Impaired fasting glucose and impaired glucose tolerance in urban population in India.

AIMS: To study prevalence of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) in urban Indians and their demographic and anthropometric characteristics. METHODS: Data on capillary blood glucose (OGTT), anthropometric and demography details were available in 10 025 subjects (M : F 4711 : 5314) aged > or = 20 years. Glucose tolerance was categorized as normal, isolated IFG, isolated IGT, IFG + IGT and diabetes using the fasting and 2-h blood glucose (2hBG; 75-g glucose load) values. Subjects with known diabetes were excluded. RESULTS: Age-standardized prevalences of IFG, IGT and newly detected diabetes were 8.7%, 8.1% and 13.9%, respectively. IFG was more prevalent in women (9.8%) than in men (7.4%) (chi2 = 13.62, P = 0.0002), while the gender differences in IGT (men 8.4%, women 7.9%) and diabetes (men 13.3%, women 14.3%) were not significant. Body mass index and waist circumference were higher in glucose-intolerant groups than in normal glucose tolerance (NGT). Prevalence of diabetes, IGT and IFG + IGT increased with age. Among the IFG, 4% had diabetes and 27.1% had IGT using 2hBG criteria. In IFG, the fasting and 2hBG values were not correlated. CONCLUSIONS: Prevalences of IFG and IGT were similar in urban Indians and an overlap occurred in only less than half of these subjects. IFG was more common in women. Subjects with IFG were older and had more adverse anthropometric characteristics in comparison with NGT. IFG did not show an increasing trend with age.     

Progression to clinically diagnosed and treated diabetes from impaired glucose tolerance and impaired fasting glycaemia.

AIMS: To evaluate the risk of diabetes in subjects with impaired fasting glycemia (IFG) as compared with impaired glucose tolerance (IGT) and normal glucose tolerance. METHODS: Men (1223) and women (1370) aged 45-64 years and free of diabetes at baseline were followed-up for 10 years, with 26 737 person years accumulated. The incident diabetic cases were identified through the national Drug Register and the Hospital Discharge Register. RESULTS: During the 10 years of follow-up, 53 (4.3%) men and 47 (3.4%) women developed diabetes. IFG alone defined 22 (15.5/1000 person years) diabetic cases, which was higher than for subjects with normal fasting glucose. Subjects with isolated IGT identified an additional 34 cases (155% more) which could not be defined by IFG alone. The area under the ROC curve was larger for 2-h glucose (0.77, 95% CI 0.72-0.82) than for fasting glucose (0.65, 0.58-0.71). The multivariate adjusted Cox hazard ratio was higher for isolated IGT (3.9, 95% CI 2.4-6.2) than for isolated IFG (2.3, 0.9-5.7) as compared with subjects with neither IFG nor IGT. CONCLUSION: Both IFG and IGT are risk predictors for diabetes, but IGT defines a much larger target population for prevention.     

High incidence of type 2 diabetes and increasing conversion rates from impaired fasting glucose and impaired glucose tolerance to diabetes in Mauritius

OBJECTIVE: To describe the incidence of different stages of glucose intolerance in a population from Mauritius followed over 11 years. RESEARCH DESIGN, METHODS AND SUBJECTS: Population-based surveys were undertaken in the multi-ethnic nation of Mauritius in 1987, 1992 and 1998 with 5083, 6616 and 6291 participants, respectively. Questionnaires, anthropometric measurements, and a 2-h 75-g oral glucose tolerance test were included. Three cohorts aged between 25 and 79 years with classifiable glucose tolerance data were identified; 3680 between 1987 and 1992, 4178 between 1992 and 1998, and 2631 between 1987 and 1998. Glucose tolerance was classified according to WHO 1999 criteria. RESULTS: The incidence rate of type 2 diabetes was higher between 1992 and 1998 than between 1987 and 1992. In men, the incidence was similar between cohorts (24.5 and 25.4 per 1000 person-years) whereas the incidence increased in women (23.3 and 16.4 per 1000 person-years). The incidence of diabetes peaked in the 45-54 year age group and then plateaued or fell. The incidences of impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) decreased in both men and women. Of normoglycaemic subjects at baseline, more women than men developed IGT and more men than women developed IFG. Of those labelled as IFG in 1987, 38% developed diabetes after 11 years. The corresponding figure for IGT was 46%. CONCLUSIONS: In this study, we report changes in incidence rates of glucose intolerance over a 11-year period. In particular, differences between men and women were observed. The increased incidence of IGT in women compared with men, and increased incidence of IFG in men compared with women was consistent with, and explains the sex biases seen in the prevalences of these states.     

