Background: Elevated 1 hour plasma glucose (>155mg/dl) and glucose curve shape are predictive markers of diabetes risk. We evaluated varying patterns of impaired glucose tolerance and associated CVD risk.
Methods: At Stanford’s South Asian Translational Heart Initiative, 260 patients were evaluated for diabetic and CVD risk: OGTT with insulin, lipid panel, HbA1c, blood pressure, BMI, QRisk2 (10-year CVD risk), inflammatory markers, and FHx. Glucose curve “shape” was categorized by phase changes and time of curve peak.
Results: Classification showed 78.3% of patients were prediabetic and 5.2% had normal glucose tolerance (NGT) but elevated 1 hour glucose. These subgroups also exhibited more unclassified and monophasic 60 min glucose peak (Mono60) shapes compared to the total population (83.8% vs. 51.9%, p <0.01). Mono 60 patients had significantly higher fasting and 2 hour glucose, insulin levels, and QRisk2 (16% vs. 12%, p<0.01) than Mono30. The median CRP of Mono60 was higher than Mono 30 (1 vs. 1.5, p=0.02). A “dose-dependent” relationship between prediabetic criteria and average glucose area under curve (AUC) was observed; elevated 1 hour glucose further stratified prediabetic severity (Figure 1).
Conclusion: Mono60 glucose patterns exceed the CVD risk stratification of prediabetes alone and may indicate a need for more aggressive medical therapy to prevent diabetes and CVD progression.
J.L. Shearer: None. K. Josan: None. A. Khandelwal: None. S. Nallamshetty: None. F. Abbasi: None. R. Dash: None.
