Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Long-Term Risk for CVD Assessed by Fasting Glucose

Diabetes Care; ePub 2019 Jan 7; Bancks, et al

Middle-age individuals with diabetes have high long-term absolute risk for cardiovascular disease (CVD), a recent study found. Researchers pooled data from 7 observational cohorts of US black and white men and women followed from 1960 to 2015. They categorized fasting glucose (FG) as follows: <5.0, 5.0–5.5, 5.6–6.2, 6.3–6.9 mmol/L, and diabetes (FG ≥7.0 mmol/L or use of diabetes medications). They also assessed risk for incident CVD according to change in FG before age 50. They found:

  • 19,630 individuals (6,197 blacks and 11,015 women) without a prior CVD event were included.
  • Risk for CVD through age 85 ranged from 15.3% (<5.0 mmol/L) to 38.6% (diabetes levels) among women and from 21.5% (5.0–5.5 mmol/L) to 47.7% (diabetes levels) among men.
  • An FG of 6.3–6.9 mmol/L was associated with higher long-term CVD risk compared with the lowest FG among men, but not women.
  • Increases in glucose during midlife with conversion to diabetes were associated with higher CV risk (1.3- to 3.6-fold) than when increasing glucose below the diabetes threshold.

Citation:

Bancks M P, Ning H, Allen NB, et al. Long-term absolute risk for cardiovascular disease stratified by fasting glucose level. [Published online ahead of print January 7, 2019]. Diabetes Care. doi:10.2337/dc18-1773.