Gender differences in the prevalence of impaired fasting glycaemia and impaired glucose tolerance in Mauritius. Does sex matter?

OBJECTIVE: To examine gender differences in the characteristics and prevalence of various categories of glucose tolerance in a population study in Mauritius. RESEARCH DESIGN AND METHODS: In 1998, a community-based cross-sectional survey was conducted in Mauritius. Categories of glucose metabolism were determined in 5388 adults, with an oral glucose tolerance test given to those who did not have previously diagnosed diabetes (n=4036). Other cardiovascular risk factors were assessed among those without known diabetes. RESULTS: For men and women the prevalence of diabetes (22.0 vs. 21.8%, respectively) and the prevalence of coexisting impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) (3.2 vs. 2.9%) were similar. However, men were twice as likely as women to have isolated IFG [5.1% (4.2-6.0) vs. 2.9% (2.3-3.5)], despite being younger, thinner and with lower plasma insulin but higher lipids. Conversely, the prevalence of isolated IGT was lower in men [9.0% (7.9-10.2) vs. 13.9% (12.6-15.1)]. Among non-diabetic individuals, fasting glucose was higher in men than women, whereas 2-h glucose was higher in women. In people without diabetes, women had significantly higher body mass index, beta cell function (HOMA-B), fasting and 2-h insulin than men and significantly lower waist-hip ratios, waist circumference, insulin sensitivity (HOMA-S) and triglycerides. CONCLUSION: In Mauritius, the distribution of impaired glucose metabolism differs by sex. The observation that IFG is more prevalent in men and IGT more prevalent in women raises important questions about their underlying aetiology and the ability of the current glucose thresholds to equally identify men and women at high-risk of developing diabetes. IFG should be seen as a complimentary category of abnormal glucose tolerance, rather than a replacement for IGT.     

Association of serum ferritin concentrations with prevalence of prediabetes,type 2 diabetes mellitus,and metabolic syndrome in a Chinese population from Sichuan

Body iron stores reflected by serum ferritin levels have been implicated in many chronic diseases. We investigated associations between serum ferritin concentrations and the risk of prediabetes, type 2 diabetes mellitus (T2DM), and metabolic syndrome (MetS) in a Chinese population. For a cross-sectional study, 3040 subjects were recruited from three communities in Sichuan. Subjects were grouped by prediabetes or T2DM status, or components of MetS. Subjects with prediabetes were classified as having impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or both (IFG + IGT). The odds ratios, assessed by gender, for the associations between serum ferritin concentration and prediabetes, T2DM, and MetS were calculated using multivariate logistic regression. The prevalence of IGT, IFG + IGT, T2DM, and MetS in the highest quartile of ferritin concentrations was higher than those in the lowest quartile, in both genders. In women, the adjusted odds ratios of IGT, IFG + IGT, T2DM, and MetS were higher in the highest ferritin quartile than the lowest; in men, only that of IFG + IGT was higher. In both genders, high ferritin levels were associated with higher odds ratios of hypertriglyceridemia and hyperglycemia, components of MetS. IGT, IFG + IGT, T2DM, and MetS were more common in the highest ferritin quartile for both genders. Elevated ferritin concentrations were associated with an increased risk for IGT and IFG + IGT in prediabetes, T2DM, and MetS, especially in women.

