Glycated haemoglobin, diabetes, and mortality in men

doi:10.1136/bmj.322.7292.996

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 subsequentmorbidity and mortality.¹ They suggest that "preventive effortsneed to consider not just those with established diabetes butwhether it is possible to reduce the population distribution ofHbA_1c [glycated haemoglobin]." This implies that the determinantis the degree ofhyperglycaemia.

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

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

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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]