Glucose level 109
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Understanding Glucose Levels: Implications of a Fasting Glucose Level of 109 mg/dL
Impaired Fasting Glucose (IFG) Criteria and Prevalence
The American Diabetes Association (ADA) revised the criteria for impaired fasting glucose (IFG) in 2003, lowering the threshold from 110 mg/dL to 100 mg/dL. This change significantly increased the number of individuals identified with IFG. For instance, in a study conducted in southern Taiwan, 14.2% of participants were newly classified as having IFG with fasting plasma glucose (FPG) levels between 100 and 109 mg/dL1. This adjustment has led to a broader recognition of individuals at risk for diabetes and cardiovascular diseases.
Cardiovascular Risks and Metabolic Parameters
Individuals with FPG levels between 100 and 109 mg/dL exhibit higher cardiovascular risk factors compared to those with normal fasting glucose (NFG) levels. Studies have shown that these individuals have increased body weight, body mass index (BMI), abdominal girth, systolic and diastolic blood pressure, 2-hour glucose levels, and triglycerides1 2. Specifically, diastolic blood pressure and uric acid levels are notably higher in this group, indicating a heightened risk for cardiovascular diseases2.
Risk of Developing Diabetes
The risk of progressing to diabetes is significantly higher for individuals with FPG levels between 100 and 109 mg/dL. Research from the Omiya MA cohort study in Japan demonstrated that the hazard ratios for developing diabetes were 3.83 for those with FPG levels of 100-104 mg/dL and 7.87 for those with FPG levels of 105-109 mg/dL, compared to individuals with FPG levels below 85 mg/dL3. This underscores the importance of monitoring and managing glucose levels even within this "borderline" range.
Endothelial Dysfunction and Pre-IFG State
Endothelial dysfunction, a precursor to atherosclerosis and cardiovascular diseases, is also associated with FPG levels between 100 and 109 mg/dL. The Flow-mediated Dilation Japan (FMD-J) study found that flow-mediated vasodilation (FMD) decreased significantly as FPG levels increased, indicating impaired endothelial function in individuals with FPG levels in this range4. This suggests that even slightly elevated glucose levels can have adverse effects on vascular health.
Insulin Resistance and Liver Function
Insulin resistance and decreased insulin secretion are prevalent among individuals with FPG levels between 100 and 109 mg/dL. A study on the Taiwanese population revealed that these individuals had higher homeostasis model assessment of insulin resistance (HOMA-IR) and lower β-cell function (HOMA-%B) compared to those with normal fasting glucose levels6. Additionally, liver enzymes such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were associated with increased insulin resistance as glucose levels rose, indicating a potential link between liver function and glucose metabolism6.
Conclusion
A fasting glucose level of 109 mg/dL, while not classified as diabetes, indicates a significant risk for developing diabetes and cardiovascular diseases. Individuals with glucose levels in this range exhibit higher metabolic and cardiovascular risk factors, impaired endothelial function, and increased insulin resistance. Monitoring and managing glucose levels, even within this "borderline" range, is crucial for preventing the progression to diabetes and mitigating associated health risks.
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Most relevant research papers on this topic
Metabolic risk factors in southern Taiwanese with impaired fasting glucose of 100 to 109 mg/dL.
The 2003 impaired fasting glucose criteria increased the prevalence and identified more impaired glucose tolerance and diabetes in southern Taiwanese, but the increase in cardiovascular risks was mainly from those with concomitant impaired glucose tolerance.
Observational StudyDifferences in metabolic parameters and cardiovascular risk between American Diabetes Association and World Health Organization definition of impaired fasting glucose in European Caucasian subjects: a cross-sectional study
The ADA definition of impaired fasting glucose (IFG) identified more individuals with significantly increased cardiovascular disease risk compared to the WHO/IDF definition in European Caucasian subjects.
Observational Study
Rigorous JournalFasting plasma glucose and incidence of diabetes --- implication for the threshold for impaired fasting glucose: results from the population-based Omiya MA cohort study.
In the Japanese population, individuals with fasting plasma glucose levels between 100-109 mg/dL have a significant risk of developing diabetes and should be notified of their potential risk.
Observational StudyPre-impaired fasting glucose state is a risk factor for endothelial dysfunction: Flow-mediated Dilation Japan (FMD-J) study
Pre-impaired fasting glucose (FBG of 95-99 mg/dL) is a risk factor for endothelial dysfunction compared to 90 mg/dL.
Observational StudyRigorous JournalReliability of blood glucose monitoring by patients with diabetes mellitus.
Self-generated blood glucose monitoring data in patients with diabetes mellitus is often unreliable, leading to misleading clinical impressions about metabolic control.
Observational Study
Highly CitedDecreased Insulin Secretion and Insulin Sensitivity Are Associated With Liver Function in Subjects With Fasting Glucose Between 100 and 109 mg/dL in Taiwanese Population
Decreased insulin sensitivity and secretion are associated with liver dysfunction in individuals with fasting glucose between 100 and 109 mg/dL, potentially contributing to the development of type 2 diabetes.
Observational StudyHemoglobin A1c in combination with fasting plasma glucose trumps fasting plasma glucose alone as predictive indicators for diabetes mellitus: an ambidirectional cohort study of Thai people with impaired fasting glucose
Combining HbA1c and fasting plasma glucose helps identify individuals with impaired fasting glucose at higher risk of developing diabetes mellitus, highlighting their need for diabetes prevention programs.
Observational StudyRigorous JournalOutcome of Patients with ST-T Changes in Non STSegment Elevation Myocardial Infarction
Glucose levels can be accurately measured using finger-piercing, continuous glucose monitoring, and CGM sensors, with the 3-minute method showing the healthiest results.
Observational StudyHigh levels of fasting glucose and glycosylated hemoglobin values are associated with hyperfiltration in a Spanish prediabetes cohort. The PREDAPS Study
Level 3 prediabetes, defined as FPG 100-109 mg/dL and HbA1c 6.1-6.4% or FPG 110-125 mg/dL and HbA1c 5.7-6.4%, is associated with a significantly higher risk of hyperfiltration compared to participants without prediabe
Observational StudyRigorous JournalT-1095, an inhibitor of renal Na+-glucose cotransporters, may provide a novel approach to treating diabetes.
T-1095, an inhibitor of renal Na+-glucose cotransporters, may provide a novel antidiabetic drug by reducing blood glucose levels and improving abnormal carbohydrate metabolism in diabetic animals.
Non-RCT
Animal StudyHighly Cited