Impaired fasting glucose and risk of diabetes in Taiwan: follow-up over 3 years

Abstract

The purpose of this paper was to examine the relationship between fasting glucose levels and development of diabetes among residents of Penghu, Taiwan. From July 1995 to June 1996, a population-based cohort study was conducted among residents aged ≥40 years on the island of Penghu, Taiwan. Of the 1601 surveyed, 1306 (81.6%) did not have diabetes. Six hundred of these 1306 persons were re-examined 3 years later. Participants with fasting plasma glucose (FPG) concentration <110 mg/dl (<6.1 mmol/l) were classified as normoglycemic, those with a glucose concentration of 110–126 mg/dl (6.1–7.0 mmol/l) had impaired fasting glucose (IFG), and those with a fasting glucose concentration of ≥126 mg/dl (7.0 mmol/l) were considered to have diabetes. During the 3-year follow-up, 4.3% of the total population (1.4% per year, 95% CI 0.9–1.9%) developed diabetes. Of those with IFG at baseline, 9.6% (3.2% per year, 95% CI 1.8–5.0%) progressed to diabetes, but only 2.5% (0.8% per year, 95% CI 0.4–1.2%) of normoglycemic people did so. The multivariate-adjusted odds ratio of developing diabetes was 4.4 (95% CI 1.9–10.6) for persons with IFG compared with those who were normoglycemic at baseline. Other significant predictors of progression to diabetes were higher waist–hip ratio (WHR), triglyceride and apolipoprotein B (apo B) levels. In this Asian Chinese population, IFG is a strong predictor of diabetes. The high rate of conversion from IFG to diabetes, combined with the previously observed high IFG prevalence, suggests future high prevalence rates of diabetes in Taiwan.