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A further revision
has been published recently (9). This report, accompanied by a American
Diabetes Association (ADA) report (10), has generated yet another round of
debate with a new classification and a revision of criteria resulting in 1)
the fasting plasma glucose threshold for diabetes being lowered from 7.8 to
7.0 mmol/L and 2) impaired fasting glycemia (fasting plasma glucose: 6.1-6.9
mmol/L) was introduced as a new category for abnormal glucose metabolism
(called impaired fasting glucose by the ADA), above "normal" but not
diagnostic of diabetes.
The ADA (but not the WHO) report recommended that the FPG rather than the
oral glucose tolerance (OGTT) should be the diagnostic test of choice both
for clinical and epidemiologic purposes. The ADA recommendation was mainly
made on the basis of inconvenience of performing the OGTT in clinical
practice. This has kept the epidemiology field alive and forms the basis for
plenty more papers!! |