The plasma levels of soluble P-selectin in subjects with prediabetes

Prediabetes has been associated with an increased risk of cardiovascular disease and mortality. Soluble P-selectin (sP-selectin) is an index of platelet activation and also a risk factor for future vascular events. sP-selectin levels were investigated in prediabetic subjects who had no confounding factors such as hypertension, obesity or dyslipidaemia. sP-selectin, hsCRP levels and HOMA-IR indexes were measured in 40 prediabetic subjects (n = 24 for IFG and n = 16 for IGT) and age-, sex- and BMI-matched 40 healthy controls. sP-selectin levels in prediabetic subjects were not significantly different compared with those in controls (p = 0.12). Prediabetic group had similar hsCRP (p = 0.29), higher HOMA-IR indexes (p < 0.001) and lower HDL cholesterol levels (p = 0.001) when compared with healthy controls. The power of the study was 0.93 for sP-selectin, 0.7 for hsCRP and 1.0 for HOMA. Our data suggest that sP-selectin may not contribute to the prothrombotic state as well as the accelerated atherogenesis associated with prediabetes.     

Associations of prediabetes with all-cause and cardiovascular mortality: A meta-analysis

Abstract

Background. Reports on the association of prediabetes with all-cause mortality and cardiovascular mortality are inconsistent.

Objective. To evaluate the risk of all-cause and cardiovascular mortality in association with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT).

Methods. Prospective cohort studies with data on prediabetes and mortality were included. The relative risks (RRs) of all-cause and cardiovascular mortality were calculated and reported with 95% confidence intervals (95% CIs).

Results. Twenty-six studies were included. The risks of all-cause and cardiovascular mortality were increased in participants with prediabetes defined as IFG of 110–125 mg/dL (IFG 110) (RR 1.12, 95% CI 1.05–1.20; and RR 1.19, 95% CI 1.05–1.35, respectively), IGT (RR 1.33, 95% CI 1.24–1.42; RR 1.23, 95% CI 1.11–1.36, respectively), or combined IFG 110 and/or IGT (RR 1.21, 95% CI 1.11–1.32; RR 1.21, 95% CI 1.07–1.36, respectively), but not when IFG was defined as 100–125 mg/dL (RR 1.07, 95% CI 0.92–1.26; and RR 1.16, 95% CI 0.94–1.42, respectively).

Conclusions. Prediabetes, defined as IFG 110, IGT, or combined IFG 110 and/or IGT, was associated with increased all-cause and cardiovascular mortality.     

Congenital Cretinism

Congenital cretinism is manifested by slowed body function, delayed skeletal growth and maturation, and mental retardation. Radiographic examination is invaluable in differentiating this disorder from conditions that mimic it. Prognosis in the case described here is guarded because of the severity and the duration of thyroid deficiency.     

Hypomagnesaemia and risk for metabolic glucose disorders: a 10-year follow-up study

Background Although several lines of evidence suggest that hypomagnesaemia is a risk factor for developing type 2 diabetes, there are no studies regarding the association between hypomagnesaemia and the risk for developing impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Our objective was to examine the association between serum magnesium levels and the risk for developing IFG, IGT and type 2 diabetes. Materials and methods A total of 1122 individuals (20–65 years of age) were enrolled between 1996 and 1997, and 817 individuals re‐examined about 10 years later. New‐onset IFG (5·6–7·0 mmol L^?1 fasting glucose), IGT (7·8–11·1 mmol L^?1 glucose 2‐h postload), and type 2 diabetes were determined from the number of subjects who had these conditions at the second examination without evidence that they were present at the first one. The relative risk of new‐onset metabolic glucose disorders and diabetes (dependent variables) was computed using Poisson regression model adjusted for age, sex, family history of diabetes, waist circumference and homeostasis model assessment for insulin resistance index. Serum magnesium levels of < 0·74 mmol L^?1 (independent variable) defined the exposed group. Results At baseline, 420 (51·4%) individuals had hypomagnesaemia. New‐onset IFG and IGT was identified in 276 (33·8%) individuals. The relative risk for IFG, IGT and IFG + IGT was 1·11 (95% confidence interval, 0·5–5·1), 1·38 (95% confidence interval, 1·1–6·3) and 1·49 (95% confidence interval, 1·1–4·9), respectively. New‐onset diabetes was identified in 78 (9·5%) individuals (relative risk 2·54; 95% confidence interval, 1·1–4·1). Conclusions Hypomagnesaemia is independently associated with the development of IGT, IFG + IGT and type 2 diabetes, but not with the development of IFG.     

