Random Blood Glucose: A Robust Risk Factor For Type 2 Diabetes.
AUTHORS
- PMID: 25650899 [PubMed].
ABSTRACT
Context: Although random blood glucose (RBG) values are common in clinical practice, the role of elevated RBG values as a risk factor for type 2 diabetes is not well described. Objective: To examine non-diagnostic, RBG values as a risk factor for type 2 diabetes Design: Cross-sectional study of NHANES participants (2005-2010) Participants: 13,792 non-fasting NHANES participants without diagnosed diabetes. Primary Outcome: Glycemic status (normal glycemia, undiagnosed prediabetes, or undiagnosed diabetes) using hemoglobin HbA1C as the criterion standard. Analysis: Multinomial logistic regression examined associations between diabetes risk factors and RBG values according to glycemic status. Associations between current US screening strategies and a hypothetical RBG screening strategy with undiagnosed diabetes were examined. Results: In unadjusted analyses, a single RBG≥100 mg/dL (5.6 mmol/L) was more strongly associated with undiagnosed diabetes than any single risk factor [Odds Ratio (95% CI) 31.2 (21.3 – 45.5)] and remained strongly associated with undiagnosed diabetes [20.4 (14.0 – 29.6)] after adjustment for traditional diabetes risk factors. Using RBG<100 mg/dL as a reference, the adjusted odds of undiagnosed diabetes increased significantly as RBG increased: RBG 100-119 mg/dL [7.1 (4.4-11.4)], RBG 120-139 mg/dL [30.3 (20.0-46.0)], RBG≥140 mg/dL [256 (150.0-436.9)]. As a hypothetical screening strategy, an elevated RBG was more strongly associated with undiagnosed diabetes than current USPSTF guidelines (hypertension alone; p<0.0001) and similar to ADA guidelines (p=0.12). Conclusions: A single RBG ≥ 100 mg/dL is more strongly associated with undiagnosed diabetes than traditional risk factors. Abnormal RBG values are a risk factor for diabetes and should be considered in screening guidelines.
Context: Although random blood glucose (RBG) values are common in clinical practice, the role of elevated RBG values as a risk factor for type 2 diabetes is not well described. Objective: To examine non-diagnostic, RBG values as a risk factor for type 2 diabetes Design: Cross-sectional study of NHANES participants (2005-2010) Participants: 13,792 non-fasting NHANES participants without diagnosed diabetes. Primary Outcome: Glycemic status (normal glycemia, undiagnosed prediabetes, or undiagnosed diabetes) using hemoglobin HbA1C as the criterion standard. Analysis: Multinomial logistic regression examined associations between diabetes risk factors and RBG values according to glycemic status. Associations between current US screening strategies and a hypothetical RBG screening strategy with undiagnosed diabetes were examined. Results: In unadjusted analyses, a single RBG≥100 mg/dL (5.6 mmol/L) was more strongly associated with undiagnosed diabetes than any single risk factor [Odds Ratio (95% CI) 31.2 (21.3 – 45.5)] and remained strongly associated with undiagnosed diabetes [20.4 (14.0 – 29.6)] after adjustment for traditional diabetes risk factors. Using RBG<100 mg/dL as a reference, the adjusted odds of undiagnosed diabetes increased significantly as RBG increased: RBG 100-119 mg/dL [7.1 (4.4-11.4)], RBG 120-139 mg/dL [30.3 (20.0-46.0)], RBG≥140 mg/dL [256 (150.0-436.9)]. As a hypothetical screening strategy, an elevated RBG was more strongly associated with undiagnosed diabetes than current USPSTF guidelines (hypertension alone; p<0.0001) and similar to ADA guidelines (p=0.12). Conclusions: A single RBG ≥ 100 mg/dL is more strongly associated with undiagnosed diabetes than traditional risk factors. Abnormal RBG values are a risk factor for diabetes and should be considered in screening guidelines.
Tags: Alumni Publications 2015