or increased blood sugar levels is a well-established risk factor for diabetes
and vascular diseases and is associated with high morbidity and mortality.
glucose levels before a person is diagnosed with diabetes mellitus (DM) is
known as "prediabetes" and consists of two subcategories-- impaired fasting
glucose (IFG) and impaired glucose tolerance (IGT). These conditions are classified based on glucose levels in
fasting state and after glucose administration.
increases a person's risk for cardiovascular diseases. IGT has been linked to
microvascular disease, retinopathy (damage to eyes) and microalbuminuria
(protein in the urine due to kidney damage), which are usually conditions
associated with diabetes, while both IFT and IGT are linked to increased risk
Syndrome (MetS) is a cluster of symptoms that predisposes an individual to
cardiovascular events. MetS symptoms
include abdominal obesity, insulin resistance, abnormal levels of fat in the
blood (dyslipidemia) and hypertension. Studies have shown that there is a
higher prevalence of MetS (85%) in type 2 DM patients when compared to the
general population (24%).
aim of this study was to assess the significance of OGTT results in predicting
the development of DM and cardiovascular disease (CVD) in patients with or
without MetS, in a population at risk for type 2 DM.
The study was conducted on 148
patients regularly attending the
primary care unit of a hospital.
screening, the fasting plasma glucose (FPG) values in the subjects were between
100 - 125 mg/dl. The subjects
fulfilled one or more criteria as defined by the American Diabetes Association
to undergo screening. These criteria
included age ≥45 years, body mass
index (BMI) ≥25 kg/m2, presence of hypertension, dyslipidemia, polycystic
ovarian syndrome, family history of type 2 DM in a 1st degree relative,
personal history of gestational DM or fetal macrosomia, IFG or IGT and history
of cardiovascular disease.
subjects had to go through an OGTT, between January and December 2005; and then
between January and February 2010, their clinical charts were checked to
evaluate progress, if any, to DM or CVD.
The following were the parameters evaluated
• Clinical -- age, gender, ethnicity, family history of
type 2 DM, history of hypertension, blood pressure levels, smoking and physical
Anthropometrical --weight, height, and
Laboratory data --- fasting glucose,
fasting OGTT and after 2 h, post-challenge glucose levels,
creatinine, and lipid profile.
total of 148 patients formed the subjects of the study. The OGTT results
revealed that, 29% of the patients had normal blood sugar, 28% had IFG, 26% had
IGT and 17% had DM. The prevalence of hypertension was greater in those with
DM while the BMI was higher in the IGT
group, when compared with the normal group.
was observed that during the observational period, DM did not develop in any
patient with normal OGTT. However, 5 persons (16%) with IFG an d28% with IGT
expected, MetS individuals had a higher incidence of DM, in comparison with
those without metabolic syndrome. However, the glucose status of an individual
was a better predictor of DM development, as no patient with normal OGTT
developed DM, irrespective of their status regarding metabolic syndrome.
of diabetes at the baseline was the major determinant of developing
cardiovascular disease. Participants
who developed CVD had both diabetes and metabolic syndrome.
In the current
study, the glucose tolerance status, regardless of MetS status, was a better
indicator of DM and CVD development than metabolic syndrome.
"Glucose tolerance status is a better predictor of
diabetes and cardiovascular outcomes than metabolic syndrome: a prospective
cohort study": Camila Furtado de Souza et al; Diabetology and Metabolic