氯氮平对长期住院精神分裂症患者糖代谢的影响

目的调查氯氮平对长期住院的精神分裂症患者糖代谢的影响。方法根据空腹静脉和餐后2 h静脉血糖水平,对服用氯氮平的长期住院男性精神分裂症患者进行糖尿病及与糖尿病相关状态的诊断。结果 67例患者中20例患者有糖尿病(29.8%),16例有糖耐量减低(IGT)(23.9%),6例有空腹血糖损害(IFG)(9%),25例为血糖代谢正常者(37.3%)。根据氯氮平剂量、体质指数和服药时间的不同将患者各分成3组,3组间的糖代谢异常发生率差异无统计学意义。正常组、IFG组、IGT组以及糖尿病组患者在胆固醇水平、体质指数、氯氮平剂量、三酯甘油水平以及服药时间之间差异无统计学意义。在IFG组,体质指数与患者每天氯氮平服用剂量之间呈显著性正相关(r=0.889,P=0.019),而在IGT组,各临床资料之间无明显相关性。结论长期服用氯氮平对精神分裂症患者糖代谢有明显影响。     

2003 ADA空腹血糖受损诊断标准在中老年患者中的评估

目的分析2003年美国糖尿病学会（ADA）空腹血糖受损（IFG）的空腹血糖（FPG）诊断标准下调对中老年糖调节受45（IGR）人群检出率的影响,并探讨区分糖调节正常与受损的FPG理想切点。方法3219例50岁以上台州农村人群分层整群随机抽样调查,空腹测毛细血管血糖。若FPG5．6mmol/L做OGTF检查。结果IFG患病率按新诊断切点5．6mmol/L为10．15％,按原切点6．1mmol/L为1．24％,两组比较,差异有统计学意义（X^2=83．55,P〈0．05）;空腹血糖受损合并糖耐量受损（IGT）患病率按新诊断切点5．6mmol／L为6．14％．按原切点6．1mmol／L为3．26％,两组比较,差异有统计学意义（X^2=10．78,P〈0．05）。计算不同FPG切点诊断IGR的约登指数,最大值对应的FPG为5．7mmol／l。结论IFG诊断标准下调后,IFG、IFG＋IGT检出率明显增加：非DM中老年人群中诊断IGR的FPG理想截定点为5．7mmol/L．     

Electronic health record identification of prediabetes and an assessment of unmet counselling needs

Rationale, aims and objectives Large clinical trials demonstrate that lifestyle modification can prevent or delay the onset of diabetes in those with prediabetes. However, recent National Health and Nutrition Survey data suggest that prediabetes often goes unrecognized, and the majority of prediabetic individuals do not report having received lifestyle advice from physicians. We explored whether electronic health record (EHR) query of glucose measurements can identify prediabetic patients, and we estimated rates of prediabetic lifestyle counselling in a large, urban, primary care practice. Methods Electronic search identified patients with plasma glucose levels of 100 to 199 mg dL^?1 between 1 June 2007 and 1 June 2009, excluding those with diabetes or diabetic medications/supplies. From these 5366 patients, 100 randomly selected patients underwent classification into provisional categories based on available EHR data: likely prediabetes, likely diabetes, glucose abnormality in the setting of acute illness, or normal glucose metabolism. In those likely to have prediabetes, we assessed lifestyle modification counselling. Results Fifty‐eight per cent (95% CI 48% to 68%) of patients sampled were likely to have prediabetes. Fourteen per cent of those sampled were likely to have diabetes. Thirty‐one per cent of prediabetics (95% CI 22% to 42%) had documented lifestyle counselling. Counselled patients had a significantly higher baseline mean body mass index compared to those not counselled (34.1 versus 29.9, P = 0.037). Conclusions EHR query using glucose measurements can identify prediabetic patients and those requiring further glucose metabolism evaluation, including those with undiagnosed diabetes. Future research should investigate EHR‐based, population‐level interventions to facilitate prediabetes recognition and counselling.     

Hemoglobin A1c and glucose criteria identify different subjects as having type 2 diabetes in middle-aged and older populations: The KORA S4/F4 Study

Abstract

Objective. The American Diabetes Association (ADA) has recently recommended HbA1c for diagnosing diabetes as an alternative to glucose-based criteria. We compared the new HbA1c-based criteria for diagnosis of diabetes and prediabetes with the glucose-based criteria.

Research design and methods. In the population-based German KORA surveys (S4/F4) 1,764 non-diabetic participants aged 31–60 years and 896 participants aged 61–75 years underwent measurements of HbA1c, fasting plasma glucose (FPG), and 2-h glucose.

Results. Only 20% of all subjects diagnosed with diabetes by glucose or HbA1c criteria had diabetes by both criteria; for prediabetes, the corresponding figure was 23%. Using HbA1c ≥ 6.5%, the prevalence of diabetes was strongly reduced compared to the glucose criteria (0.7% instead of 2.3% in the middle-aged, 2.9% instead of 7.9% in the older subjects). Only 32.0% (middle-aged) and 43.2% (older group) of isolated impaired glucose tolerance (i-IGT) cases were detected by the HbA1c criterion (5.7% ≤ HbA1c < 6.5%).

Conclusion. By glucose and the new HbA1c diabetes criteria, different subjects are diagnosed with type 2 diabetes in middle-aged as well as older subjects. The new HbA1c criterion lacks sensitivity for impaired glucose tolerance.     

Detection of Undiagnosed Diabetes and Prediabetic States in High-risk Emergency Department Patients

Background: Diabetes is often not diagnosed until complications appear, and one‐third of those with diabetes may be undiagnosed. Prediabetes and diabetes are conditions in which early detection would be appropriate, because the duration of hyperglycemia is a predictor of adverse outcomes, and there are effective interventions to prevent disease progression and to reduce complications. Objectives: The objectives were to determine the prevalence of diabetes mellitus and prediabetes in emergency department (ED) patients with an elevated random glucose or risk factors for diabetes but without previously diagnosed diabetes and to identify which at‐risk ED patients should be considered for referral for confirmatory diagnostic testing. Methods: This two‐part study was composed of a prospective 2‐year cohort study, and a 1‐week cross‐sectional survey substudy, set in an urban ED in Los Angeles County, California. A convenience sample was enrolled of 528 ED patients without previously diagnosed diabetes with either 1) a random serum glucose ≥ 140 mg/dL regardless of the time of last food intake or a random serum glucose ≥ 126 mg/dL if more than 2 hours since last food intake or 2) at least two predefined diabetes risk factors. Measurements included presence of diabetes risk factors, ED glucose, cortisol, insulin and glycosylated hemoglobin (HbA_1c), and 2‐hour oral glucose tolerance test results, administered at 6‐week follow‐up. Results: Glycemic status was confirmed at follow‐up in 256 (48%) of the 528 patients. Twenty‐seven (11%) were found to have diabetes, 141 (55%) had prediabetes, and 88 (34%) had normal results. Age, ED glucose, HbA_1c, cortisol, and random serum glucose ≥ 140 mg/dL were associated with both diabetes and prediabetes on univariate analysis. A random serum glucose ≥ 126 mg/dL after 2 hours of fasting was associated with diabetes but not prediabetes; ED cortisol, insulin, age ≥ 45 years, race, and calculated body mass index (BMI) were associated with prediabetes but not diabetes. In multivariable models, among factors measurable in the ED, the only independent predictor of diabetes was ED glucose, while ED glucose, age ≥ 45 years, and symptoms of polyuria and polydipsia were independent predictors of prediabetes. All at‐risk subjects with a random ED blood glucose > 155 mg/dL had either prediabetes or diabetes on follow‐up testing. Conclusions: A substantial fraction of this urban ED study population was at risk for undiagnosed diabetes and prediabetes, and among the at‐risk patients referred for follow‐up, the majority demonstrated diabetes or prediabetes. Notably, all patients with two risk factors and a random serum glucose > 155 mg/dL were later diagnosed with prediabetes or diabetes. Consideration should be given to referring ED patients with risk factors and a random glucose > 155 mg/dL for follow‐up testing.     

