The effect of lowering the threshold for diagnosis of impaired fasting glucose.
OBJECTIVE
The aim of this study was to evaluate the effect of lowering the fasting plasma glucose (FPG) criteria for impaired fasting glucose (IFG) on the prevalence of IFG and the risk for the development of diabetes associated with IFG in Koreans.


METHODS
A total of 7,211 subjects who had normal glucose tolerance (NGT) or IFG were recruited. Subjects were evaluated at baseline and after two years follow up. Clinical data including total cholesterol, FPG and blood pressure were examined.


RESULTS
Lowering the criteria for IFG from 6.1 mmol/L (110 mg/dL) to 5.6 mmol/L (100 mg/dL) increased the prevalence of IFG from 6.6% (494 subjects) to 24.4% (1829 subjects). After the 2 years follow up period, 91 subjects (1.3%) developed diabetes. Twenty one (0.3%) subjects developed diabetes among 5,382 NGT subjects and 70 (3.8%) subjects developed diabetes among 1,829 IFG (5.6-7.0 mmol/L) subjects. Lowering the IFG threshold from 6.1 mmol/L to 5.6 mmol/L resulted in a 18.4% decrease in specificity and 23.9% increase in sensitivity for predicting diabetes. The baseline FPG for predicting the development of diabetes after 2 years at a point on the receiver operating characteristic curve that was closest to the ideal 100% sensitivity and 100% specificity was 5.7 mmol/L (103 mg/dL).


CONCLUSIONS
Lowering the FPG criterion of IFG should have benefits in predicting new onset type 2 diabetes mellitus in Koreans. The economic and health benefits of applying the new IFG criteria should be evaluated in future studies.
Kim
So Hun
SH
Department of Internal Medicine, Inha University College of Medicine, 7-206 3-ga, Shinhung-dong, Jung-gu, Incheon 400-711, Korea.
Shim
Wan Sub
WS
Kim
Eun A
EA
Kim
Eun Joo
EJ
Lee
Seung Hee
SH
Hong
Seong Bin
SB
Kim
Yong Seong
YS
Park
Shin Goo
SG
Leem
Jong Han
JH
Lim
Jong Whan
JW
Lee
Hun-Jae
HJ
Nam
Moonsuk
M
D000328:Adult; D044466:Asian People; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D005215:Fasting / Q000097:blood*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose