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Isolated post-challenge hyperglycaemia confirmed as a risk factor for mortality.
J E Shaw1, A M Hodge, M de Courten
1International Diabetes Institute, Melbourne, Australia.
Diabetologia
|August 14, 1999
Summary
Isolated post-challenge hyperglycemia, identified by a 2-hour glucose test, significantly increases mortality risk. This condition, common in the population, doubles the risk of death and requires consideration in diabetes screening programs.
Area of Science:
- Endocrinology
- Epidemiology
- Public Health
Background:
- Isolated post-challenge hyperglycemia is defined by elevated 2-hour post-challenge plasma glucose levels (> /= 11.1 mmol/l) with normal fasting plasma glucose (< 7.0 mmol/l).
- The association between this specific hyperglycemic state and overall mortality remains incompletely understood.
Purpose of the Study:
- To investigate the relationship between isolated post-challenge hyperglycemia and all-cause, cardiovascular, and cancer mortality.
- To assess the public health implications of isolated post-challenge hyperglycemia in diverse populations.
Main Methods:
- Pooled data from three population-based longitudinal studies conducted in Mauritius, Fiji, and Nauru.
- Mortality rates were analyzed in 9179 participants followed for 5 to 12 years using Cox proportional hazards models.
Main Results:
- Isolated post-challenge hyperglycemia was identified in 243 individuals (31% of newly diagnosed diabetes cases).
- Participants with isolated post-challenge hyperglycemia exhibited a significantly increased risk of all-cause mortality (men: 2.7, women: 2.0) and cardiovascular mortality (men: 2.3, women: 2.6) compared to those without diabetes.
- Men with isolated post-challenge hyperglycemia showed a particularly high risk of cancer mortality (8.0).
Conclusions:
- Isolated post-challenge hyperglycemia is a prevalent condition detectable only through 2-hour glucose measurements.
- This hyperglycemic state is associated with at least a twofold increased risk of mortality.
- Current screening programs relying solely on fasting glucose may miss individuals at elevated risk, necessitating a re-evaluation of screening strategies.