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TITLE:

PREDICTORS OF INCIDENT TYPE 2 DIABETES MELLITUS IN RURAL SINDH POPULATION WITH NORMAL FASTING GLUCOSE LEVEL

AUTHORS:

Om Parkash, Ravi Kumar, Mahmood Khan, Fayaz Hussain, Kanchan Devi

ABSTRACT:

Abstract: Background: Little is known about the natural course of normal fasting glucose (NFG) in Asians and the risk factors for future diabetes. Methods: A total of 370 people from OPD of LUMHS Hyderbad/Jamshoro (163 men, 207 women) with NFG levels and no history of diabetes, aged 34 to 71 year, were enrolled. Oral glucose tolerance tests were performed at baseline, 1 year, 1.5 year and 2 years after enrollment. Results: During 2 years of follow-up, 16.1% of participants met criteria for diabetes diagnosis, and 39.6% of subjects still had NFG levels at the time of diabetes diagnosis. During 2 year of follow-up, age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01 to 1.10; P=0.026) and family history of diabetes (OR, 3.24; 95% CI, 1.42 to 7.40; P=0.005) were independently associated with future diabetes diagnosis; however, fasting glucose level was not an independent predictor. During 2 years of follow-up, family history of diabetes (OR, 2.76; 95% CI, 1.37 to 5.54; P =0.004), fasting insulin level (OR, 1.01; 95% CI, 1.00 to 1.02; P=0.037), and fasting glucose level (OR, 3.69; 95% CI, 1.13 to 12.01; P=0.030) were associated with diabetes diagnosis independent of conventional risk factors for diabetes. Conclusion: A substantial number of subjects with NFG at baseline still remained in the NFG range at the time of diabetes diagnosis. A family history of diabetes and fasting insulin and glucose levels were associated with diabetes diagnosis during 2 years of follow-up; however, fasting glucose level was not associated with diabetes risk within the relatively short-term follow-up period of 1.1 year in subjects with NFG. Keywords: Blood glucose; Diabetes mellitus, type 2; Epidemiology; Fasting; Glucose tolerance test.

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