| A large proportion of prediabetes and diabetes goes undiagnosed when only fasting plasma glucose and/or HbA1c are measured in overweight or obese patients. | |
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MedLine Citation:
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PMID: 20627649 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: The purposes of the study were to determine the prevalence of unrecognized dysglycaemia in overweight (body mass index [BMI] 25-29.9 kg/m(2)) and obese (BMI ≥30 kg/m(2)) patients, to assess the extent to which measures of fasting plasma glucose (FPG) and/or HbA(1c), compared with oral glucose tolerance tests (OGTTs), misdiagnose dysglycaemia, and to determine the factors associated with an isolated abnormal post-OGTT glucose value. METHODS: OGTT was performed and HbA(1c) was measured in 1283 inpatients with BMI scores ≥ 25 kg/m(2) and no history of dysglycaemia. RESULTS: Prediabetes was found in 257 (20.0%) subjects (197 with impaired glucose tolerance, 29 with impaired fasting glucose, 31 with both) and diabetes in 77 (6.0%), including 22 with FPG ≥ 7 mmol/L (WHO definition). The sensitivity of FPG >6 mmol/L, FPG >5.5 mmol/L, HbA(1c) ≥ 6% and the recommendations of the French National Agency of Accreditation and Evaluation in Health Care (ANAES) to identify patients with abnormal OGTTs was 29.9, 41.3, 36.8 and 15.6%, respectively. The factors that were independently associated with diabetes in obese women with FPG <7 mmol/L were age (per 10 years: OR 1.54 [1.00-2.11]; P=0.049) and FPG (OR 6.1 [1.4-30.0]; P=0.014), whereas age (OR 1.26 [1.09-1.44]; P<0.01) and waist circumference (per 10 cm: OR 1.17 [1.01-1.33]; P<0.05) were independently associated with dysglycaemia in obese women with FPG <6.1 mmol/L. CONCLUSION: In overweight and obese patients: dysglycaemia is commonly seen; FPG alone, compared with OGTT, failed to diagnose 70% of dysglycaemia cases; FPG >5.5 mmol/L and HbA(1c) ≥ 6.0% are not necessarily substitutes for OGTT; and older age and larger waist circumference should be used to select those obese women with normal FPG who might further benefit from OGTTs to diagnose dysglycaemia. |
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Authors:
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E Cosson; E Hamo-Tchatchouang; I Banu; M-T Nguyen; S Chiheb; H Ba; P Valensi |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Diabetes & metabolism Volume: 36 ISSN: 1878-1780 ISO Abbreviation: Diabetes Metab. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-24 Completed Date: 2010-11-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9607599 Medline TA: Diabetes Metab Country: France |
Other Details:
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Languages: eng Pagination: 312-8 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Masson SAS. All rights reserved. |
Affiliation:
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Department of Endocrinology, Diabetology, Nutrition, Jean-Verdier Hospital, AP-HP, avenue du 14 Juillet, 93143 Bondy cedex, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Aged Biological Markers / blood Blood Glucose / metabolism* Body Mass Index Comorbidity Diabetes Mellitus / blood, diagnosis*, epidemiology, etiology Fasting Female France / epidemiology Glucose Tolerance Test* Hemoglobin A, Glycosylated / metabolism* Humans Hyperglycemia / blood, diagnosis Male Middle Aged Obesity / complications* Overweight / complications* Prediabetic State / blood, diagnosis*, epidemiology, etiology Predictive Value of Tests Retrospective Studies Socioeconomic Factors Waist Circumference |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Blood Glucose; 0/Hemoglobin A, Glycosylated |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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