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Review
. 2017 Nov 22;9(11):1273.
doi: 10.3390/nu9111273.

Prevalence of Pre-Diabetes across Ethnicities: A Review of Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT) for Classification of Dysglycaemia

Wilson C Y Yip  1   2 , Ivana R Sequeira  3   4 , Lindsay D Plank  5 , Sally D Poppitt  6   7   8
Affiliations
Review

Prevalence of Pre-Diabetes across Ethnicities: A Review of Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT) for Classification of Dysglycaemia

Wilson C Y Yip et al. Nutrients. .

Abstract

Prediabetes can be defined by the presence of impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), or glycated haemoglobin (HbA1c) to identify individuals at increased risk of developing type 2 diabetes (T2D). 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) but the same cut-off values for IGT (7.8-11.0 mmol/L). This review investigates whether there are differences in prevalence of IFG, IGT, and combined IFG&IGT between ethnicities, in particular Asian Chinese and European Caucasians. In total, we identified 19 studies using the WHO1999 classification, for which the average proportional prevalence for isolated (i)-IFG, i-IGT, and combined IFG&IGT were 43.9%, 41.0%, and 13.5%, respectively, for Caucasian and 29.2%, 49.4%, and 18.2%, respectively, for Asian. For the 14 studies using ADA2003 classification, the average proportional i-IFG, i-IGT, and combined IFG&IGT prevalences were 58.0%, 20.3%, and 19.8%, respectively, for Caucasian; 48.1%, 27.7%, and 20.5%, respectively, for Asian. Whilst not statistically different, there may be clinically relevant differences in the two populations, with our observations for both classifications indicating that prevalence of i-IFG is higher in Caucasian cohorts whilst i-IGT and combined IFG&IGT are both higher in Asian cohorts.

Keywords: ethnicity; fasting plasma glucose; impaired fasting glucose; impaired glucose tolerance; obesity; oral glucose tolerance test; prediabetes; type 2 diabetes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Proposed hypothesis of lipid overspill from subcutaneous adipose into ectopic sites leading to insulin resistance and type 2 diabetes (T2D) [14].
Figure 2
Figure 2
Flow-chart of study selection process. CVD: cardiovascular disease.
Figure 3
Figure 3
Forest plots for prevalence of prediabetes using WHO1999 classification. (a) Prevalence of WHO1999 i-IFG prediabetic population; (b) Prevalence of WHO1999 i-IGT prediabetic population; (c) Prevalence of WHO1999 IFG&IGT prediabetic population.
Figure 3
Figure 3
Forest plots for prevalence of prediabetes using WHO1999 classification. (a) Prevalence of WHO1999 i-IFG prediabetic population; (b) Prevalence of WHO1999 i-IGT prediabetic population; (c) Prevalence of WHO1999 IFG&IGT prediabetic population.
Figure 4
Figure 4
Forest plots for prevalence of prediabetes using ADA2003 classification. (a) Prevalence of ADA2003 i-IFG prediabetic population; (b) Prevalence of ADA2003 i-IGT prediabetic population; (c) Prevalence of ADA2003 IFG&IGT prediabetic population.
Figure 4
Figure 4
Forest plots for prevalence of prediabetes using ADA2003 classification. (a) Prevalence of ADA2003 i-IFG prediabetic population; (b) Prevalence of ADA2003 i-IGT prediabetic population; (c) Prevalence of ADA2003 IFG&IGT prediabetic population.
See this image and copyright information in PMC

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