medwireNews: A meta-analysis highlights the increased risk of future cardiovascular disease and mortality among people with prediabetes.
“Importantly, we observed increased risks when fasting plasma glucose was as low as 5.6 mmol/L according to the current ADA [American Diabetes Association] definition of impaired fasting glucose,” say Yunzhao Hu (First People’s Hospital of Shunde, Foshan, China) and study co-authors.
Prediabetes according to the ADA fasting glucose definition was associated with a 13% increased risk for cardiovascular disease, a 10% increased risk for coronary heart disease, and a 6% increased risk for stroke compared with normoglycemia. It also conferred a 13% increased risk for death from any cause, with all of these associations being statistically significant.
The team’s meta-analysis involved 53 studies with 1,611,339 participants who were followed up for a median of 9.5 years. There were similar associations for other prediabetes definitions – World Health Organization fasting glucose (6.1–6.9 mmol/L) and impaired glucose tolerance (2-hour plasma glucose 7.8–11.0 mmol/L), and the ADA and UK National Institute for Health and Care Excellence glycated hemoglobin definitions.
The only exception was that neither glycated hemoglobin definition predicted mortality, the researchers note in The BMJ.
Hu et al stress that prediabetes is a risk factor rather than a disease, so their findings should not promote pharmacologic treatment in everyone with the condition.
“At present, lifestyle modification is the mainstay management for people with prediabetes,” they write. “High risk subpopulations with prediabetes, especially combined with other cardiovascular risk factors, should be selected for controlled trials of pharmacological treatment.”
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