HealthDay News — Prediabetes defined by hemoglobin A1c (HbA1c) is associated with worse prognosis than definition by fasting plasma glucose (FPG) or 2-hour plasma glucose (2hPG), according to a study published in Diabetes Care.

Dorte Vistisen, PhD, from Steno Diabetes Center Copenhagen in Denmark, and colleagues followed 5427 participants aged 50 to 79 years without diabetes for a median of 11.5 years to examine the incidence rates of a major event (nonfatal/fatal cardiovascular disease or all-causemortality) for different definitions of prediabetes. Of the cohort, 11.6% had prediabetes by the World Health Organization (WHO)/International Expert Committee (IEC) criteria and 36.8% had prediabetes by the American Diabetes Association (ADA) criteria. In a subset of 4730 individuals with additional measures of 2hPG, 14.0% had prediabetes.

The researchers found that the incidence rate in the context of prediabetes versus normoglycemia was 54% and 37% higher with the WHO/IEC and ADA definitions, respectively, and decreased to 17% and 12% after adjustment for confounders. Prediabetes by HbA1c correlated with a doubling in the incidence rate by the IEC and ADA criteria. Excess risk was reduced to 13% and 17%, respectively, upon adjustment. In the adjusted analysis, prediabetes by FPG or 2hPG was not linked to excess risk.

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“The excess risk among individuals with prediabetes is mainly explained by the clustering of other cardiometabolic risk factors associated with hyperglycemia,” the authors wrote.

Disclosures: Several authors disclosed financial ties to the pharmaceutical industry.

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Vistisen D, Witte DR, Brunner EJ, et al. Risk of cardiovascular disease and death in individuals with prediabetes defined by different criteria: the Whitehall II study [published online February 16, 2018]. Diabetes Care. doi:10.2337/dc17-2530.