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6.1. Impaired Fating Glucoseucose (IFG)
Impaired fasting glucose is the stage used to define fasting plasma glucose between
normal glycaemia and diabetes. It is defined between the 110-125 mg/dl
margins, according to WHO and IDF.
According to the WHO and IDF criteria, a 5% or higher prevalence is stated,
which increases with age; according to the ADA criteria, its prevalence triples or
quadruples (71).
The classification as impaired fasting glucose can be hardly reproducible. If
glycaemia repeats after six weeks, impaired fasting glucoseis confirmed in 51% to
64% of the cases; 10% of the cases are classified as diabetic and the rest as normal
(70).
These patients have a five-fold risk to develop diabetes (70). Their cardiovascular
risk (AMI, stroke, non-fatal strode) is higher (RR 1.19), and likewise is
mortality higher (RR 1.28) (70).
SR of cohort
studies
2+
6.2. Impaired Glucose Tolerance (IGT)
IGT is the stage defined by a plasma glycaemia in venous blood between 140 mg/
dl and 200 mg/dl two hours after the 75g glucose tolerance test.
It is more frequent in women. Its prevalence is around 10%; it increases with
age and varies depending on race.
IGT reproducibility after six weeks is low. It is confirmed in 33% to 48% of
the cases; 36% to 48% are reclassified as normal and 6% to 13% as diabetic (2; 70).
IGT is associated with a higher risk than altered basal glycaemia to develop
diabetes. This risk is 6 times higher than in normoglycaemic patients [RR 6.02 (CI
95%: 4.66 a 7.38)], and up to 12 times more if both are associated [RR 12.21 (CI
95%: 4.32 a 20.10)] (70).
IGT also implies a higher cardiovascular mortality risk (RR 1.48) and overall
mortality risk (RR 1.66) (70).
SR of cohort
studies
2+
6.3. Preventive interventions in patients with intermediate
hyperglycaemia
There are several SRs (72-74), evidence summaries (70) and a recent RCT (75)
not included in the SR, which analyse the pharmacological and non-pharmacological
intervention effectiveness in the prevention of diabetes and cardiovascular
morbimortality in diabetic stages. There is no uniformity in the inclusion criteria
of patients in the studies.
SR of RCT
1+
48 CLINICAL PRACTICE GUIDELINES IN THE NHS