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Hyperglycaemia: link to excess mortality.

E Eschwège1, B Balkau

  • 1INSERM Unit 258, Villejuif, France.

International Journal of Clinical Practice. Supplement
|October 12, 2001
PubMed
Summary
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Diagnosing diabetes using 2-hour post-challenge glucose levels, not just fasting glucose, significantly predicts premature death risk. Both fasting and 2-hour glucose levels are linked to increased mortality from all causes.

Area of Science:

  • Endocrinology
  • Epidemiology
  • Public Health

Background:

  • Asymptomatic diabetes is characterized by chronic hyperglycemia.
  • Current diagnostic criteria primarily rely on fasting hyperglycemia, as 2-hour post-challenge glucose measurements are less commonly used.
  • Previous research has explored the association between different diagnostic definitions of diabetes and mortality risk.

Purpose of the Study:

  • To evaluate the impact of different diagnostic definitions of diabetes, specifically fasting versus 2-hour post-challenge glucose levels, on the risk of premature death.
  • To compare the predictive value of fasting hyperglycemia and 2-hour post-challenge hyperglycemia for all-cause and cardiovascular mortality.

Main Methods:

  • Meta-analysis of studies from the Diabetes Epidemiology: Collaborative Analysis of Diagnostic Criteria in Europe (DECODE) project.

Related Experiment Videos

  • Analysis of 20-year follow-up data from the Whitehall, Paris, and Helsinki studies.
  • Examination of mortality risks associated with different glucose level distributions.

    • Main Results:

    • The 2-hour post-challenge glucose level, but not fasting glucose, independently predicted all-cause mortality in the DECODE study.
    • Increasing 2-hour post-challenge glucose levels showed a significant relative risk for cardiovascular mortality, unlike fasting glucose.
    • Men with higher 2-hour post-challenge glucose levels had a significantly higher risk of all-cause mortality.
    • Isolated 2-hour post-challenge hyperglycemia was associated with the highest all-cause mortality in the Paris Prospective study.
    • J-shaped relationships were observed between both fasting and 2-hour glucose levels and all-cause, cardiovascular, and cancer mortalities in men without known diabetes.

    Conclusions:

    • Hyperglycemia, whether defined by fasting or 2-hour post-challenge glucose levels, is a risk factor for premature death.
    • The 2-hour post-challenge glucose measurement appears to be a stronger independent predictor of mortality risk compared to fasting glucose.
    • Rethinking diagnostic criteria for diabetes to include 2-hour post-challenge glucose levels may improve risk stratification for premature mortality.