Type 2 Diabetes and its Relation to Impaired Fasting and Postload Glucose The Hoorn Study

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Type 2 Diabetes and its Relation toImpaired
Fasting and Postload GlucoseThe Hoorn Study

• Sarah Kiff
• Biology Department
• Eastern CT State University

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Relation of Impaired Fasting and Postload Glucose
With Incident Type 2 Diabetes In a Dutch
PopulationThe Hoorn StudyJournal of the
American Medical Association2852109-2113

• Written by Femmie de Vegt, PhD Jacqueline M.
  Dekker, PhD Agnes Jager, MD, PhD Ellen
  Hienkens, MSc Pieter J. Kostense, PhD Coen D.
  A. Stehouwer, MD, PhD Giel Nijpels, MD, PhD Les
  M. Bouter, PhD and Robert J. Heine, MD, PhD

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Type 2 Diabetes

• Low insulin production or the inability to use
  insulin.
• Symptoms include
• Increase urination, increased thirst, and
  dehydration.
• Glucose blood levels are elevated, and glucose is
  excreted in the urine.

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Follow Up Study

• Investigated the cumulative incidence of diabetes
  in the white population of the Hoorn study, which
  was followed up for 6 years.
• Compared the incidence of diabetes among
  participants having
• Normal fasting glucose (NFG),
• Normal glucose tolerance (NGT),
• Impaired fasting glucose (IFG),
• Impaired glucose tolerance (IGT),
• Both IFG and IGT,
• at baseline and according to the World Health
  Organization (WHO)-1985, American Diabetes
  Association (ADA)-1997 and WHO-1999 diagnostic
  criteria.

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Methods
Statistical Analysis Odds Ratios (ORs)
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Glucose MeasurementsDiagnostic criteria

• ADA-1997
• NFG FPG lt110mg/dL
• IFG FPG 110-126mg/dL
• WHO-1985
• NGT 2hPG lt140mg/dL
• FPG lt 126mg/dL
• IGT 2hPG 140-200mg/dL
• FPG lt 126mg/dL

• WHO-1999
• IFG
• FPG 110-126mg/dL
• IGT
• 2hPG 140-200mg/dL

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Other Measurements

• Body Mass Index (BMI) wt/h2
• Waist-hip ratio (WHR) wc/hc
• Blood Pressure

• Smoking habits
• Participation in sports (hours per week)

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Statistical Methods

• P values based on 2-sided tests
• Cumulative incidence (n developed/total at risk
  at baseline)
• Follow up duration

• OR chance for diabetes, to chance of
  nonconversion to diabetes
• Other statistically significant variabels
• FPG, 2hPG, and WHR (x100)

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Six-Year Cumulative Incidence of Diabetes
According to WHO-1985 Diagnostic Criteria
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Six-Year Cumulative Incidence of Diabetes
According to ADA Diagnostic Criteria
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Cumulative Incidence of Diabetes (WHO-1999
Criteria) for Combinations of Impaired Fasting
and Impaired Postload Glocuse Levels
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Variables Predictive of the Development of
Diabetes During 6 Years of Follow-up Adjusted for
Age, Sex, and Follow-up Duration
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In Conclusion

• Highest cumulative incidence of diabetes was
  found in both IFG and IGT at baseline.
• Combination of IFG and IGT the risk of diabetes
  is very high.
• WHR, not BMI was an important predictor for
  diabetes.

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