Fasting glucose levels
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Fasting Glucose Levels: Insights from Recent Research
Normal Fasting Glucose Levels and Type 2 Diabetes Risk
Higher Normoglycemic Range and Diabetes Risk
Recent studies have shown that even within the normal fasting plasma glucose (FPG) range, higher levels can independently predict the risk of type 2 diabetes. A study involving young men in the Israel Defense Forces found that those with FPG levels of 87 mg/dL (4.83 mmol/L) or more had a progressively increased risk of developing type 2 diabetes compared to those with lower levels. This risk was further amplified when combined with high serum triglyceride levels or a high body-mass index (BMI).
Impaired Fasting Glucose and Cardiovascular Risk
The concept of impaired fasting glucose (IFG) has been scrutinized to determine its threshold for predicting future diabetes and cardiovascular risks. Research from Mauritius indicated that cardiovascular risk and the risk of future diabetes increase continuously with rising FPG levels, without a clear threshold at 6.1 mmol/L. This suggests that even lower limits, such as 5.8 mmol/L, could be more indicative of future health risks.
Genetic Influences on Fasting Glucose Levels
MTNR1B and Other Genetic Variants
Genetic studies have identified several loci associated with fasting glucose levels. Variants in the MTNR1B gene, particularly the rs10830963 allele, have been linked to higher fasting glucose levels and reduced beta-cell function, increasing the risk of type 2 diabetes. Other significant loci include G6PC2 and GCK, which also influence fasting glucose concentrations .
New Genetic Loci and Glucose Homeostasis
Further genome-wide association studies have uncovered additional loci that impact fasting glucose and insulin levels. These include genes involved in signal transduction, cell proliferation, and glucose sensing, such as ADCY5, MADD, and SLC2A2. These findings highlight the complex genetic regulation of glucose homeostasis and its implications for diabetes risk.
Dietary and Fasting Interventions
Impact of Fasting and Energy-Restricting Diets
Systematic reviews and meta-analyses have demonstrated that fasting and energy-restricting diets can significantly reduce fasting blood sugar (FBS), insulin levels, and insulin resistance (HOMA-IR). These diets were particularly effective in overweight or obese individuals when followed for more than eight weeks.
Intermittent Fasting and Glucose Metabolism
Intermittent fasting diets (IFD) have also shown promise in improving glucose metabolism. A meta-analysis revealed that IFD significantly reduced BMI, fasting glucose levels, and insulin resistance, suggesting metabolic benefits for the general population without diabetes.
Clinical Outcomes and Fasting Glucose
Fasting Glucose and Coronary Artery Disease
High fasting glucose levels have been associated with worse clinical outcomes in patients with coronary artery disease. The Bezafibrate Infarction Prevention (BIP) study found that patients with diabetes or IFG had higher rates of adverse cardiovascular events compared to those with normal fasting glucose levels. This underscores the importance of monitoring and managing fasting glucose levels in patients with cardiovascular conditions.
Conclusion
The body of research indicates that fasting glucose levels, even within the normal range, are crucial indicators of future diabetes and cardiovascular risks. Genetic factors play a significant role in regulating these levels, and dietary interventions, including fasting and energy-restricting diets, can effectively improve glucose metabolism. Monitoring and managing fasting glucose levels is essential for preventing type 2 diabetes and improving clinical outcomes in patients with cardiovascular diseases.
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