     

A high prevalence of diabetes mellitus and impaired glucose tolerance in the Danagla community in Northern Sudan

The prevalence and associated factors of diabetes mellitus (DM) and impaired glucose tolerance (IGT) were studied in a tribal community with an apparently high diabetes prevalence. A sample of 724 subjects aged ≥ 25 years was selected using a multi-stage cluster method and underwent a 75 g oral glucose tolerance test. The crude prevalence of DM and IGT were 8.3 % (men 9.9 %; women 7.5 %) and 7.9 % (men 4.1 %; women 9.7 %), respectively. Age-adjusted prevalence rates, according to the standard population of Segi, were 10.4 % (95 % CI 7.7–13.2) and 9.8 % (95% CI 7.2–12.5) for DM and IGT, respectively. No urban/rural differences were found in the prevalence rates of DM and IGT. New cases (5.1%) were almost twice as common as previously known cases (3.2 %). Family history of diabetes, obesity, and advanced age were associated with higher rates of diabetes. The results confirmed that diabetes is common in the Danagla community compared to other communities of northern Sudan. Varying environmental, nutritional, and genetic factors may contribute to this high prevalence. These findings will have profound impact on the health services for this community and the Sudan as a whole. © 1998 John Wiley & Sons, Ltd.     

Increasing incidence of abnormal glucose tolerance in women with prior abnormal glucose tolerance during pregnancy: DIAGEST 2 study

Aims Mild blood glucose abnormalities during pregnancy may be linked to later glucose tolerance abnormalities or diabetes mellitus. Our aim was to determine the prevalence of diabetes mellitus (DM), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) 6.75 years after delivery in women with differential blood glucose status during pregnancy. Methods We compared long‐term outcomes among control women (n = 221), women with abnormal glucose tolerance during pregnancy (AGT; n = 322) and women with gestational diabetes (GDM; n = 466) who participated in DIAGEST 1. Women were recruited from 15 public maternity units in France. Clinical parameters could be determined in 155 control, 220 AGT and 338 GDM subjects. Rates of DM, IGT, IFG and ‘Any Abnormality’ were compared between the groups (American Diabetes Association criteria). Results Adherence to follow‐up was 70.7%. Rates of DM, IGT and IFG were respectively 0.9% DM, 2.1% IGT and 3.6% IFG in the control group; rates in the AGT group were 6.3%, 11.3% and 6.3%. In GDM women, the rates of DM, IGT and IFG were, respectively, 18.0%, 13.4% and 8.5%. Predictors for DM were previous GDM, medical history of hypertension, age at delivery ≥ 33 years, family history of diabetes, fasting glucose during pregnancy ≥ 5.5 mmol/l and the severity of hyperglycaemia during pregnancy defined by the number of abnormal blood glucose values fasting, 1, 2 and 3 h during the glucose tolerance test at diagnosis of GDM. Conclusion This study has identified a high prevalence of glucose tolerance abnormalities after AGT during pregnancy. Compared with GDM women, women with AGT have an intermediate risk of later diabetes.     

社区自然人群糖调节受损者5年转归及其影响因素

目的 探讨糖调节受损人群发生糖尿病的危险性及其影响因素.方法 2002年6月至8月,采用抽样分层横断面现场调查方法于上海市浦东新区社区中检出192例糖调节受损者.2007年同期进行随访,观察单纯糖耐量受损、单纯空腹血糖受损、糖耐量受损合并空腹血糖受损、糖尿病人群比例,变化.使用t检验、方差分析、卡方检验进行统计学分析.结果 5年中死亡5例,存活的187例中79例发生糖尿病,糖尿病年转化率为8.4%(79/187/5年).基线单纯糖耐量受损者糖尿病年转化率为8.2%(47/114/5年),基线单纯空腹血糖受损者精尿病年转化率为6.3%(12/38/5年),基线糖耐量受损合并空腹血糖受损者糖尿病年转化率为11.4%(20/35/5年).正常糖耐量年转化率为6.3%(59/187/5年).单纯糖耐量受损者和糖耐量受损合并空腹血糖受损者发生糖尿病的风险分别是单纯空腹血糖受损者的1.4倍(95%可信区间为0.753～2.508,P=0.29)和107倍(95%可信区间为1.021～2.80,P=0.028).转化为糖尿病者较未转化为精尿病者高血压、肥胖的比例增高,基线年龄、体重指数、腰围、腰臀比和2 h血精明显升高,随访结束时体重指数和收缩压较基线时增高.结论 上海市浦东新区糖耐量受损合并空腹血糖受损者糖尿病转化率最高.多种代谢异常可促进糖调节受损人群向糖球病转化.     