Incidence of type 2 diabetes in southern Spain (Pizarra Study)

Background Few European studies have used an oral glucose tolerance test (OGTT) to examine the incidence of type 2 diabetes. We determined the incidence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes in a population from southern Spain. Material and methods A population‐based cohort study was undertaken in Pizarra, Spain. Baseline data were recorded on age, sex, weight, height, waist and hip circumferences, and diabetes status for 1051 persons, of whom 910 were free of type 2 diabetes (at‐risk sample). Of these, 714 completed the 6‐year follow‐up study. Body mass index, waist‐to‐hip ratio and weight increase since baseline were calculated. The homeostasis model assessment equations were used to estimate the indices of insulin resistance and β‐cell function. Each person received an OGTT at baseline and after 6 years. Results Type 2 diabetes developed in 81 people for a total of 4253 person‐years, representing an incidence of 19·1 cases per 1000 person‐years (95% confidence interval, 15·3–23·6). Age and the presence of obesity, central obesity and carbohydrate metabolism disorders [IFG (cut off = 100 mg dL^?1, capillary blood glucose level), IGT or both] at baseline were significant markers for the onset of type 2 diabetes during follow‐up. After adjusting for these variables, multivariate analysis showed weight increase, waist‐to‐hip ratio and the indices of insulin resistance and β‐cell function were significantly associated with the risk for type 2 diabetes. Conclusions The incidence of type 2 diabetes in a population from southern Spain is high. It is probably associated with the high prevalence of obesity and weight increase in this population.     

Early Lifestyle Intervention in Patients with Non-insulin-dependent Diabetes Mellitus and Impaire Glucose Tolerance

Non-insulin-dependent diabetes mellitus (NIDDM) is preceded by impaired glucose tolerance (IGT) lasting for years before manifesting as overt hyperglycaemia. Both genetic and environmental factors contribute to the development of IGT and NIDDM. Obesity, physical inactivity and high-fat diet have been found to predict IGT and NIDDM. Therefore, a diet and exercise intervention from diagnosis of NIDDM could improve the treatment outcome and prognosis of patients with NIDDM. Furthermore, because subjects with IGT are at increased risk for diabetes and atherosclerotic vascular diseases, it is reasonable to assume that in terms of reducing the incidence and long-term consequences of NIDDM an intervention at this phase is more effective than in overt diabetes. Although the nonpharmacological approach is generally accepted as the first-line treatment for NIDDM its efficacy has often been questioned. Therefore, it is important to carry out long-term controlled studies to find out to what extent lifestyle modification could improve the metabolic control and level of major cardiovascular risk factors known to be associated with poor outcome in NIDDM. This kind of study also gave relevant experience in planning studies aiming at primary prevention of NIDDM. One-year dietary and exercise intervention on newly diagnosed NIDDM patients in Kuopio, Finland resulted in a better metabolic control and a moderate reduction in cardiovascular risk factors as compared to the conventional treatment group. After the second year of follow-up only 12.5% in the intervention group were receiving oral antidiabetic drugs vs. 34.8% in the conventional treatment group. Weight reduction and a reduced use of saturated fats appeared to be the main determinants of successful treatment results. Good aerobic capacity was associated with an increase in HDL cholesterol. A multicentre primary prevention study on IGT patients is continuing in Finland applying the same principles of intervention as used in the study on newly diagnosed NIDDM patients. Pilot results show that glucose tolerance can be improved by lifestyle changes.     

糖化血红蛋白对精神分裂症患者糖尿病的诊断效果

目的评估糖化血红蛋白（Hb A1c）对精神分裂症患者糖尿病的诊断效果。方法采用随机整群抽样的方法,抽取新入院的符合国际疾病分类第十版（ICD-10）诊断标准的精神分裂症患者826例,于次日早晨7：30静脉采血测定空腹血糖（FPG）、Hb A1c,同时进行葡萄糖耐量实验（OGTT）测定2 h后血糖（PG 2 h）。分析三者对糖尿病的检出率,比较Hb A1c和FPG诊断糖尿病的误差率,比较Hb A1c和PG 2 h诊断糖尿病的一致性。结果 FPG、Hb A1c、PG 2 h对糖尿病的检出率分别为12.6%、10.3%、9.8%。Hb A1c和FPG诊断糖尿病的误差率分别为0.36%、5.20%,两者误差率比较差异有统计学意义（P〈0.01）。Hb A1c和PG 2 h诊断糖尿病的吻合系数k=0.73,吻合度为高度。结论在精神科临床Hb A1c诊断糖尿病效果可靠,并具有更多优势。     

General effect on high-risk persons when general practitioners are trained in intensive treatment of type 2 diabetes

Objective

Within the frame of a randomized clinical trial to examine whether training of general practitioners (the intervention group) in intensive lifestyle modification and pharmacological treatment of patients with type 2 diabetes has a spillover effect on individuals with impaired fasting glycaemia (IFG) or impaired glucose tolerance (IGT).

