Fasting Plasma Glucose Best Predictor of Diabetes Risk

Fasting plasma glucose may be the best predictor of risk of new-onset diabetes in hypertension patients, showing that the risk of new-onset diabetes was 19-fold higher than those in the lowest quartile according to a subgroup analysis of data from a major trial. Ajay Gupta, M.D. of Imperial College London said that each 18mg/dL (1 mmol/l) increase above 90mg/dL (5 mmol/l) was associated with a 5.8-fold increase in the risk of new onset-diabetes (95%CI 5.23-6.43).

The data Dr Gupta and colleagues analyzed was derived from a subgroup of the ASCOT-BPLA (Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm) trial.

The primary results of the 19,342-patient trial, which were reported last year at this meeting, indicated that combination therapy with Norvasc (amlodipine) and Aceon (perindopril) was more effective than treatment with the beta-blocker atenolol with or without bendroflumethiazide.

At baseline, 14,120 of the ASCOT patients were not diabetic, but over 5.5 years of follow-up 1,366 patients developed diabetes.

Another significant predictor of new-onset diabetes was body mass index. Every five-unit increase in BMI over 35 kg/ m2 increased risk of new onset diabetes by 49% (hazard ratio 1.49 [1.-38-1.62 P<0.001]).

Serum triglyceride and systolic blood pressure were also identified as risk factors. By contrast, Dr. Gupta said that high HDL, age older than 55, and moderate alcohol use significantly reduced the risk of new-onset diabetes.

Using the identified risk factors, the investigators developed a composite risk score. For patients in the highest quartile, the risk of new-onset diabetes was 19-fold higher than those in the lowest quartile, Dr. Gupta said.

European Society of Cardiology/World Congress of Cardiology: Gupta AK "Determinants of new onset diabetes among hypertensive patietns randomized in the ASCOT-BPLA Trial"

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