Type 2 Diabetes and its Relation to Impaired Fasting and Postload Glucose The Hoorn Study Sarah Kiff Biology Department Eastern CT State University

Relation of Impaired Fasting and Postload Glucose With Incident Type 2 Diabetes In a Dutch Population The Hoorn Study Journal of the American Medical Association 285: 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

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.

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.

Methods Statistical Analysis Odds Ratios (ORs)

Glucose Measurements Diagnostic criteria ADA-1997 NFG = FPG <110mg/dL IFG = FPG mg/dL WHO-1985 NGT = 2hPG <140mg/dL FPG < 126mg/dL IGT = 2hPG mg/dL FPG < 126mg/dL WHO-1999 IFG = FPG mg/dL IGT = 2hPG mg/dL

Other Measurements Body Mass Index (BMI) = wt/h 2 Waist-hip ratio (WHR) = wc/hc Blood Pressure Smoking habits Participation in sports (hours per week)

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)

Six-Year Cumulative Incidence of Diabetes According to WHO-1985 Diagnostic Criteria

Six-Year Cumulative Incidence of Diabetes According to ADA Diagnostic Criteria

Cumulative Incidence of Diabetes (WHO-1999 Criteria) for Combinations of Impaired Fasting and Impaired Postload Glocuse Levels

Variables Predictive of the Development of Diabetes During 6 Years of Follow-up Adjusted for Age, Sex, and Follow-up Duration

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.