Prevalence and determinants of diabetes mellitus and glucose intolerance in a Canarian Caucasian population – comparison of the 1997 ADA and the 1985 WHO criteria. The Guía Study.

Pablos-Velasco, Pedro de; Martínez-Martín, Francisco Javier; Rodríguez-Pérez, Fátima; Anía, Basilio J.; Losada, Antonio; Betancor, P.

doi:10.1046/j.1464-5491.2001.00451.x

Cited by 64 publications

(27 citation statements)

References 19 publications

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“…The results in the present study, in which IFG and IGT were employed in healthy Japanese subjects, are consistent with the results of these previous reports. However, several studies have reported (using the 1997 ADA criteria) that both IFG and IGT were associated with an increased prevalence of cardiovascular risk factors (38)(39)(40). Using the 2003 ADA criteria for IFG, Kim et al (41) did not observe an increased prevalence of cardiovascular risk factors.…”

Section: Discussionmentioning

confidence: 98%

Differences in Insulin Action and Secretion, Plasma Lipids and Blood Pressure Levels between Impaired Fasting Glucose and Impaired Glucose Tolerance in Japanese Subjects

et al. 2008

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Section: Discussionmentioning

confidence: 98%

Differences in Insulin Action and Secretion, Plasma Lipids and Blood Pressure Levels between Impaired Fasting Glucose and Impaired Glucose Tolerance in Japanese Subjects

et al. 2008

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“…This is consistent with the observations of other comparisons of the ADA to WHO criteria. For example, the 10 most recent studies we identified in which the ADA criteria were compared with other criteria, the sensitivity ranged from as low as 31% in a an obese French population to as high as 79% in Canarian Caucasians (13,14,(25)(26)(27)(28)(29)(30)(31)(32) (Table 6). We identified two cut-off values (fasting plasma glucose Ն5.7 mmol/l and an HbA 1c Ն5.9%) that minimize the number of false positives and false negatives.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Strategies to Detect Glucose Intolerance in a Multiethnic Population

et al. 2003

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OBJECTIVE -Identifying individuals who have elevated glucose concentrations is important for clinicians so that preventive strategies can be invoked, and it is useful for researchers who study associations between elevated glucose and adverse health outcomes. These methods should be applicable worldwide across different ethnic groups. Therefore, the objective of our analysis was to determine whether using the fasting glucose and HbA 1c together could improve the classification of individuals with impaired glucose tolerance and diabetes in a multiethnic cohort randomly assembled in Canada.RESEARCH DESIGN AND METHODS -We determined the optimum diagnostic criteria to identify people with abnormal glucose tolerance using fasting plasma glucose, 2-h post-glucose load plasma glucose, and HbA 1c in 936 Canadians of South Asian, Chinese, and European descent.RESULTS -The sensitivity of the American Diabetes Association (ADA) criteria to diagnose diabetes compared with the World Health Organization definitions was poor at 48.3% (95% confidence interval [CI] 35.7-61.0). Using a receiver operator characteristic curve, the optimum combined cut-point using fasting glucose and HbA 1c to diagnose diabetes was a fasting glucose Ն5.7 mmol/l and an HbA 1c Ն5.9%. These cut-points were associated with a sensitivity and specificity of 71.7% (60.3-83.1) and 95.0% (93.5-96.4), respectively, a positive likelihood ratio (LR) of 14.3 (9.6 -19.0), and a negative LR of 0.3 (0.2-0.4). Significant ethnic variation in the sensitivity and specificity of this approach was observed: 47.4% (24.9 -69.8) and 97.6% (95.9 -99.4) among Europeans, 78.6% (57.1-100) and 95.9% (93.6 -98.2) among Chinese, and 85.2% (71.8 -98.6) and 91.3% (88.1-94.6) among South Asians, respectively. Participants with impaired glucose tolerance could not be identified reliably using the fasting glucose or HbA 1c alone or in combination.CONCLUSIONS -The sensitivity of the ADA criteria to diagnose diabetes is low, and there is substantial variation between ethnic groups. Fasting glucose and HbA 1c may be used together to improve the identification of individuals who have diabetes, allowing clinicians to streamline the use of the oral glucose tolerance test. Diabetes Care 26:290 -296, 2003I ndividuals with diabetes have an increased risk of developing significant end-organ damage, such as retinopathy, cataracts, nephropathy, neuropathy, and cardiovascular disease (CVD) (1,2). Tight glucose control has been demonstrated to attenuate many of these complications in patients with both type 1 and type 2 diabetes. Individuals with dysglycemia (i.e., elevated glucose levels below the diabetic cut-offs) also have an increased risk of diabetes, CVD, and death (3,4). Although there are no proven pharmacological therapies indicated for this group, some are being evaluated, and diet and lifestyle changes such as weight loss and exercise are effective (5,6). Nevertheless, identifying individuals who have dysglycemia (from normal glucose tolerance to frank diabetes) is important for clinic...

