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Diabetes Care. 2001 Jun;24(6):1023-8.

Comparison of the effect of plasma glucose concentrations on microvascular disease between Pima Indian youths and adults.

Author information

  • 1National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, 1550 E. Indian School Road, Phoenix, AZ 85014, USA. jkrakoff@mail.nih.gov

Abstract

OBJECTIVE:

To examine whether the current adult guidelines for diagnosis of diabetes are applicable to youth (age <20 years).

RESEARCH DESIGN AND METHODS:

We analyzed fasting plasma glucose (FPG) and 2-h plasma glucose (PG) in two groups of Pima Indians, youths aged 5-19 years and adults aged 20-34 years, in relation to the incidence of microvascular disease when subjects were reexamined at ages 25-39 (youths) and 40-54 (adults). Microvascular disease was defined as retinopathy or a urine protein-to-creatinine ratio > or =0.5 g.

RESULTS:

An increase in the incidence of microvascular disease occurred at nearly the same level of glycemia in both groups. For youths, this increase occurred at FPG approximately 7.3 mmol/l and 2-h PG approximately 10.0 mmol/l; for adults, this increase occurred at FPG approximately 7.5 mmol/l and 2-h PG approximately 10.3 mmol/l. Sensitivity of the adult diagnostic guidelines of FPG > or =7.0 mmol/l and 2-h PG > or =11.1 mmol/l for the detection of microvascular disease was much lower (with higher specificity) in youths than in adults. Receiver operating characteristics (ROC) curve areas were lower for FPG and 2-h PG for youths, suggesting that microvascular disease was less strongly predicted by baseline glucose.

CONCLUSION:

The current adult guidelines for diagnosis of diabetes are applicable to youth, as they identify a population at high risk of microvascular complications.

PMID:
11375364
[PubMed - indexed for MEDLINE]
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