Editorials

Impaired glucose tolerance

BMJ 1996; 312 doi: http://dx.doi.org/10.1136/bmj.312.7026.264 (Published 03 February 1996) Cite this as: BMJ 1996;312:264
  1. Melanie J Davies,
  2. I Peter Gray
  1. Consultant physician Department of Diabetes, Leicester Royal Infirmary, Leicester LE1 5WW
  2. Professor of chemical pathology University of Witwatersrand, Parktown, Johannesburg 2193, Republic of South Africa

    Detection and follow up should aim to reduce excess morbidity and mortality

    Impaired glucose tolerance is defined as a fasting plasma glucose concentration of less than 7.8 mmol/l and between 7.8 and 11.1 mmol/l two hours after a 75 g oral glucose load. This definition was first established in 1980 by the World Health Organisation, replacing terms such as “borderline” or “chemical” diabetes.1 It is based on long term prospective studies which conclude that individuals with lesser degrees of glucose intolerance are not at risk of microvascular complications such as retinopathy.2 The advent of health promotion clinics and screening programmes is likely to mean higher rates of detection. However, the clinical significance of impaired glucose tolerance remains unclear.3 Should people who are found to have impaired glucose tolerance be followed up, and what treatment, if any, should they receive?

    Impaired glucose tolerance is common; it affects about 11% of people aged 20-74 years in the United States and 17% of those aged 40-65 years in Britain.4 5 The pathogenesis is controversial, particularly the question of whether it is insulin resistance or insulin deficiency that predominates. (This may have …

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