Design

A high-risk screening study for type 2 diabetes with an intervention programme, where general practices were randomized to provide standard treatment versus intensive lifestyle modification and pharmacological treatment to newly diagnosed diabetic patients.

Setting

General practices in Denmark.

Subjects

Of 1821 individuals identified with IFG or IGT, results from oral glucose tolerance tests after one and three years were available in 1510 individuals.

Main outcome measures

Progression rates from IFG and IGT to diabetes and effect of intervention were estimated in a regression model using interval censoring.

Results

A total of 442 persons developed diabetes. There was no significant overall effect of intervention on progression rates. For risk factors, no difference in rate of change was found between randomization groups, but a difference was found between general practices within the same randomization groups.

Conclusion

General practitioners identify a high number of incident diabetes cases in individuals with IFG or IGT found by high-risk screening. Intervention at the general practitioner''s level in intensive treatment type 2 diabetes does not have a significant spillover effect reducing the risk of diabetes from pre-diabetic conditions. This could indicate that intervention strategies should be specifically targeted at individuals with IFG or IGT, either by training general practitioners or directly at the individual level.     

Safety and Efficacy of Pitavastatin in Patients With Impaired Fasting Glucose and Hyperlipidemia: A Randomized,Open-labeled,Multicentered, Phase IV Study

PurposeAlthough the role of high-intensity lipid-lowering therapy in cardiovascular protection has broadened, concerns still exist about new-onset diabetes mellitus (NODM), especially in vulnerable patients. This study aimed to compare the effect of high-dose (4 mg/d) and usual dose (2 mg/d) pitavastatin on glucose metabolism in patients with hyperlipidemia and impaired fasting glucose (IFG).MethodsIn this 12-month study, glucose tolerance and lipid-lowering efficacy of high-dose pitavastatin (4 mg [study group]) was compared with that of usual dose pitavastatin (2 mg [control group]) in patients with hyperlipidemia and IFG. The primary end point was the change of glycosylated hemoglobin (HbA_1c) after 24 weeks of treatment. The secondary end points were as follows: (1) NODM within 1 year after treatment, (2) change of lipid parameters, (3) changes of adiponectin, and (4) change of blood glucose and insulin levels.FindingsOf the total 417 patients screened, 313 patients with hypercholesterolemia and IFG were randomly assigned into groups. The mean (SD) change in HbA_1c was 0.06% (0.20%) in the study group and 0.03% (0.22%) in the control group (P = 0.27). Within 1 year, 27 patients (12.3%) developed NODM, including 12 (10.6%) of 113 patients in the study group and 15 (14.2%) of 106 in the control group (P = 0.43). The study group had a significantly higher reduction of total cholesterol and LDL-C levels and a higher increase in apolipoprotein A1/apolipoprotein B ratio (0.68 [0.40] vs 0.51 [0.35], P < 0.01).ImplicationsThe high-dose pitavastatin therapy did not aggravate glucose metabolism compared with the usual dose therapy. Moreover, it had a better effect on cholesterol-lowering and apolipoprotein distribution in the patients with hyperlipidemia and IFG.     

Metabolic characteristics in individuals with impaired glucose homeostasis

We sought to clarify whether impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or both (IFG/IGT) represent the most severe impairment in insulin resistance (IR) and insulin secretion. Among the 159 Chinese subjects, 21 were diagnosed as having IFG, 103 as having IGT and 35 as having both. IR and beta-cell function were assessed using homeostatic model assessment (HOMA) and an insulin-suppression test (IST). No differences were evident between the groups in blood pressure, body mass index, plasma insulin fasting levels and lipid profiles. However, plasma 2-h insulin levels were higher in the IGT and IFG/IGT groups. Beta-cell functions were not different between these groups. But, the result of glucose tolerance was different, in which the IFG/IGT and IFG groups displayed higher insulin sensitivity than IGT via HOMA instead of no difference via IST in the three patient groups.     