糖尿病前期尿白蛋白排泄率和微量白蛋白尿患病率的比较

目的　比较糖耐量正常 (NGT)、单纯空腹血糖受损 (I IFG)、单纯糖耐量低减 (I IGT)、糖耐量低减合并空腹血糖受损 (IGT/IFG)、新诊断的 2型糖尿病 (2型DM ) 5种不同糖代谢状态的尿白蛋白排泄率 (UAE)和微量白蛋白尿 (MAU )患病率。方法　根据 75g口服葡萄糖耐量试验 (75gOGTT)结果 ,将 2 93 4例受试者分为 :NGT组 13 3 2例、I IFG组 186例、I IGT组 470例、IGT/IFG组 2 3 6例、新诊断的 2型DM组 710例。用放射免疫法测定过夜 12h尿白蛋白。UAE在 2 0～ 2 0 0μg/min之间定义为MAU。 结果　 (1)UAE水平 [中位数 (四分位数 ) ] ,在新诊断的 2型DM组为8 50 (4 89～ 15 95) μg/min、IGT/IFG组为 6 93 (4 85～ 10 89) μg/min、I IGT组为 6 51(4 0 9～10 74) μg/min ,均高于I IFG组的 5 56(3 70～ 9 2 3 ) μg/min(P值均 <0 0 1) ;I IFG组与NGT组的 5 2 6(3 50～ 8 12 ) μg/min比较差异无显著性 (P >0 0 5) ;MAU的患病率在新诊断的 2型DM组为 2 0 7%、IGT/IFG组为 13 1%、I IGT组为 11 7%、I IFG组为 5 8%、NGT组为 5 6% ,同样呈现上述变化规律。(2 )多元逐步回归分析显示 :UAE与OGTT 2h血糖、舒张压、体重指数呈现独立正相关。logistic回归分析显示 ,导致MAU危险性增加的因素有OGTT 2h血糖、舒张     

Diabetes and impaired glucose regulation in first-degree relatives of patients with type 2 diabetes in isfahan, iran: prevalence and risk factors

OBJECTIVES: The aim of this study was to estimate the prevalence of diabetes, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) in first-degree relatives (FDR) of people with type 2 diabetes mellitus. METHODS: A cross-sectional study of FDR of type 2 diabetes patients was conducted between 2003 and 2005. A total of 2,368 FDR of type 2 diabetes outpatients aged 30-60 years (614 men and 1754 women) from Isfahan Endocrine and Metabolism Research Center (Iran) were examined. All subjects underwent a standard 75 g 2-h oral glucose tolerance test (OGTT). IGT, IFG and type 2 diabetes were diagnosed according to the criteria of the American Diabetes Association (ADA). The mean (SD) age of participants was 43.1 (6.9) years. RESULTS: The prevalence of type 2 diabetes, IGT and IFG were 10.3% (95% CI: 9.1-11.5), 19.5% (17.9-21.1) and 17.3% (15.8-18.8) respectively. The prevalence rates were significantly higher than those reported for a control population of the same age (type 2 diabetes, 6.0% (95% CI: 5.7-6.2) and IGT 9.6 (95% CI: 9.3-9.9)). IGT was more frequent among women (OR: 0.66; 95% CI: 0.51-0.87), whereas diabetes (OR: 1.31; 95% CI: 0.96-1.78) and IFG (OR: 1.41; 95% CI: 1.10-1.80) were higher in men. Multivariate analysis revealed that age and obesity or abdominal obesity were significantly associated with diabetes, IGT and IFG. CONCLUSIONS: FDR of people with type 2 diabetes in Iran are at higher risk of IGT and type 2 diabetes than the population at large. Risk increases with age and obesity. These findings may be useful for the identification of persons at risk of developing type 2 diabetes and strongly support the regular screening of FDR of type 2 diabetes patients.     

