 15:373–377.

    Article  CAS  PubMed  Google Scholar 

  29. Ikram MK, de Jong FJ, Vingerling JR, et al.: Are retinal arteriolar or venular diameters associated with markers for cardiovascular disorders? The Rotterdam Study. Invest Ophthalmol Vis Sci 2004, 45:2129–2134.

    Article  PubMed  Google Scholar 

  30. Kawasaki R, Wang JJ, Rochtchina E, et al.: Cardiovascular risk factors and retinal microvascular signs in an adult Japanese population: the Funagata Study. Ophthalmology 2006, 113:1378–1384.

    Article  PubMed  Google Scholar 

  31. Kawasaki R, Wang JJ, Wong TY, et al.: Impaired glucose tolerance, but not impaired fasting glucose, is associated with retinopathy in Japanese population: the Funagata study. Diabetes Obes Metab 2008, 10:514–515.

    Article  CAS  PubMed  Google Scholar 

  32. Nguyen TT, Wang JJ, Amirul Islam FM, et al.: Retinal arteriolar narrowing predicts incidence of diabetes. The Australian Diabetes, Obesity and Lifestyle (AusDiab) Study. Diabetes 2008, 57:536–539.

    Article  CAS  PubMed  Google Scholar 

  33. Nguyen TT, Wang JJ, Sharrett AR, et al.: Relationship of retinal vascular caliber with diabetes and retinopathy: the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care 2008, 31:544–49.

    Article  CAS  PubMed  Google Scholar 

  34. Wong TY, Islam FM, Klein R, et al.: Retinal vascular caliber, cardiovascular risk factors, and inflammation: the multi-ethnic study of atherosclerosis (MESA). Invest Ophthalmol Vis Sci 2006, 47:2341–2350.

    Article  PubMed  Google Scholar 

  35. Klein R, Klein BE, Knudtson MD, et al.: Are inflammatory factors related to retinal vessel caliber?: the Beaver Dam Eye Study. Arch Ophthalmol 2006, 124:87–94.

    Article  PubMed  Google Scholar 

  36. Pickup JC, Crook MA: Is type II diabetes mellitus a disease of the innate immune system? Diabetologia 1998, 41:1241–1248.

    Article  CAS  PubMed  Google Scholar 

  37. Fox CS, Larson MG, Leip EP, et al.: Glycemic status and development of kidney disease: the Framingham Heart Study. Diabetes Care 2005, 28:2436–2440.

    Article  PubMed  Google Scholar 

  38. Fox CS, Larson MG, Leip EP, et al.: Predictors of new-onset kidney disease in a community-based population. JAMA 2004, 291:844–850.

    Article  CAS  PubMed  Google Scholar 

  39. Li X-Y, Xu M, Wang J-G, et al.: Serum C-reactive protein (CRP) and microalbuminuria in relation to fasting and 2-hour postload plasma glucose in a Chinese population. Clin Endocrinol 2009, 70:691–697.

    Article  CAS  Google Scholar 

  40. Coutinho M, Gerstein HC, Wang Y, Yusuf S: The relationship between glucose and incident cardiovascular events. A meta-regression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care 1999, 22:1385–1387.

    Article  Google Scholar 

  41. Levitzky YS, Pencina MJ, D’Agostino RB, et al.: Impact of impaired fasting glucose on cardiovascular disease: the Framingham Heart Study. J Am Coll Cardiol 2008, 51:264–270.

    Article  CAS  PubMed  Google Scholar 

  42. The DECODE Study Group: Glucose tolerance and cardiovascular mortality. Arch Intern Med 2001, 161:397–404.

    Article  Google Scholar 

  43. Eschwege E, Richard JL, Thibult N, et al.: Coronary heart disease mortality in relation with diabetes, blood glucose and plasma insulin levels. The Paris Prospective Study, ten years later. Horm Metab Res Suppl 1985, 15:41–46.

    CAS  PubMed  Google Scholar 

  44. Rodriguez BL, Lau N, Burchfiel CM, et al.: Glucose intolerance and 23-year risk of coronary heart disease and total mortality: the Honolulu Heart Program. Diabetes Care 1999, 22:1262–1265.

    Article  CAS  PubMed  Google Scholar 

  45. Fuller JH, Shipley JJ, Rose G, et al.: Coronary heart disease risk and impaired glucose tolerance: the Whitehall Study. Lancet 1980, 1:1373–1376.

    Article  CAS  PubMed  Google Scholar 

  46. Curb JD, Rodriguez BL, Burchel CM, et al.: Sudden death, impaired glucose tolerance and diabetes in Japanese American men. Circulation 1995, 1:2591–2595.

    Google Scholar 

  47. Weyer C, Bogardus C, Pratley RE: Metabolic characteristics of individuals with impaired fasting glucose and/or impaired glucose tolerance. Diabetes 1999, 48:2197–2203.

    Article  CAS  PubMed  Google Scholar 

  48. Nóvoa FJ, Boronat M, Saavedra P, et al.: Differences in cardiovascular risk factors, insulin resistance, and insulin secretion in individuals with normal glucose tolerance and in subjects with impaired glucose regulation: the Telde Study. Diabetes Care 2005, 28:2388–2393.

    Article  PubMed  Google Scholar 

  49. Hu FB, Stampfer MJ, Haffner SM, et al.: Elevated risk of cardiovascular disease prior to clinical diagnosis of type 2 diabetes. Diabetes Care 2002, 25:1129–1134.

    Article  PubMed  Google Scholar 

  50. Young LH, Wackers FJ, Chyun DA, et al.: Cardiac outcomes after screening for asymptomatic coronary artery disease in patients with type 2 diabetes: the DIAD study: a randomized controlled trial. JAMA 2009, 301:1547–1555.

    Article  CAS  PubMed  Google Scholar 

  51. American Diabetes Association: Standards of Medical Care in Diabetes-2009. Diabetes Care 2009, 32(Suppl 1):S13–S61.

    Article  Google Scholar 

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Correspondence to Robert Chilton.

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Oliveros, R.A., Zion, A.S., Rosenberg, Y. et al. Impaired fasting glucose as a treatment target in diabetes management. Curr Cardiol Rep 11, 460–467 (2009). https://doi.org/10.1007/s11886-009-0066-0

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