BMJ 2001;322:996 ( 21 April )

Letters

Glycated haemoglobin, diabetes, and mortality in men

    Maybe disturbance in physiological mechanisms regulating blood glucose is risk factor for cardiovascular death
    Analytical information is required for generalisation of data
    Authors' reply
    Medicine is now using diagnostic criteria rather than reference ranges

Maybe disturbance in physiological mechanisms regulating blood glucose is risk factor for cardiovascular death

The first 150 words of the full text of this article appear below.

EDITOR---Khaw et al contribute to the substantial literature showing an association between measures of glycaemia and subsequent morbidity and mortality.1 They suggest that "preventive efforts need to consider not just those with established diabetes but whether it is possible to reduce the population distribution of HbA1c [glycated haemoglobin]." This implies that the determinant is the degree of hyperglycaemia.

In the non-diabetic population, glycated haemoglobin principally reflects the fasting blood glucose concentration, which has been shown by several groups to predict morbidity and mortality. One of these groups, the DECODE (diabetes epidemiology: collaborative analysis of diagnostic criteria in Europe) Study Group, also measured the blood glucose concentration two hours after a load and found that fasting concentrations were not additionally predictive within two hour blood glucose categories.2

In a cross sectional study with carotid intima media thickness as a marker of atherosclerosis, blood glucose concentrations after a load (in . . . [Full text of this article]
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Relevant Article

Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of European Prospective Investigation of Cancer and Nutrition (EPIC-Norfolk)
Kay-Tee Khaw, Nicholas Wareham, Robert Luben, Sheila Bingham, Suzy Oakes, Ailsa Welch, and Nicholas Day
BMJ 2001 322: 15. [Abstract] [Full Text] [PDF]

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