Undiagnosed Glucose Intolerance in the Community: the Isle of Ely Diabetes Project

Williams, D. R. R.; Wareham, NJ; Brown, D. C.; Byrne, Christopher D.; Clark, P.; Cox, Brian D.; Cox, Lorna; Day, Nicholas E.; Hales, C. N.; Palmer, C.; Shackleton, J. R.; Wang, T. W. M.

doi:10.1111/j.1464-5491.1995.tb02058.x

Cited by 147 publications

(129 citation statements)

References 23 publications

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“…Furthermore, the more insulin resistant GDM subjects had the greater decrease in adult height, resembling the Type II group. Our results thus agree with previous reports concerning Type II [1,2]. It could be speculated that the subset of GDM who will eventually develop permanent Type II are found among those whose stature is shorter than expected.…”

Section: Discussionsupporting

confidence: 83%

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Decreased stature in gestational diabetes mellitus

et al. 1998

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Adult height is determined by genetic and acquired factors. It has been reported that middle-aged patients with impaired glucose tolerance or Type II (non-insulin-dependent) diabetes mellitus are short compared with normal control subjects [1,2]. In middle-aged diabetic patients it is, however, difficult to exclude the effect of ageing and long standing metabolic effects on height.There is a lot of evidence that Type II diabetes and gestational diabetes mellitus (GDM) are both manifestations of the same pathophysiological process, which includes insulin resistance and impaired betacell function [3,4]. Gestational diabetes mellitus is a heterogeneous disorder; it is characterised by hyperglycaemia or glucose intolerance with onset or first recognition during pregnancy. This is usually temporary and affects a younger group of people who have completed their skeletal growth and have not yet suffered age-related bone loss [5]. We considered that pregnant women with various degrees of glucose Diabetologia (1998) Summary Short stature has been associated with various degrees of abnormal glucose tolerance in middle-aged people, where the effects of age and metabolic control would be difficult to exclude. We chose to examine body stature in women with gestational diabetes mellitus (GDM), a prediabetic state affecting a young group of people. A sample of 2772 Greek pregnant women, referred for GDM screening was examined. After a 100-g oral glucose tolerance test, 1787 women were classified as normal (N), 300 women were found with one abnormal glucose value (OAV) and 685 women with GDM. Basal insulin resistance was calculated in 640 women by homeostasis model assessment. In addition, 51 pregnant women with pre-existing Type II (non-insulin-dependent) diabetes mellitus and 109 with pre-existing Type I (insulin-dependent) diabetes mellitus were included in the study. There was a gradual decrease in mean height (cm) as glucose intolerance became more severe: N: 161.0 ± 6.2, OAV:160.2 ± 6.1, GDM:158.7 ± 6.3, Type II diabetes 158.2 ± 7.0 (p < 0.001, analysis of variance]. Height in Type I diabetes (160.1 ± 5.9) did not differ from the normal group. The difference in height between the normal and GDM groups remained (p < 0.001) when body weight, age, birth before or after 1960 and educational status were also taken into account. An independent correlation was also found between height and insulin resistance (n = 640) adjusted for the above mentioned variables. In conclusion, short stature appears to be associated with glucose intolerance as an independent variable, even when this intolerance is both mild and temporary. The previously unrecognised independent association of stature with basal insulin resistance merits further investigation. [Diabetologia (1998) 41: 997± 1001]

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Section: Discussionsupporting

confidence: 83%

“…It has been reported that middle-aged patients with impaired glucose tolerance or Type II (non-insulin-dependent) diabetes mellitus are short compared with normal control subjects [1,2]. In middle-aged diabetic patients it is, however, difficult to exclude the effect of ageing and long standing metabolic effects on height.…”

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confidence: 99%

Decreased stature in gestational diabetes mellitus

et al. 1998

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“…The group with HbA 1c Ͼ7% largely comprises people with undiagnosed type 2 diabetes. Undiagnosed type 2 diabetes is common 20 and may be present for several years before clinical diagnosis, 21 and individuals are at increased risk of cardiovascular events during this time. 22 Indeed, people with undiagnosed diabetes may have a higher cardiovascular risk than those with …”

Section: Discussionmentioning

confidence: 99%

Glycated Hemoglobin and Risk of Stroke in People Without Known Diabetes in the European Prospective Investigation Into Cancer (EPIC)–Norfolk Prospective Population Study

Myint

Sinha

Wareham

et al. 2007

Stroke

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Background and Purpose-Diabetes is a well-recognized risk factor for cardiovascular diseases. Evidence suggests a linear relationship between blood glucose and myocardial infarction, even at blood glucose concentrations below the threshold for diabetes. The relationship between blood glucose concentration and stroke in people without established diabetes has been studied less extensively. Methods-We examined the prospective relationship between usual blood glucose level measured by glycohemoglobin (HbA 1c ) concentrations and incident stroke risk in a general population without diabetes and stroke at baseline assessment in the European Prospective Investigation Into Cancer (EPIC)-Norfolk. Results-A total of 10 489 men and women aged 40 to 79 years at baseline were followed up (meanϭ8.5 years). Mean age, systolic and diastolic blood pressure, body mass index, total cholesterol, triglycerides, and proportion of current smokers increased and mean high-density lipoprotein cholesterol decreased with increasing HbA 1c concentrations. There were 164 incident strokes identified over 88 652 person-years. After adjustment for age, sex, and cardiovascular risk factors, the relative risks (95% CI) for stroke for participants with HbA 1c concentrations 5% to 5.4%, 5.5% to 6.9%, and Ն7% were 0.78 (0.50 to 1.22), 0.83 (0.54 to 1.27), and 2.83 (1.40 to 5.74), respectively, compared with those with HbA 1c Ͻ5%. Conclusions-In contrast to the continuous linear relationship observed between blood glucose level and coronary heart disease risk, the association between blood glucose level and stroke risk appears to be more consistent with a threshold relationship. These observations may give insights into the differing pathogenesis of different vascular diseases. (Stroke.

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“…Both diseases are burdensome and costly for the individual as well as for society. For every individual with diagnosed type 2 diabetes there is another one with undiagnosed diabetes and an additional two with a high risk of developing diabetes based on the presence of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) [5][6][7][8]. The number of individuals without diabetes, but with an undetected high risk of developing cardiovascular disease, is even higher [9].…”

Section: Introductionmentioning

confidence: 99%

HbA1c and cardiovascular risk score identify people who may benefit from preventive interventions: a 7 year follow-up of a high-risk screening programme for diabetes in primary care (ADDITION), Denmark

et al. 2011

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Aims/hypothesis The measurement of HbA 1c is suggested as a diagnostic test for diabetes. Screening for diabetes also identifies individuals with elevated cardiovascular risk but who are free of diabetes. This study aims to assess whether screening by HbA 1c or glucose measures alone, or in combination with a cardiovascular risk assessment, identifies people who may benefit from preventive interventions, i.e. people with screen detected diabetes and people belonging to groups with excess mortality, during a median follow-up of 7 years.

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Undiagnosed Glucose Intolerance in the Community: the Isle of Ely Diabetes Project

Cited by 147 publications

References 23 publications

Decreased stature in gestational diabetes mellitus

Decreased stature in gestational diabetes mellitus

Glycated Hemoglobin and Risk of Stroke in People Without Known Diabetes in the European Prospective Investigation Into Cancer (EPIC)–Norfolk Prospective Population Study

HbA1c and cardiovascular risk score identify people who may benefit from preventive interventions: a 7 year follow-up of a high-risk screening programme for diabetes in primary care (ADDITION), Denmark

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