Impaired glucose tolerance in a middle-aged male urban population: a new approach for identifying high-risk cases.
From an urban population (n = 9,033) of 47-49-year-old males, 6,956 participated in a multiphase screening programme, of whom 1.5% were already registered as diabetic patients, 1.7% were then found to be diabetic; of 6,325 subjects given oral glucose tolerance tests, 6.6% were found to have impaired glucose tolerance (WHO criteria, 1985). In 889 asymptomatic cases with initial capillary whole blood glucose values greater than or equal to 6.6 mmol/l fasting and/or 2 h post-load, fluctuation in oral glucose tolerance was studied at repeat tests within one month; the mean differences in glucose values between the first and second test were less than -1% (fasting) and -15% (2 h post-load); there were no differences in body weight, and 62% of those with initially impaired glucose tolerance had normalised by the repeat test. Only in 109 cases (1.7%) were 2 h post-load values in the 7.8-11.0 mmol/l range both at the first and the repeat test; these cases were comparable vis-à-vis body mass index, triceps skin fold, blood pressure and initial glucose and insulin values, but had significantly lower oxygen uptake (2.34 +/- 0.54 l/min vs 2.63 +/- 0.68 l/min; p less than 0.003), as compared with subjects with initially impaired glucose tolerance but normal repeat test outcome. However, subjects with high normal first test results (2 h value in the 7.0-7.7 mmol/l range) and second test results in the 7.0-11.0 mmol/l range, resembled those with persistent impairment of glucose tolerance in all respects (including oxygen uptake). The repeat test procedure (including ergometry), is therefore to be recommended in selecting true risk cases.
Eriksson
K F
KF
Department of Medicine, University of Lund, Malmö General Hospital, Sweden.
Lindgärde
F
F
D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D001835:Body Weight; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D005215:Fasting; D005951:Glucose Tolerance Test; D006029:Glycosuria; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013548:Sweden; D014505:Urban Population
D001786:Blood Glucose; D007328:Insulin