Fasting Plasma Glucose Change Predicts Diabetes
The study focused on 116,816 adult residents of China who had been included in a database (compiled by the Rich Healthcare Group) of more than 200,000 residents who underwent medical assessments in 2010-2016. Researchers analyzed incident diabetes relative to several metabolic markers: FPG, TG, total cholesterol, HDL-C, change in FPG, change in TyG, and change in TG:HDL-C ratio. FPG change referred to the difference in levels measured at baseline and the final visit.

During a median follow-up of 3.1 years, 2669 people developed incident type 2 diabetes (788 women and 1881 men). The overall age-standardized incidence of diabetes was 12.87 per 1000 person-years, and was 11.04 per 1000 person-years in women, and 14.69 per 1000 person-years in men. FPG changes were a consistent indicator of incident diabetes. People with increases in FPG greater than about 1 mmol/L had a significantly increased rate of incident diabetes.

The association between changes in FPG and incident diabetes was stronger than for several other candidate metabolic markers including triglyceride (TG) level, FPG at baseline (as opposed to change in FPG), body mass index, ratio of TG to high-density lipoprotein cholesterol (HDL-C), and fasting triglyceride-glucose (TyG) index. The association of FPG changes with incident diabetes was nonlinear and showed a characteristic relationship that was consistent regardless of the distribution of several variables including age, sex, triglycerides (TG), and systolic and diastolic blood pressure.