Hello,
According to this letter
Article Diagnostic criteria should be considered when reviewing the ...
It was written that "The definitions given for IFG or IGT in terms of the range of FPG were inconsistent across studies.".
On table 1, I knew that The World Health Organization (WHO, 1999) and the American Diabetes Association (ADA, 2003) utilise different cut-off values for IFG (WHO: 6.1–6.9 mmol/L; ADA: 5.6–6.9 mmol/L)
However, I can't understand completely why the authors of 3 RCTs used the cut-off 5.3 mmol/L. We contacted authors already but we don't think they would reply me because these papers were published before 2012.
Could you please explain why the cut-off was 5.3 mmol/L, not 5.6 mmol/L nor 6.1 mmol/L?
Thanks in advance.
Ngan
The quest for normal glucose levels with type II diabetes is a ‘carrot on a stick’, a reward of health that is promised to someone as an incentive to achieve “normal” fasting glucose or Normal Hemoglobin A1c. Both activities are an unrealistic hope or fantasy.
On the flip side, the are individuals with “normal” fasting glucose or Normal Hemoglobin A1c that are obese, hypertense, suffering from cardiovascular disease, fatty liver and kidney disease identified as ‘Metabolic syndrome’. Clearly, the quest for normal glucose level in a blood test is not the answer.
Metabolic syndrome, Syndrome X, and Type II Diabetes all have in common – insulin resistance.
Insulin, the pancreatic secreted hormone is essential for health by regulating somatic blood glucose. However, when lifestyle and wrong dietary choices continue to be made the produced insulin becomes glycated, the non-enzymatic glycosylation a covalent attachment of a sugar to the fifty- one (51) amino acids that make up insulin. Glycated insulin is not recognized and will not open the insulin portals of
muscles, fat and liver cells don’t respond as they should to insulin, not allowing glucose ingress into the cell.
The first diagnostic criteria to evaluate risk for diabetes type II or, especially to evaluate the efficacy of diabetes type II prevention studies should be to determine insulin resistance! The HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) is a simple, yet powerful tool that can be followed and appreciated by study participants or patients. Using only fasting glucose and insulin placed in the HOMA formula provides an indices, measuring insulin resistance, type II diabetes risk.