Impaired Glucose Tolerance and Impaired Fasting Glycemia
Impaired glucose tolerance (IGT) and impaired fasting glycemia (IFG) are recognized as an intermediate group of people who have higher blood glucose level than the recognized normal value but not sufficiently high as described in diabetes mellitus. In 197
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Impaired Glucose Tolerance and Impaired Fasting Glycemia
Impaired glucose tolerance (IGT) and impaired fasting glycemia (IFG) are recognized as an intermediate group of people who have higher blood glucose level than the recognized normal value but not sufficiently high as described in diabetes mellitus. In 1979, IGT was introduced to change the word “borderline diabetes” and other situations of increased level of blood sugar that did not produce risk of a microvascular complication. WHO in 1985 recognized IGT as a clinical class of glucose intolerance and subsequently categorized it as a state in the natural history of disturbed carbohydrate metabolism. The people with IFG and/or IGT have a high chance toward diabetes state in the future. Though IFG and IGT should not be considered as clinical entities in their own, they should be considered as risk factors for DM and cardiovascular disease (CVD). This prediabetes condition are usually connected with obesity (though abdominal obesity or visceral obesity is mainly connected with this situation), hypertension, and dyslipidemia with higher level of triglycerides and/or reduced quantity of high-density lipoprotein (HDL) cholesterol (Petersen and McGuire 2005; Nathan et al. 2007; NHS Lanarkshire 2011; American Diabetes Association 2013a, b).
“IGT” Versus “IFG”: Clinical Characteristic IGT and IFG generally refer to impaired glucose regulation, though these terms are stated unequivocally, but IFG and IGT are not the same and symbolize dissimilar abnormalities of regulation of glucose, IFG in the fasting state and IGT in postprandial. IFG is defined as a level of fasting plasma glucose (after 8 h of fasting) which is higher than the normal reference range but below than those required to diagnose DM. As per ADA 2013 criteria, fasting plasma glucose levels between 100 and 125 mg/dL are considered as IFG, while the WHO considers IFG if the plasma glucose level found is between 110 and 125 mg/ dL. IGT reflects a plasma glucose level higher than the normal reference range but below than those required to diagnose DM after 2 h of 75-g oral glucose administration (during OGTT as per WHO guideline). Plasma glucose value between 140 and 199 mg/dL after 2 h of glucose administration during OGTT is considered as IGT. Currently, ADA recognized HbA1C value to determine the prediabetes condition. HbA1C value in between 5.7 and 6.4 % is considered as prediabetes (Reinauer et al. 1999; Rao et al. 2004; American Diabetes Association 2013b).
© Springer Science+Business Media Singapore 2016 S. Sen et al., Diabetes Mellitus in 21st Century, DOI 10.1007/978-981-10-1542-7_3
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Impaired Glucose Tolerance and Impaired Fasting Glycemia
The metabolic determinants of plasma glucose values during fasting and after 2 h of glucose load in an oral glucose tolerance test are not entirely similar. Therefore, the people categorized under IGT may not have IFG or vice versa. In general, capacity of the human body to maintain sufficient basal insulin secretion reflects the fasting glucose lev
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