Comparison of glucose tolerance categories according to World Health Organization and American Diabetes Association diagnostic criteria in a population-based study in Brazil. The Japanese-Brazilian Diabetes Study Group.

Gimeno, Suely Godoy Agostinho; Ferreira, Sandra Roberta Gouvêa; Franco, Laércio Joel; Iunes, Magid

doi:10.2337/diacare.21.11.1889

Cited by 56 publications

(46 citation statements)

References 5 publications

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“…and increased basal hepatic glucose output, whereas subjects with isolated post-load hyperglycaemia have decreased peripheral insulin sensitivity. 8,12,15 There is evidence that such metabolic differences may be relevant from a clinical standpoint: patients with post-load hyperglycaemia have worse cardiovascular risk profiles 10,24 and increased death risks.…”

Section: Discussionmentioning

confidence: 99%

WHO and ADA criteria for the diagnosis of diabetes mellitus in relation to body mass index. Insulin sensitivity and secretion in resulting subcategories of glucose tolerance

et al. 2002

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OBJECTIVE:To determine the influence of body mass index (BMI) on agreement between the American Diabetes Association (ADA) and the new World Health Organization diagnostic criteria for the diagnosis of diabetes mellitus and to investigate the metabolic profile of the resulting subcategories. DESIGN: Cross-sectional study SUBJECTS: A total of 3018 subjects with no previous history of diabetes and fasting glucose < 7.8 mmol=l, with a wide range of BMIs. MEASUREMENTS: (1) Prevalence of impaired glucose regulation (IGR) and diabetes (DM) according to ADA and WHO diagnostic criteria; (2) basal and post-load insulin sensitivity and secretion, calculated on the basis of data derived from an oral glucose tolerance test (OGTT). RESULTS: The diagnosis according to the two classifications was concordant in 2490 subjects, discordant in 528 (452 were identified as impaired glucose tolerance (IGT) and 76 as DM only by means of OGTT). The disagreement increased with increasing BMI, being as high as 25.3% in subjects with BMI ! 35 kg=m 2 . Subjects with isolated fasting hyperglycaemia were mainly characterised by reduced insulin sensitivity and secretion in the basal state, but normal first-phase insulin secretion and moderately reduced insulin sensitivity after glucose challenge. Subjects with isolated 2 h hyperglycaemia were mainly characterised by normal basal insulin secretion and by a marked insulin resistance associated with a blunted first-phase insulin secretion after the glucose load. CONCLUSIONS:The disagreement between ADA and WHO classifications is particularly relevant in obesity, making OGTT mandatory in these subjects. Different pathogenic mechanisms are involved in isolated fasting or post-load hyperglycaemia, possibly related to a different site of insulin resistance (hepatic vs peripheral), and=or to a different disregulation of insulin secretion (basal vs post-load). A correct identification of the underlying mechanism(s) is the rationale for future studies to detect the effectiveness of different pharmacological or behavioural approaches.

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Section: Discussionmentioning

confidence: 99%

WHO and ADA criteria for the diagnosis of diabetes mellitus in relation to body mass index. Insulin sensitivity and secretion in resulting subcategories of glucose tolerance

et al. 2002

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“…There has been a protracted and controversial debate on this point and it is summarized in detail elsewhere [65,76,77]. What is not disputed is that the chronic hyperglycaemia of diabetes is associated with long-term damage and dysfunction of various organs, especially the retina, kidney, nerves and cardiovascular system [35, 76,77].…”

Section: Screening For Diabetesmentioning

confidence: 99%

Diabetes epidemiology as a tool to trigger diabetes research and care

1999

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“…Diabetes and glucose intolerance have been established as major risk factors for cardiovascular disease and total mortality in the Honolulu Heart Program and other middle-aged populations (3)(4)(5)(6)(7)(8)(9). During the last few years, several reports have compared the prevalence of diabetes and cardiovascular risk factors using the World Health Organization (WHO) 1998 (10) and American Diabetes Association (ADA) 1997 (11) classifications (12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Most of these studies have shown that substantially more subjects with diabetes are identified when the 2-h postload glucose is used in addition to the fasting glucose and suggest that there is value in using the postload measurement.…”

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confidence: 99%

The American Diabetes Association and World Health Organization Classifications for Diabetes

et al. 2002

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OBJECTIVE -To compare the prevalence of diabetes according to the American Diabetes Association (ADA) and World Health Organization (WHO) classifications in a sample of elderly Japanese-American men; to examine the association with total and cardiovascular mortality by diabetes status using both classifications; and to determine whether the fasting or 2-h glucose measurement is a stronger predictor of adverse outcomes. RESEARCH DESIGN AND METHODS -Examinationsgiven from 1991 to 1993 in the Honolulu Heart Program were used as baseline for these analyses. Subjects were 71-93 years of age at that time and were followed for total and cardiovascular disease mortality for up to 7 years.RESULTS -A total of ϳ66% of individuals who had diabetes by WHO criteria were missed when the ADA definition was used. The relative risks of total and cardiovascular mortality for those with versus those without diabetes were similar for both definitions; however, when fasting and postload glucose measures were analyzed as continuous variables, the 2-h measurement was a superior predictor and was independent of fasting glucose. In contrast, fasting glucose was not an independent predictor of these outcomes in the presence of the 2-h measurement.CONCLUSIONS -The prevalence of glucose metabolism abnormalities was very high among elderly Japanese-American men. The WHO classification was superior to the ADA classification in identification of subjects at high risk for adverse outcomes. Therefore, we conclude that the 2-h glucose measurement is valuable and should be retained in epidemiologic studies. Diabetes Care 25:951-955, 2002

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Comparison of glucose tolerance categories according to World Health Organization and American Diabetes Association diagnostic criteria in a population-based study in Brazil. The Japanese-Brazilian Diabetes Study Group.

Cited by 56 publications

References 5 publications

WHO and ADA criteria for the diagnosis of diabetes mellitus in relation to body mass index. Insulin sensitivity and secretion in resulting subcategories of glucose tolerance

WHO and ADA criteria for the diagnosis of diabetes mellitus in relation to body mass index. Insulin sensitivity and secretion in resulting subcategories of glucose tolerance

Diabetes epidemiology as a tool to trigger diabetes research and care

The American Diabetes Association and World Health Organization Classifications for Diabetes

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