Resumen de Longitudinal Trajectories of HbA^sub 1c^ and Fasting Plasma Glucose Levels During the Development of Type 2 Diabetes: The Toranomon Hospital Health Management Center Study 7 (TOPICS 7)
Yoriko Heianza, Yasuji Arase, Kazuya Fujihara, Shiun Dong Hsieh, Kazumi Saito, Hiroshi Tsuji, Satoru Kodama, S. Hara, Naoya Yahagi, Hitoshi Shimano, Nobuhiro Yamada, Hirohito Sone
To describe the trajectory of HbA^sub 1c^ and glucose concentrations before the diagnosis of diabetes. The study comprised 1,722 nondiabetic Japanese individuals aged 26-80 years. Fasting plasma glucose (FPG) and HbA^sub 1c^ were measured annually for a mean of 9.5 (SD 1.8) years. Diabetes occurred in 193 individuals (FPG =7.0 mmol/L, self-reported clinician-diagnosed diabetes, or HbA^sub 1c^ >6.5%). Mean HbA^sub 1c^ values were >5.6% each year before diagnosis in diabetes cases. Mean HbA^sub 1c^ (5.69% [95% CI 5.50-5.88]) was higher in the 21 individuals who developed diabetes 10 years after the baseline examination than in nondiabetic individuals after 10 years (5.27% [5.25-5.28]). From 3 years to 1 year prediagnosis, HbA^sub 1c^ increased 0.09% (SE 0.01)/year, reaching 5.90% (5.84-5.96) 1 year prediagnosis. In the entire group, marked increases in HbA^sub 1c^ of 0.3% (SE 0.05%)/year and FPG of 0.63 (0.07) mmol/L/year predicted diabetes. HbA^sub 1c^ trajectory increased sharply after gradual long-term increases in diabetic individuals.
