Elevated fasting plasma glucose levels during childhood—even within the normoglycemic range—appear to predict prediabetes and diabetes in young adulthood, according to a report from the Bogalusa Heart Study.
Moreover, high-normal fasting plasma glucose predicts later diabetes status independently of other traditional risk factors, said Dr. Quoc Manh Nguyen and associates at Tulane University, New Orleans.
Subjects were aged 4-18 years at study inception in 1978 and have been followed for a mean of 21 years. At the last survey, 1,723 subjects were classified as normoglycemic, 79 as prediabetic, and 47 as diabetic.
Subjects who had high-normal levels of fasting plasma glucose at baseline (86-99 mg/dL) were more than twice as likely to develop prediabetes or diabetes in young adulthood as were those with lower baseline levels.
Fasting plasma glucose level predicted later diabetes risk even after the data were controlled for other cardiometabolic risk factors, Dr. Nguyen and colleagues said (Arch. Ped. Adolesc. Med. 2010;164:124-8).
In an editorial, Dr. Matthew W. Gillman of Harvard Medical School, Boston, noted that the prevalence of prediabetes was 6%-7% among adults whose childhood glucose exceeded 86 mg/dL, but was only 2% for those whose childhood levels were lower.
Nevertheless, it would be premature to recommend using high-normal childhood glucose levels to predict later prediabetes. It would not be “sensible” to label all such children as at risk when only 7% are likely to develop the disorder, Dr. Gillman noted (Arch. Ped. Adolesc. Med. 2010;164:198-9).
The study was supported by the National Institute on Aging and the American Heart Association. Dr. Nguyen and Dr. Gillman reported no relevant conflicts of interest.