Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of European Prospective Investigation of Cancer and Nutrition (EPIC-Norfolk)
A study in this week's BMJ shows that the concentration of glucose in the blood resembles blood pressure and blood cholesterol in terms of predicting cardiovascular risk. These findings have important implications for public health and may provide a practical screening tool for diabetes or impaired glucose tolerance.
Researchers in Cambridge identified 4,662 men aged 45-79 years who had attended a health examination and had their blood glucose concentration measured as part of the European Prospective Investigation of Cancer and Nutrition in Norfolk. Men with known diabetes had greater risk of dying from all causes, cardiovascular disease, and ischaemic heart disease compared with men without diabetes. Risk of death increased with increasing blood glucose concentrations. Even in men without diabetes, blood glucose concentration was related to risk of death, with the lowest rates in those with concentrations below 5%.
Blood glucose concentration seems to resemble blood pressure and blood cholesterol in terms of the continuous relation with cardiovascular risk, say the authors. These findings have important implications for public health: a reduction of just 0.1% or 0.2% blood glucose concentration in the whole population would reduce total mortality by 5% and 10% respectively, they explain.
Preventative efforts need to consider not just those with established diabetes, but whether it is possible to reduce the population distribution of blood glucose concentration through simple lifestyle changes, such as diet or physical activity, they conclude.
Kay-Tee Khaw, Professor of Clinical Gerontology, Institute of Public Health, University of Cambridge, UK Email: firstname.lastname@example.org