open access

Vol 3, No 4 (2002): Practical Diabetology
Original articles (translated)
Published online: 2002-09-25
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Are lower fasting plasma glucose levels at diagnosis of type 2 diabetes associated with improved outcomes? U.K. Prospective Diabetes Study 61

Stephen Colagiuri, Carole A. Cull, Rury R. Holman, w imieniu grupy UKPDS
Diabetologia Praktyczna 2002;3(4):233-244.

open access

Vol 3, No 4 (2002): Practical Diabetology
Original articles (translated)
Published online: 2002-09-25

Abstract

INTRODUCTION. Type 2 diabetes may be present for several years before diagnosis, by which time many patients have already developed diabetic complications. Earlier detection and treatment may reduce this burden, but evidence to support this approach is lacking.
MATERIAL AND METHODS. Glycemic control and clinical and surrogate outcomes were compared for 5,088 of 5,102 U.K. Diabetes Prospective Study participants according to whether they had low (< 140 mg/dl [< 7.8 mmol/l]), intermediate (140 to < 180 mg/dl [7.8 to < 10.0 mmol/l]), or high (≥ 180 mg/dl [≥ 10 mmol/l]) fasting plasma glucose (FPG) levels at diagnosis. Individuals who presented with and without diabetic symptoms were also compared.
RESULTS. Fewer people with FPG in the lowest category had retinopathy, abnormal biothesiometer measurements, or reported erectile dysfunction. The rate of increase in FPG and HbA1c during the study was identical in all three groups, although absolute differences persisted. Individuals in the low FPG group had a significantly reduced risk for each predefined clinical outcome except stroke, whereas those in the intermediate group had significantly reduced risk for each outcome except stroke and myocardial infarction. The low and intermediate FPG groups had a significantly reduced risk for progression of retinopathy, reduction in vibration sensory threshold, or development of microalbuminuria.
CONCLUSIONS. People presenting with type 2 diabetes with lower initial glycemia who may be earlier in the course of their disease had fewer adverse clinical outcomes despite similar glycemic progression. Since most such people are asymptomatic at diagnosis, active case detection programs would be required to identify them.

Abstract

INTRODUCTION. Type 2 diabetes may be present for several years before diagnosis, by which time many patients have already developed diabetic complications. Earlier detection and treatment may reduce this burden, but evidence to support this approach is lacking.
MATERIAL AND METHODS. Glycemic control and clinical and surrogate outcomes were compared for 5,088 of 5,102 U.K. Diabetes Prospective Study participants according to whether they had low (< 140 mg/dl [< 7.8 mmol/l]), intermediate (140 to < 180 mg/dl [7.8 to < 10.0 mmol/l]), or high (≥ 180 mg/dl [≥ 10 mmol/l]) fasting plasma glucose (FPG) levels at diagnosis. Individuals who presented with and without diabetic symptoms were also compared.
RESULTS. Fewer people with FPG in the lowest category had retinopathy, abnormal biothesiometer measurements, or reported erectile dysfunction. The rate of increase in FPG and HbA1c during the study was identical in all three groups, although absolute differences persisted. Individuals in the low FPG group had a significantly reduced risk for each predefined clinical outcome except stroke, whereas those in the intermediate group had significantly reduced risk for each outcome except stroke and myocardial infarction. The low and intermediate FPG groups had a significantly reduced risk for progression of retinopathy, reduction in vibration sensory threshold, or development of microalbuminuria.
CONCLUSIONS. People presenting with type 2 diabetes with lower initial glycemia who may be earlier in the course of their disease had fewer adverse clinical outcomes despite similar glycemic progression. Since most such people are asymptomatic at diagnosis, active case detection programs would be required to identify them.
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Keywords

diagnosis of type 2 diabetes mellitus; fasting blood glucose; UKPDS

About this article
Title

Are lower fasting plasma glucose levels at diagnosis of type 2 diabetes associated with improved outcomes? U.K. Prospective Diabetes Study 61

Journal

Clinical Diabetology

Issue

Vol 3, No 4 (2002): Practical Diabetology

Pages

233-244

Published online

2002-09-25

Bibliographic record

Diabetologia Praktyczna 2002;3(4):233-244.

Keywords

diagnosis of type 2 diabetes mellitus
fasting blood glucose
UKPDS

Authors

Stephen Colagiuri
Carole A. Cull
Rury R. Holman
w imieniu grupy UKPDS

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