The prevalence of type 2 diabetes continues to increase in developed countries.
1
,
2
This indicates the expanding importance of diabetes as a cause of morbidity and mortality.
Recent studies also have shown a widespreading of unrecognized and untreated diabetes
mellitus in general populations.
1
,
3
,
4
,
5
However, data regarding the prevalence of undiagnosed diabetes in so-called “well-characterized”
coronary patients are scarce. In 1997, the American Diabetes Association (ADA) adopted
new criteria for detection of diabetes.
- Behar S.
- Boyko V.
- Benderly M.
- Mandelzweig L.
- Graff E.
- Reicher-Reiss H.
- Schneider H.
- Shotan A.
- Balkin J.
- Brunner D.
- Goldbourt U.
BIP Study Group
Asymptomatic hyperglycemia in coronary heart disease frequency and associated lipid and lipoprotein levels in the Bezafibrate Infarction Prevention (BIP) register.
Asymptomatic hyperglycemia in coronary heart disease frequency and associated lipid and lipoprotein levels in the Bezafibrate Infarction Prevention (BIP) register.
J Cardiovasc Risk. 1995; 2: 241-246
6
The major changes in comparison with World Health Organization (WHO) criteria
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are establishing a fasting blood glucose (FBG) ≥126 mg/dl instead of 140 mg/dl for
the diagnosis, and the suggestion that oral glucose tolerance tests are not needed
in routine practice for the diagnosis of diabetes. The major purpose of the ADA criteria
was to help resolve the problem of undiagnosed diabetes using more aggressive and
simple screening. These modifications were justified on the basis of the incidence
and prevalence of diabetic retinopathy without analysis of their implications on mortality.
The application of the ADA criteria on American, Asian, European, and other populations
induced changes in the prevalence of diabetes ranging from a reduction of 4% to an
increase of 13%.
8
,
9
,
- Harris M.I.
- Flegal K.M.
- Cowie C.C.
- Eberhardt M.S.
- Goldstein D.E.
- Little R.R.
- Wiedmeyer H.M.
- Byrd-Holt D.D.
Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in
U.S. adults. The Third National Health and Nutrition Examination Survey 1988–1994.
Diabetes Care. 1998; 21: 518-524
10
Whether WHO or ADA criteria can better identify persons at risk for increased mortality
in different populations as well as long-term prognosis of the newly recognized borderline
diabetic person with FBG 126 to 139 mg/dl are unknown.To read this article in full you will need to make a payment
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References
Diabetes Statistics. National Diabetes Information Clearinghouse. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, NIH publication 1999:99–3926.
- Rapid rise in the incidence of type 2 diabetes from 1987 to 1996.Arch Intern Med. 1999; 159: 1450-1456
- Prevalence and risks of hyperglycaemia and undiagnosed diabetes in patients with acute myocardial infarction.Lancet. 1984; 1: 1264-1267
- Prevalence of hyperglycaemia and undiagnosed diabetes mellitus in patients with acute myocardial infarction.Acta Med Scand. 1986; 220: 329-332
- Asymptomatic hyperglycemia in coronary heart disease.J Cardiovasc Risk. 1995; 2: 241-246
- Report of the expert committees on the diagnosis and classification of diabetes mellitus.Diabetes Care. 1997; 20: 1183-1197
World Health Organization Expert Committee on Diabetes Mellitus. Second Report. Series No. 646. Geneva: WHO, 1980.
DECODE Study Group. Will new diagnostic criteria for diabetes mellitus change phenotype of patients with diabetes? Reanalysis of European epidemiological data. DECODE Study Group on behalf of the European Diabetes Epidemiology Study Group. Br Med J 1998;317:371–375.
- Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey 1988–1994.Diabetes Care. 1998; 21: 518-524
- Comparison of the results between two diagnostic criteria by ADA and WHO among subjects with FPG 5.6–7.8 mmol/l in Kin-Hu and Kin-Chen, Kinmen, 1991–1994.Diabetes Res Clin Pract. 1999; 45: 51-59
- Rationale and design of a secondary prevention trial of increasing serum high-density lipoprotein cholesterol and reducing triglycerides in patients with clinically manifest atherosclerotic heart disease (the Bezafibrate Infarction Prevention Trial).Am J Cardiol. 1993; 71: 909-915
- Fibrinogen is a predictor of mortality in coronary artery disease patients.Arterioscler Thromb Vasc Biol. 1996; 16: 351-356
International Classification of Diseases. Clinical Modification. 9th rev. vol. I. Ann Arbor, MI: Edwards, 1981.
- Final report.Arch Intern Med. 1987; 147: 830-842
SAS Institute Inc. SAS/STAT. User’s Guide, version 6, 4th edition, volume 2. Cary, NC. SAS Institute Inc., 1987.
SAS/STAT software: changes and enhancements, release 6.07. Cary, NC. SAS Institute Inc., SAS technical report P-229, 1992:620.
- Diabetes and cardiovascular disease. A statement for healthcare professionals from the American Heart Association.Circulation. 1999; 100: 1134-1146
Article info
Publication history
Accepted:
June 30,
2000
Received in revised form:
June 30,
2000
Received:
May 22,
2000
Identification
Copyright
© 2000 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