Diabesity in Australia: an affair of the heart

The objective of the Australian Diabetes and Lifestyle Study (AusDiab) was to determine the frequency of diabetes and other categories of glucose intolerance (impaired glucose tolerance (IGT) and impaired fasting glucose (IFG)), as well as other cardiovascular risk factors in Australia and to compare the prevalence with previous Australia data. The study involved a national sample involving 11 247 participants aged 25 years from the six states and the Northern Territory. They were examined in a cross-sectional survey using the 75-g oral glucose tolerance test to assess fasting and 2-h plasma glucose levels. The World Health Organization diagnostic criteria were used to determine the prevalence of abnormal glucose tolerance. The prevalence of diabetes in Australia was 8.0% in men and 6.8% in women, and an additional 17.4% of men and 15.4% of women had IGT or IFG. The overall diabetes prevalence in Australia was 7.4%, and an additional 16.4% had IGT or IFG. Diabetes prevalence has more than doubled since 1981, and this is only partially explained by changes in age profile and obesity. Almost one in four Australians 25 years and over has either diabetes or a condition of impaired glucose metabolism. This condition is associated with substantially increased immediate risk of heart disease as well as increased risk of diabetes in the future. In addition, there were high prevalences of other key cardiovascular disease risk factors. Australia has a rapidly rising prevalence of diabetes and other categories of abnormal glucose tolerance. The prevalence of abnormal glucose tolerance in Australia is one of the highest yet reported from a developed nation with a predominantly European background.     

Factors determining normalization of glucose intolerance in middle‐aged Swedish men and women: a 8–10‐year follow‐up

Aims To examine factors in middle‐aged Swedish men and women predicting the conversion from a state of abnormal glucose regulation to normal glucose tolerance (NGT) after 8–10 years. Methods At baseline 3128 men and 4821 women, aged 35–56 years, without previously diagnosed diabetes underwent an oral glucose tolerance test and completed a questionnaire. At follow‐up, 2383 men and 3329 women were re‐examined. The study group consisted of 156 men and 124 women with impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or both at baseline. Results The rate of reversal to NGT from IFG or IGT was similar regardless of gender. In participants having IFG or IGT, reversal to NGT was predicted by low fasting and 2‐h insulin, homeostasis model assessment of insulin resistance and of pancreatic β cell function, body mass index and waist circumference without differences between gender and baseline glucose tolerance group. Low 2‐h glucose, however, predicted reversal to NGT in men with IFG at baseline, but not in men with IGT at baseline, or in women with either IFG or IGT at baseline. Men reverting to NGT had higher coffee consumption and women had higher baseline leisure‐time physical activity. In multiple logistic regression, including all participants, low fasting and 2‐h glucose remained independent predictors of reverting to NGT. Conclusions Factors predicting reversal to NGT were measures correlated with low insulin resistance, but also lower insulin secretion, perhaps indicating a lower pancreatic β cell workload in those who reverted. In men, but not in women, low 2‐h glucose was of predictive value.     