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“…De Pablos-Velasco et al (19) showed that in a Caucasian population, both IFG and IGT had higher prevalence of certain cardiovascular risk factors compared with normal glucose tolerance; and at the same time, IFG was associated with higher total-to-HDL cholesterol ratio than IGT. Among a Swedish population, Larsson et al (20) did not find differences between IFG and IGT, whereas IFG plus IGT showed higher BMI, cholesterol, and triglyceride values than IGT and higher triglyceride values than IFG.…”

Section: Research Design and Methods -This Research Was Conducted In mentioning

confidence: 99%

Impaired Fasting Glucose and Impaired Glucose Tolerance in Women With Prior Gestational Diabetes Are Associated With a Different Cardiovascular Profile

et al. 2003

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OBJECTIVE -The purpose of this study was to investigate the association of cardiovascular risk factors to impaired glucose tolerance (IGT) and to impaired fasting glucose (IFG) in women with prior gestational diabetes mellitus (GDM).RESEARCH DESIGN AND METHODS -We studied 838 women with prior GDM. Postpartum glucose tolerance status was classified as normal, IFG, IGT, IFG plus IGT, and diabetes according to the World Health Organization criteria. Postpartum BMI, waist circumference, blood pressure, triglyceride, cholesterol, and HDL cholesterol were assessed.RESULTS -BMI and blood pressure were significantly higher in women with IFG than in women with normal glucose status. BMI and waist circumference were significantly higher in women with IFG plus IGT than in women with normal glucose status. No differences were observed between women with IGT and normal glucose status. The prevalence of hypertension and obesity was significantly increased in IFG compared with normal glucose status. The prevalence of obesity and abnormal lipids was significantly increased in IFG plus IGT compared with normal glucose status. IGT showed no increased prevalence of cardiovascular risk factors.CONCLUSIONS -Traditional cardiovascular risk factors have a stronger association with isolated IFG than with isolated IGT in women with prior GDM. Diabetes Care 26:2318 -2322, 2003W omen with gestational diabetes mellitus (GDM) are at an increased risk for the development of diabetes (usually type 2) after pregnancy (1). Likewise, women with prior GDM, when compared with women with no history of GDM, are found to have higher BMI (2), higher blood pressure (3,4), and an altered lipid profile with increased LDL cholesterol and triglyceride levels and decreased HDL cholesterol levels (2-4). Furthermore, changes in endothelial function (5) and increased levels of adhesion molecules (6), together with a higher prevalence of microalbuminuria (7), abnormal electrocardiograms, and cardiovascular events (3) are observed in women with prior GDM. This spectrum of abnormalities is associated with insulin resistance even in situations of normal glucose tolerance (8,9).On the other hand, the establishment of two intermediate categories between normal glucose homeostasis and diabetes (impaired glucose tolerance [IGT] and impaired fasting glucose [IFG]) (10) has raised concern in which of these disturbances has a major role in predicting the development of type 2 diabetes or cardiovascular disease.The aim of this study was to investigate the association of cardiovascular risk factors to IGT and IFG in the postpartum evaluation of women with GDM. RESEARCH DESIGN AND METHODS -This research was conducted in the Diabetes and PregnancyUnit at the University Hospital La Paz in Madrid between 1992 and 2000. We studied 838 Caucasian women (mean age 32.4 Ϯ 4.6 years; mean parity 1.8 Ϯ 0.9) with singleton gestations complicated by GDM and who attended the initial postpartum assessment (3-6 months after delivery) when lactation was concluded. The total number of women...

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Prevalence and determinants of diabetes mellitus and glucose intolerance in a Canarian Caucasian population – comparison of the 1997 ADA and the 1985 WHO criteria. The Guía Study.

Cited by 64 publications

References 19 publications

Differences in Insulin Action and Secretion, Plasma Lipids and Blood Pressure Levels between Impaired Fasting Glucose and Impaired Glucose Tolerance in Japanese Subjects

Differences in Insulin Action and Secretion, Plasma Lipids and Blood Pressure Levels between Impaired Fasting Glucose and Impaired Glucose Tolerance in Japanese Subjects

Diagnostic Strategies to Detect Glucose Intolerance in a Multiethnic Population

Impaired Fasting Glucose and Impaired Glucose Tolerance in Women With Prior Gestational Diabetes Are Associated With a Different Cardiovascular Profile

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