Routine measurements mark out highest-risk patients with dysglycemia
medwireNews: The short-term risk for developing diabetes is very high in primary care patients with impaired fasting glucose (IFG) who also have elevated triglycerides and a large waist circumference, report researchers.
People with this combination of risk factors comprised 22.8% of 1101 patients with IFG identified in primary care practices in Hong Kong. But during an average follow-up of 6.5 months, over half (52.2%) of these patients progressed to diabetes, compared with 36.8% of patients overall.
A further 22.9% of patients had a normal waistline and triglyceride level, and 28.2% of these patients developed diabetes during follow-up. Diabetes rates were only slightly higher for the 47.0% of patients with isolated central obesity and the 7.3% with isolated hypertriglyceridemia, at 34.6% and 30.0%, respectively.
“[S]imultaneous measurement of waist circumference and triglyceride[s] could serve as a simple screening tool to identify individuals with IFG who are at high risk of developing diabetes in primary care clinics,” write Esther Yu (The University of Hong Kong) and co-researchers in Diabetic Medicine.
The rates of type 2 diabetes varied according to the definition, with the highest proportion identified from oral glucose tolerance testing, followed by glycated hemoglobin levels and then fasting plasma glucose. But the association of hypertriglyceridemia plus central obesity with diabetes risk persisted regardless of the definition used.
And this association (using any type 2 diabetes criterion) remained after accounting for factors including baseline fasting plasma glucose, family history, and physical activity, with the presence of hypertriglyceridemia plus central obesity increasing the risk for diabetes by a significant 58% relative to having neither of these factors.
By contrast, the other two groups (with isolated obesity or hypertriglyceridemia) did not have a significantly increased diabetes risk after accounting for baseline variables.
The researchers note that screening all primary care patients for high triglycerides and elevated waist circumference would not be practical, but suggest that, in the case of those with IFP, it “might serve as a potentially time- and cost-saving strategy” to direct intensive preventive measures to the most at-risk patients.
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