不同年龄段糖尿病分布及受损情况分析

目的了解通州区连续5年来不同性别、不同年龄段体检人群中糖尿病分布及受损情况。方法随机选取通州区部分在职及退休职工为研究对象,共1 916例,年龄21～85岁,以10岁为一个年龄组,共分为6组,采用酶法测定该组人群的空腹血糖。结果随着年龄增加,该组人群的血糖值异常者比例相应增高,其中以60～69岁组最高;血糖在男性中的含量与女性相比差异无统计学意义(P>0.05);同时发现糖尿病在20～29岁年龄段的发病率有上升趋势,连续5年来糖尿病受损患者比例也在逐年升高,2012年其比例达到9.5%。结论体检测定血糖对于健康体检有重要意义,有利于早期发现糖尿病受损情况,并提醒、指导患者采取相应预防及治疗措施,以避免和减少糖尿病并发症及代谢综合征等的发生。     

妊娠期糖尿病治疗对其后代儿童期肥胖症的影响

目的评估妊娠期糖尿病的治疗对其后代儿童时期肥胖症发病情况的影响。方法选取入院生产的137名患有妊娠期糖尿病的妇女,对接受治疗与未接受治疗的孕妇后代进行追踪研究,研究指标包括身高、体质量、血压、腰围、空腹血糖、空腹胰岛素、甘油三酯含量和高密度脂蛋白及胆固醇的含量。结果治疗组与未治疗组的后代体质量指数>P95（肥胖）的例数分别占总人数的8.8%和9.5%（P=0.79）,体质量指数>P85（超重）的例数占总人数的16.8%和19.7%（P=0.65）。其中治疗组与未治疗组的体质量指数、空腹血糖值、甘油三酯含量、高密度脂蛋白含量、血压值、胰岛素抵抗值之间差异并无统计学意义（P>0.05）。但治疗组与未治疗组女性后代的空腹血糖和胰岛素抵抗值之间的差异有统计学意义（P=0.002,0.02）。结论尽管妊娠期糖尿病的治疗可以降低其女性后代的空腹血糖值,但总体而言并未降低儿童时期肥胖症的发生率。     

糖化血红蛋白对糖尿病的诊断价值分析

目的探讨糖化血红蛋白（HbA1c）在糖尿病（DM）诊断中的应用价值。方法 286例健康人和680例DM患者均行口服葡萄糖耐量试验（OGTT）,用特定蛋白分析仪检测HbA1c水平,用BS-420生化分析仪测定血糖,对结果进行分析。结果从健康组到DM组之间的HbA1c的变化关系可看出：DM组患者空腹血糖（FPG）、餐后2h血糖（2hPG）及HbA1c均明显高于健康组（均P〈0.01）,以HbA1c≥6.5%作为DM诊断临界值,其诊断灵敏度为99.18%,诊断特异性为94.45%,均优于以FPG≥7.0mmol/L作为诊断临界值的诊断灵敏度（76.43%）和诊断特异性（89.82%）。结论 HbA1c的值为6.5%时用于诊断DM,与FPG≥7.0mmol/L时联合应用可增加诊断DM的能力。     

糖负荷后2小时血糖在糖尿病诊断中的意义

目的：探讨糖负荷后2小时血糖（2hPG）在糖尿病诊断中的意义。方法：4660例连续的内分泌门诊病人采用口服葡萄糖耐量试验（OGTT），对其血浆葡萄糖结果进行分析。结果：4660例中，2856例（61．3％）2hPG达到糖尿病诊断标准，其中622例（21．8％）空腹血浆葡萄糖（FPG）小于7．0mmol/L；2319例（49．8％）FPG达到糖尿病诊断标准，其中85例（3．7％）2hPG小于11．1mmol/L。1710例FPG小于6．1mmol/L,其中274例（16％）2hPG达到糖尿病诊断标准。631例FPG大鼠或等于6．1mmol/L，且小于7．0mmol/L，以2hPG标准判断达糖尿病标准者348例（55％），糖耐量减低（IGT）213例（34％），空腹高血糖（IFG）70例（11％）。结论：2hPG诊断糖尿病敏感性高于FPG标准，且漏诊率也低于FPG标准，2hPG标准和FPG标准不能相互取代。FPG正常不能排除糖尿病，FPG大于或等于6．1mmol/L且小于7．0mmol/L者，必须核查OGTT，以了解是否为糖尿病或IGT。