Less Stringent ADA Prediabetes Criteria vs More Stringent Criteria
The CDC’s diabetes prevention program (DPP)
treats prediabetes to enable an individual to
avoid or delay type 2 diabetes. The general
definition of prediabetes is something like the
following: prediabetes is where an individual has
abnormally high blood glucose, but the blood
glucose is not high enough to be called diabetes.
The criteria used by the DPP to determine the
abnormally high blood glucose is based on the
criteria used by the American Diabetes Association
(ADA) and the CDC. However, the criteria used by
the ADA and the CDC differ from the criteria used
by the World Health Organization (WHO), and the
National Institute for Health and Care Excellence
(NICE).
The prediabetes criteria used by WHO and NICE are
more stringent than the prediabetes criteria used
by the ADA and the CDC. So a
study was done “to evaluate the associations
between different definitions of prediabetes and
the risk of cardiovascular disease and all cause
mortality.”
The ADA uses the
following criteria for prediabetes: a
fasting plasma glucose (FPG) greater than or equal
to 100 mg/dL and less than or equal to 125 mg/dL;
an impaired glucose tolerance (IGT) where the
glucose is greater than or equal to 140 mg/dL and
less than or equal to 200 mg/dL; and hemoglobin
A1c greater than or equal to 5.7% and less than or
equal to 6.4%.
The WHO uses the
following criteria for prediabetes: an FPG
greater than or equal to 110 mg/dL and less than
or equal to 125 mg/dL; an IGT where the glucose is
greater than or equal to 140 mg/dL and less than
or equal to 200 mg/dL. NICE uses a hemoglobin A1c
of 6.0-6.4% as it's criteria.
The above referenced study took the form of a meta
analysis where 53 studies were included. The
studies consisted of 1,611,339 subjects. The
subjects were looked at for a period of about 9 ½
years. The investigators concluded that
individuals who satisfied the less stringent ADA
prediabetes criteria experienced an increased risk
of “cardiovascular events, coronary heart disease,
stroke, and all cause mortality.”
Further, because prediabetes can increase the risk
of metabolic problems, investigators suggested
that “high risk populations with prediabetes,
especially combined with other cardiovascular risk
factors, should be selected for controlled trials
of pharmacological treatment.”
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posted by Information Uncover at
3:14 PM
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