Progression to clinically diagnosed and treated diabetes from impaired glucose tolerance and impaired fasting glycaemia

  1. Q. Qiao1,*,
  2. J. Lindström1,
  3. T. T. Valle1,
  4. J. Tuomilehto1,2

Article first published online: 24 NOV 2003

DOI: 10.1111/j.1464-5491.2003.01054.x

Issue

Diabetic Medicine

Diabetic Medicine

Volume 20, Issue 12, pages 1027–1033, December 2003

Additional Information

How to Cite

Qiao, Q., Lindström, J., Valle, T. T. and Tuomilehto, J. (2003), Progression to clinically diagnosed and treated diabetes from impaired glucose tolerance and impaired fasting glycaemia. Diabetic Medicine, 20: 1027–1033. doi: 10.1111/j.1464-5491.2003.01054.x

Author Information

  1. 1

    Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, National Public Health Institute and

  2. 2

    Department of Public Health, University of Helsinki, Helsinki, Finland

*Correspondence to: Dr Qing Qiao, Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, National Public Health Institute, Mannerheimintie 166, KTTL, 6 kr, FIN-00300 Helsinki, Finland. E-mail: qing.qiao@ktl.fi

Publication History

  1. Issue published online: 24 NOV 2003
  2. Article first published online: 24 NOV 2003
  3. Accepted 30 April 2003

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Keywords:

  • area under ROC curve;
  • hazard ratio;
  • impaired fasting glycemia;
  • impaired glucose tolerance;
  • incidence of diabetes;
  • risk predictor;
  • ROC curve

Abstract

Aims  To evaluate the risk of diabetes in subjects with impaired fasting glycemia (IFG) as compared with impaired glucose tolerance (IGT) and normal glucose tolerance.

Methods  Men (1223) and women (1370) aged 45–64 years and free of diabetes at baseline were followed-up for 10 years, with 26 737 person years accumulated. The incident diabetic cases were identified through the national Drug Register and the Hospital Discharge Register.

Results  During the 10 years of follow-up, 53 (4.3%) men and 47 (3.4%) women developed diabetes. IFG alone defined 22 (15.5/1000 person years) diabetic cases, which was higher than for subjects with normal fasting glucose. Subjects with isolated IGT identified an additional 34 cases (155% more) which could not be defined by IFG alone. The area under the ROC curve was larger for 2-h glucose (0.77, 95% CI 0.72–0.82) than for fasting glucose (0.65, 0.58–0.71). The multivariate adjusted Cox hazard ratio was higher for isolated IGT (3.9, 95% CI 2.4–6.2) than for isolated IFG (2.3, 0.9–5.7) as compared with subjects with neither IFG nor IGT.

Conclusion  Both IFG and IGT are risk predictors for diabetes, but IGT defines a much larger target population for prevention.

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