Stabilizing IGT for a time has significant long-term vascular benefits
medwireNews: Delaying progression from impaired glucose tolerance (IGT) to type 2 diabetes reduces the risk for micro- and macrovascular complications, shows 24 years of follow-up of the Da Qing trial.
Indeed, the magnitude of benefit was similar to that associated with temporary reversion to normal glucose tolerance.
“The findings further emphasise that delaying diabetes onset is a key not only to curbing the increasing incidence of diabetes, but more importantly is an effective means of reducing the incidence of its serious long-term vascular complications,” write the researchers in Diabetologia.
Across 24 years of follow-up, people who had retained IGT during the 6-year randomized lifestyle intervention phase had a significant 34% lower risk for cardiovascular disease than those who had progressed to diabetes, and those who had reverted to normal glucose tolerance had a 37% risk reduction.
The corresponding risk reductions for microvascular disease were 52% and 66%, with no significant difference found between the normal and IGT groups.
All 540 participants in the current analysis had IGT on entry to the Da Qing Diabetes Prevention Study, which progressed to diabetes in 46.7%, reverted to normal in 32.2%, and remained stable in 21.1% during the randomized phase.
People who improved or stabilized their blood glucose “had a much longer median delay in the onset of diabetes, and consequently experienced many fewer years of exposure to diabetes levels of hyperglycaemia and other associated metabolic abnormalities,” observe Guangwei Li (Fuwai Hospital, Beijing, China) and co-researchers.
This is the most likely reason for the long-term reduction in vascular risk, they note.
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