Definition of impaired fasting glucose needs re-evaluation

The definition of impaired fasting glucose (IFG) should be lowered to a fasting plasma glucose (FPG) of 90 mg/dL from its current level of 100 mg/dL. At a FPG of 90 mg/dl, incidence of atherosclerotic cardiovascular disease has been found to rise sharply, according to Devang M. Desai, MD. He presented his findings at the American College of Cardiology's 56th annual scientific session.

Current guidelines identify IFG as levels of 100 mg/dL to 125 mg/dL, and normal fasting glucose values as those

He conducted a retrospective review of 566 randomly selected patient charts from a preventive cardiology clinic. Average age was 55 years, average body mass index was 30, 55% had hypertension, and 64% had hypercholesterolemia.

Prevalence of atherosclerotic cardiovascular disease increased significantly with increasing FPG levels (p

The significant jump in atherosclerotic cardiovascular disease with FPG of 90 mg/dL implies that the cut-off point for IFG, as well as diabetes, may need to be re-evaluated, Dr. Desai said. "These ‘cusp' patients [FPG of 90 to 99 mg/dL] need to be on your radar screen," he said. "I don't know if I would put all of them on a statin but they do need aggressive care."

"We know that IFG is a risk factor for cardiovascular disease," he said. "The range of glucose levels that we call ‘impaired' needs to be rethought."