medwireNews: A random blood glucose test in people without diabetes may provide a good indication of who has an increased risk for developing cardiovascular disease (CVD) over the subsequent decade, a study suggests.
“The current study emphasizes that the risk of cardiovascular disease starts before the diagnostic cut-off point for diabetes and that screening for casual blood glucose levels, also among those who are not suspected of having diabetes, is important,” say the researchers.
Hilde Kristin Refvik Riise (Western Norway University of Applied Sciences, Bergen) and colleagues assessed data from 159,731 participants of the Cohort of Norway survey in 1994 to 2003, who did not have a diagnosis of diabetes at the time of the survey. The majority of these people – around 82% – had a normal casual blood glucose level (ie, taken at random so not necessarily fasting) of less than 7.8 mmol/L (140 mg/dL), while 1–2% were classed as borderline (7.8–11.0 mmol/L; 140–200 mg/dL), and less than 0.5% had a high glucose level (>11.0 mmol/L; 200 mg/dL).
People with high glucose levels were older and less educated than those with normal levels, and they had higher cholesterol and blood pressure levels and were more likely to be obese.
Compared with people with normal casual glucose levels, those with borderline or high levels had significantly increased risks for stroke, cardiovascular mortality, and all-cause mortality during up to 12.7 years of follow-up, after accounting for age, sex, cholesterol levels, systolic blood pressure, BMI, time since last meal, smoking status, education, and marital status.
The risk increase was larger for those with high glucose levels than those with borderline levels. For example, cardiovascular mortality was increased by 90% and 29% in people with high and borderline levels, respectively.
There was also a numerically increased risk for myocardial infarction, but this did not attain statistical significance for either group.
However, when the researchers analyzed glucose levels as a continuous variable, they found a significant association with all endpoints, with each 1 mmol/L increase associated with a significant 3%, 5%, 7%, and 6% increase in the risk for myocardial infarction, stroke, cardiovascular mortality, and all-cause mortality, respectively.
“Thus, the use of casual glucose measurements in general practice might be an important marker for further follow-up to identify people at risk of diabetes and CVD many years before diagnosis,” write the researchers in BMJ Open Diabetes Research & Care.
“Such early identification of high-risk individuals can delay the development of diabetes and its complications.”
The risk increases for these endpoints associated with higher glucose tended to be larger among women than men, although not significantly so. There was “no clear pattern” for risk differences in younger versus older people, reports the team.
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