A1C vs FPG to diagnose prediabetes; prediabetes and CHF; and how much weight loss is too much? Reports from ADA 2017.
Cardiovascular Complications of Diabetes: 3 Studies At-a-Glance
Presented at the American Diabetes Association 77th Scientific Sessions, June 9-13, 2017
Prediabetes in middle-aged, but not older adults was found to be an independent risk factor for developing congestive heart failure (CHF).
Among adults aged younger than 65 years, prediabetes was associated with higher incidence of CHF hospitalization vs those with normoglycemia, with lesser effects found in subjects aged older than 65 years.
Prediabetes as an independent risk factor for incident CHF was more prevalent in middle-aged vs older adults. Incidence of CHF increased with longer duration of diabetes.
Higher Incidence of Cardiovascular Disease Mortality in Prediabetic Individuals Diagnosed by HbA1c than by Fasting Glucose: The Whitehall II Study
With poor correlation between fasting plasma glucose (FPG) and HbA1c (A1c) in determining prediabetes, subsequent prognosis for cardiovascular disease (CVD) and mortality may differ depending on diagnostic method.
Prediabetic individuals diagnosed with A1c had an almost two-fold higher risk of CVD or death compared to those diagnosed by FPG, suggesting that the ADA threshold for determining impaired fasting glucose is too low.
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While modest weight loss of > 5% is commonly recommended for overweight or obese patients with diabetes, this study determined that large weight loss, sometimes unintentional, may reflect poor prognosis.
In this selection of Studies at ADA 77th Scientific Sessions included evaluations of whether prediabetes and the criteria used to determine prediabetes, and large weight loss in diabetics may be factors in cardiovascular disease and mortality.