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Pre-diabetes and future risk of stroke

People suffering from pre-diabetes run the risk of future stroke, suggests a study published in British Medical Journal, online.

Pre-diabetes (impaired glucose tolerance) is also known as borderline diabetes. People with this condition have a higher than normal glucose level, but not high enough to indicate diabetes. People with pre-diabetes also have the same vascular risk factors as people with Type 2 diabetes, such as high blood pressure, high cholesterol and obesity. Almost all people who suffer from Type 2 diabetes had pre-diabetes first.

A range of 70.2 to 100 mg/dl is normal, while a level of 100 to 126 mg/dl is considered a sign of pre-diabetes.

The objective of the study was twofold: to investigate the direction and magnitude of the relation of pre-diabetes with the risk of future stroke after accounting for other stroke risk factors, and to evaluate whether this relation varies on the basis of the threshold for impaired fasting glucose or inclusion of impaired glucose tolerance criteria in the diagnosis of pre-diabetes.

To understand the relation between pre-diabetes and risk of stroke, researchers from the University of California analyzed results of 15 studies involving 760,925 participants. The team took into account other cardiovascular risk factors such as lifestyle and weight.

The researchers found that pre-diabetes based on the 1997 American Diabetes Association (ADA) definition of 110 to 125 mg/dl carried a 21 percent increased risk of stroke. However, pre-diabetes was redefined by the ADA in 2003 as an impaired fasting glucose of 100 to 125mg/dl. The researchers found that in studies using this definition, there was no increased risk of stroke. These findings indicate that the risk of stroke only starts to increase at, or above a fasting glucose level of 110 mg/dl.

The study concluded that people were at a “modestly higher risk of future stroke” if their fasting glucose was 110 to 125mg/dl/. However, those with the 2003 ADA’s definition (100 to 125mg/dl) are not at increased risk.

People diagnosed with pre-diabetes must adopt a healthy lifestyle and manage their weight in order to reduce the risk for Type 2 diabetes and cardiovascular diseases.

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