Isolated post-challenge hyperglycaemia confirmed as a risk factor for mortality.
OBJECTIVE
The aim of this study was to examine the possible link between isolated post-challenge hyperglycaemia (2-h post-challenge plasma glucose >/= 11.1 mmol/l, and fasting plasma glucose < 7.0 mmol/l) and mortality.


METHODS
The data from three population based longitudinal studies (in Mauritius, Fiji and Nauru) were pooled and mortality rates were determined in 9179 people who were followed for between 5 and 12 years.


RESULTS
There were 595 people with previously diagnosed diabetes, and 799 with newly diagnosed diabetes, of whom 243 (31) had isolated post-challenge hyperglycaemia. In comparison with people without diabetes, people with isolated post-challenge hyperglycaemia had an increased risk of all-cause mortality [Cox proportional hazards ratio (95 % CI): 2.7 (1.8-3.9) - men; 2.0 (1.3-3.3) - women], and of cardiovascular mortality [2.3 (1.2-4.2) - men; 2.6 (1.3-5.1) - women]. In addition, men with isolated post-challenge hyperglycaemia had a high risk of cancer death [8.0 (3.6-17.9)].


CONCLUSIONS
These data show that isolated post-challenge hyperglycaemia, which can only be identified by the 2-h glucose, is common, and at least doubles the mortality risk. This should be considered in the design of screening programmes that use only fasting glucose.
Shaw
J E
JE
International Diabetes Institute, Melbourne, Australia.
Hodge
A M
AM
de Courten
M
M
Chitson
P
P
Zimmet
P Z
PZ
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000401:mortality*; D003920:Diabetes Mellitus / Q000097:blood* / Q000401:mortality; D005215:Fasting; D005260:Female; D005367:Fiji / Q000453:epidemiology; D006801:Humans; D006943:Hyperglycemia / Q000097:blood*; D008297:Male; D008436:Mauritius / Q000453:epidemiology; D008849:Micronesia / Q000453:epidemiology; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis
D001786:Blood Glucose