Association of beta3-adrenergic receptor gene polymorphism with insulin resistance in Japanese-American men

The Trp64Arg variant of the beta3-adrenergic receptor (beta3-AR) gene is relatively common in Japanese people. We hypothesized that this variant may be associated with obesity and insulin resistance when combined with a westernized lifestyle. To test this hypothesis, we investigated the relationships between the beta3-AR gene variant and obesity and insulin resistance in Japanese-American men, who are known to have a higher prevalence of type 2 diabetes mellitus (DM). The subjects were 152 Japanese-American men living in Hawaii, 83 with normal glucose tolerance (NGT), 40 with impaired glucose tolerance (IGT), and 29 with DM. The frequency of the Trp64Arg allele of the beta3-AR gene was 0.18, almost identical to that of the mainland Japanese. The prevalence of the Trp64Arg allele was 30.1% in NGT, 35.0% in IGT, and 41.4% in DM subjects (nonsignificant). The Trp64Arg variant of the beta3-AR gene showed no significant relationship with obesity or insulin resistance in NGT subjects. However, fasting and 2-hour insulin levels and insulin resistance as determined by homeostasis model assessment (HOMA) were significantly higher in IGT subjects with the Trp64Arg variant. Although indices of obesity were the same in IGT subjects with and without the Trp64Arg variant, differences in the body mass index (BMI) and percent body fat between NGT and IGT subjects were greater for individuals with the Trp64Arg variant. Thus, there is an association between the Trp64Arg variant of the beta3-AR gene and insulin resistance in Japanese-Americans with IGT.     

Study of the Prevalence of Diabetes Mellitus in Adults in the Shougang Corporation in Beijing

The aim was to determine the burden of diabetes mellitus (DM) in an urban area of China to aid us in planning preventive measures for those at risk of DM. A survey was conducted among the 29 859 subjects aged between 30 and 64 belonging to 32 units of the Shougang Corporation (a heavy industry enterprise) within the Beijing area. WHO study protocols and diagnostic criteria were used to determine the prevalence of DM and impaired glucose tolerance (IGT). The results showed that the age-adjusted prevalance of DM and impaired glucose tolerance (IGT) was 3.63 % and 4.19 %, respectively, both increasing with age. Peak prevalence for both occurred in the 60–64 age group. Prevalence showed no difference between the sexes in DM but was higher for females in IGT. Obesity, being overweight, a family history of diabetes mellitus and in women, a history of delivering babies with macrosomia, all correlated closely with the prevalence of DM and IGT. High protein intake was also associated with DM. Smoking had no effect on either DM or IGT. Intellectual workers had a higher incidence of IGT than manual workers. Seventy per cent DM was undiagnosed prior to the survey. This survey, done according to the recommendation of WHO, and including appropriate adjustments, reflects the growing prevalence of DM and IGT in this population. It can be compared with other studies for epidemiological analysis.     

High prevalence of undiagnosed diabetes mellitus in Southern Germany: Target populations for efficient screening. The KORA survey 2000

AIMS/HYPOTHESIS: To estimate the prevalence of undiagnosed diabetes mellitus, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG), and their relations with cardiovascular risk factors in the general population aged 55 to 74 years in Southern Germany. METHODS: Oral glucose tolerance tests were carried out in a random sample of 1353 subjects aged 55 to 74 years participating in the KORA (Cooperative Health Research in the Region of Augsburg) Survey 2000. Prevalences of glucose tolerance categories (1999 WHO criteria) were adjusted for sample probabilities. The numbers needed to screen (NNTS) to identify one person with undiagnosed diabetes were estimated from age-adjusted logistic regression models. RESULTS: Sample design-based prevalences of known and unknown diabetes, IGT, and IFG were 9.0%, 9.7%, 16.8%, 9.8% in men, and 7.9%, 6.9%, 16.0%, 4.5% in women, respectively. In both sexes, participants with undiagnosed diabetes had higher BMI, waist circumference, systolic blood pressure, triglycerides, uric acid, and lower HDL-cholesterol than normoglycaemic subjects. A combination of abdominal adiposity, hypertension, and parental diabetes in men resulted in a NNTS of 2.9 (95%CI: 2.0-4.6). In women, the combination of increased triglycerides, hypertension and parental diabetes history yielded a NNTS of 3.2 (95%CI: 2.2-5.1). CONCLUSION/INTERPRETATION: About 40% of the population aged 55 to 74 years in the Augsburg region have disturbed glucose tolerance or diabetes. Half of the total cases with diabetes are undiagnosed. Cardiovascular risk factors worsen among glucose tolerance categories, indicating the need for screening and prevention. Screening for undiagnosed diabetes could be most efficient in individuals with abdominal adiposity (men), hypertriglyceridaemia (women), hypertension, and parental diabetes history.     

