Association of the extent of return to fasting state 2-hours after a glucose challenge with incident prediabetes and type 2 diabetes: The CARDIA study

Sithara Vivek, Mercedes R. Carnethon, Anna Prizment, April P. Carson, Michael P. Bancks, David R. Jacobs, Bharat Thyagarajan

Research output: Contribution to journalArticlepeer-review

Abstract

AIM: To evaluate whether the extent of return to fasting state 2-hours after a glucose challenge among normoglycemic individuals is associated with lower risk of incident prediabetes/ type 2 diabetes in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study.

METHODS: We evaluated this association among 1879 normoglycemic adults who were categorized into three groups: 'Low post load' (2hPG < FPG); 'Medium post load' (2hPG ≥ FPG and < 75 th percentile of the difference); and 'High post load' (2hPG > FPG and ≥ 75 th percentile of the difference). We used Cox proportional hazards regression to evaluate the association of the difference in 2hPG and FPG with incident diabetes/prediabetes after adjustment for demographic and clinical covariates.

RESULTS: During 20 years of follow-up, 8% developed type 2 diabetes and 35% developed prediabetes. Compared to those with 'Low post load', the risk of type 2 diabetes was higher for participants with 'High post load' [HR: 1.56, 95% CI (1.03, 2.37)] and similar for participants with 'Medium post load' [HR: 0.99, 95% CI (0.64, 1.52)]. However, HRs for incident prediabetes among participants with 'High post load' [HR = 1.2, 95 %CI = (0.98, 1.46)] was not significantly different compared to participants with 'Low post load'.

CONCLUSION: Among normoglycemic individuals, a difference between 2hPG and FPG concentration > 0.9 mmol/L can be used to stratify individuals at higher risk for developing type 2 diabetes.

Original languageEnglish (US)
Article number109004
JournalDiabetes Research and Clinical Practice
Volume180
Early online dateAug 12 2021
DOIs
StatePublished - Oct 2021

Bibliographical note

Funding Information:
Funding Information : The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201800005I & HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I).

Publisher Copyright:
© 2021 Elsevier B.V.

Keywords

  • Normal glucose tolerant
  • Normoglycemic
  • OGTT
  • Prediabetes
  • Type 2 Diabetes

PubMed: MeSH publication types

  • Journal Article

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