Thanks Dave for bringing this important reference to our attention, it lends support to our clinical practice (i.e such cases are for real and not imaginatory). As said before, such GTTs provide a single fasting diabetic glucose level only and it is prudent to repeat the fasting glucose to get a second diabetic level, thereby fulfilling the WHO criteria for diagnosis of diabetes mellitus. I wonder whether such subgroup perform regular exercise that improves their postprandial glycaemia with lesser effect on their fasting glycaemia. Any comments!!
Best wishes
Mohammad
Dr. M Al-Jubouri, Consultant Chemical Pathologist
>From: Dave Hullin <
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>Reply-To: Dave Hullin <
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>To:
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>Subject: Fasting Hyperglycaemia with Normal 2hr Glucoses
>Date: Thu, 31 Jul 2003 10:40:35 +0100
>
>Dear Mohammad
>
>As a follow -up to your posting on how to intrepret fasting plasma glucoses
> > 7.0 mmol/L in the absence of glucose > 11.1 mmol/L the DECODE Study
>(Lancet 354, 617 1999) looked at 17,300 GTT's on men. Approx 25% had some
>form of glucose intolerance by WHO criteria and of these some 4% had FPG >=
>7.0 mmol/L but 2hr glucose < 7.8 mmol/L and another 5% had
>FPG >= 7.0 mmol/L with 2 hr glucoses between 7.8 and 11.1 mmol/L.
>
>Should these men be labelled as diabetic? It would seem so. The hazard
>ratios for death within a median period of follow up of 7.3 years was 1.8
>for both groups when compared with a control population with normal glucose
>tolerance. (The figures for women were essentially similar).
>
>Dave Hullin
>
>Dr D A Hullin
>Department of Clinical Biochemistry
>Royal Glamorgan Hospital
>Ynysmaerdy
>Llantrisant
>CF72 8XR
>Tel: 01443 443358
>
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