Type II Diabetes Mellitus and impaired glucose tolerance in Yemen: prevalence, associated metabolic changes and risk factors

OBJECTIVE: To investigate the prevalence of type II Diabetes Mellitus (DM) and impaired glucose tolerance (IGT) and identify the metabolic abnormalities and risk factors associated with these conditions in an urban city of Yemen. RESEARCH DESIGN AND METHODS: Cross-sectional, population-based study investigating 498 adults (245 males and 253 females) aged 25-65 years. The 1999 modified World Health Organization criteria were adopted for the diagnosis of Diabetes Mellitus and IGT. A standard questionnaire was applied and blood lipids, blood pressure, body mass index (BMI) and waist/hip ratio (WHR) were determined. RESULTS: The overall prevalence of type II Diabetes Mellitus was 4.6% (7.4% in males and 2% in females). Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) were found in 2% and 2.2% of the study population. Factors independently related to any abnormality in glucose tolerance, using logistic regression analysis, were sex, hyperlipidaemia, hypertriglyceridaemia, and hypertension; whereas sex and age related to DM. More than 80% of the type II diabetics were over the age of 40, 35% being hyperlipidaemic, 22% being hypertensive and 18% obese. Sixty percent of IGT subjects were hyperlipidaemic and 20% were obese. Approximately 78% of obese individuals (>/=30 kg/m(2)) had normal glucose tolerance. CONCLUSION: The prevalence of type II DM and its potential increase reflected by the high prevalence of obesity in normal glucose tolerance subjects in the Yemeni population constitutes a major public health problem.     

四川巴中地区老年人糖尿病及糖调节受损患病率的调查

目的了解四川巴中地区老年人糖尿病（DM）及糖调节受损的发病现状。方法采用多级抽样的方法,抽取2414名巴中地区60岁及以上人群进行问卷调查、体检、血糖检查和糖耐量试验。结果2414名对象中,有252例患DM,患病率为10．4％;女性DM患病率高于男性,城镇高于农村,大专及以上文化程度的发病率最低,从事脑力劳动的高于体力劳动的,随经济收入的增高,DM患病率增高。单纯IFG患病率为6．6％,单纯的IGT患病率为22．8％,IFG合并IGT的患病率为1．9％。结论巴中地区老年人糖尿病及糖调节受损的患病形势严峻,应重视和加强防治工作。     

The prevalence of hypertension and diabetes defined by fasting and 2-h plasma glucose criteria in urban Nepal.

