Major Finding: High-normal fasting plasma glucose levels in childhood may predict prediabetes and diabetes in young adulthood.
Data Source: Data from the Bogalusa Heart Study involving 1,849 subjects who were 4-18 years at the initiation of the trial.
Disclosures: Dr. Nguyen's study was supported by the National Institute on Aging and the American Heart Association, and Dr. Gillman's involved funding from the National Institutes of Health. Both Dr. Nguyen and Dr. Gillman reported no relevant conflicts of interest.
Elevated fasting plasma glucose levels during childhood—even when they remain within the normoglycemic range—appear to predict prediabetes and diabetes in young adulthood, according to a new report.
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.
The investigators used data from the Bogalusa Heart Study to assess diabetes risk over a 2-decade span. The study subjects were aged 4-18 years at its 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, defined as 86-99 mg/dL, were more than twice as likely to develop prediabetes or diabetes in young adulthood as were those with lower levels of fasting plasma glucose at baseline.
Moreover, 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 comment accompanying this report, Dr. Matthew W. Gillman of Harvard Medical School, Boston, noted that the prevalence of prediabetes was 6%–7% among adult subjects whose childhood glucose exceeded 86 mg/dL, but was only 2% for those whose childhood glucose 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).