Glucose tolerance and cardiovascular mortality

Cardiovascular disease is the major cause of mortality and morbidity among patients with type 2 diabetes. The association between glucose tolerance and cardiovascular mortality has been assessed by a number of prospective studies in recent years. The authors reviewed 15 related studies that assessed fasting or postchallenge glucose levels. The results showed that postchallenge hyperglycemia contributed to cardiovascular risk, though different studies produced different hyperglycemia threshold levels. The data relating fasting hyperglycemia to cardiovascular risk were inconclusive. The Diabetes Epidemiology: Collaborative Analysis of Diagnostic Criteria in Europe study, based on a large European population with more than 260,000 person-years of follow-up, showed that asymptomatic diabetes as well as impaired glucose tolerance, detected by elevated 2-hour glucose, increased the risk of death from cardiovascular causes and all causes, independently of other known risk factors and the level of fasting glucose. In contrast, mortality associated with the fasting glucose concentration depended largely on the level of 2-hour glucose. (CVR&R.

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