AIMS: To determine the prevalence of diabetes, impaired fasting glucose and impaired glucose tolerance (IGT) in people aged >/= 40 years in urban communities of Nepal, comparing the fasting and 2-h plasma glucose (PG) criteria for diagnosis of diabetes and to relate the prevalence to age, gender and hypertension. METHODS: Field surveys of fasting and 2-h PG and blood pressure (BP) were done by cluster sampling in seven urban populations of Nepal. Of 1180 eligible individuals invited, 1012 (85.7%) aged >/= 40 years participated. RESULT: The age and sex standardized prevalence of diabetes (known and newly diagnosed), IGT and impaired fasting glycaemia (IFG) were 19.0%, 10.6% and 9.9%, respectively. Of the total population, 30.5% (37.8% of men and 25.3% of women) had some abnormality of glucose tolerance. Of all diabetic individuals, 54.4% (53.8% of men and 55.1% of women) were undiagnosed. The prevalence of diabetes increased with age until the age of 75 years. The prevalence of diabetes was higher in men than in women (P < 0.001). The sensitivity of the fasting plasma glucose (FPG) criterion compared with either FPG or 2-h PG or both criteria for the diagnosis of diabetes was 70.5%[95% confidence interval (CI) 60.7, 78.8] and the corresponding sensitivity of 2-h PG criterion was 79% (95% CI 69.8, 86.1). The age- and sex-standardized prevalence of hypertension (BP >/= 140/90 mmHg) was 22.7%. Hypertension was less common in subjects with normal plasma glucose than in those with diabetes (18.8% vs. 36.7%). Similarly, of all subjects with hypertension, 29.1% had diabetes (known or newly diagnosed) and 43.0% had glucose intolerance of some form. CONCLUSIONS: Our study shows that diabetes and hypertension are common and related problems in people aged >/= 40 years in urban Nepal. The overall sensitivity of the 2-h PG criteria was greater than that of the FPG criteria for diagnosing diabetes, except in subjects aged >/= 60 years.     

Increasing prevalence of Type 2 diabetes mellitus in all ethnic groups in Mauritius.

AIMS: To describe the prevalence of different stages of glucose intolerance in a population from Mauritius followed over 11 years. METHODS: Population-based surveys were undertaken in the multiethnic nation of Mauritius in 1987, 1992 and 1998, with 5083, 6616, and 6291 participants, respectively. Questionnaires, anthropometric measurements, and a 2-h 75-g oral glucose tolerance test were included. Subjects aged between 25 and 75 years with classifiable data were identified; 4991, 6463 and 5392 from 1987, 1992 and 1998, respectively. Glucose tolerance was classified according to WHO 1999 criteria. RESULTS: The prevalence of Type 2 diabetes increased significantly during the period studied, from 12.8% in 1987, to 15.2% in 1992, and 17.9% in 1998. The increasing prevalence was seen in both men and women, and in all age groups. The prevalence of known diabetes (KDM) increased progressively, and more markedly than the increase in newly diagnosed diabetes (NDM). A diagnosis of impaired glucose tolerance (IGT) was more prevalent amongst women whereas impaired fasting glucose (IFG) was more common amongst men. The prevalences of IGT and IFG did not change markedly during the period. The prevalence of diabetes and IGT was similar for participants of Indian, Creole and Chinese background in each survey, and the increasing prevalence of diabetes was seen in all ethnic groups. CONCLUSION: In this study, we report an increasing prevalence of diabetes over an 11-year period in Mauritius. This increase was seen in both sexes, and in all age and ethnic groups, and was mainly due to an increase in the numbers of those with known diabetes.     

Diabetes in Ghana: a community based prevalence study in Greater Accra

Data on the prevalence of diabetes in Ghana is scanty and unreliable. In the present study we have ascertained the prevalence of diabetes, impaired fasting glycaemia (IFG) and impaired glucose tolerance (IGT) in a random cluster sample of Ghanaians aged 25 years and above from the Greater Accra area of Ghana. Diabetes, IFG and IGT were defined by criteria of the American Diabetes Association and World Health Organization. The mean age of the 4733 subjects involved in the study was 44.3+/-14.7 years, and participation rate was 75%. The crude prevalence of diabetes was 6.3%. Out of 300 subjects with diabetes, 209 (69.7%) had no prior history of the disease. Diabetes, IGT and combined IFG and IGT increased with age. The oldest age group (64+ years) had the highest diabetes prevalence (13.6%). The age-adjusted prevalence of diabetes, IFG and IGT, were 6.4, 6.0 and 10.7%, respectively. Diabetes was more common in males than females (7.7 vs. 5.5%) [P<0.05]. Worsening glycaemic status tended to be associated with increase in age, body mass index, systolic and diastolic blood pressures. Ascertainment of predictors for diabetes in Ghanaians and the significance of the relatively high rates of and IFG and IGT however, remain to be determined.