Document Detail


A large proportion of prediabetes and diabetes goes undiagnosed when only fasting plasma glucose and/or HbA1c are measured in overweight or obese patients.
MedLine Citation:
PMID:  20627649     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
E Cosson; E Hamo-Tchatchouang; I Banu; M-T Nguyen; S Chiheb; H Ba; P Valensi
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetes & metabolism     Volume:  36     ISSN:  1878-1780     ISO Abbreviation:  Diabetes Metab.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-24     Completed Date:  2010-11-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607599     Medline TA:  Diabetes Metab     Country:  France    
Other Details:
Languages:  eng     Pagination:  312-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Masson SAS. All rights reserved.
Affiliation:
Department of Endocrinology, Diabetology, Nutrition, Jean-Verdier Hospital, AP-HP, avenue du 14 Juillet, 93143 Bondy cedex, France.
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MeSH Terms
Descriptor/Qualifier:
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:
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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