The paired values of FPG and HbA1c or FPG and fructosamine helped to identify potentially diabetic subjects, the diagnosis of which could be further confirmed by the 75-g OGTT. Using this approach approximately 80% of OGTTs could have been saved, depending on the diagnostic cutoff value of FPG.

Up to 70% of the Chinese Type 2 diabetic outpatients have GI symptoms, which is a much higher rate than in non-diabetic control subjects. Duration of diabetes is the most important factor associated with the presence of such GI symptoms.

OBJECTIVE -We have previously suggested using the paired values of fasting plasma glucose (FPG) and HbA 1c to identify potential diabetic subjects. In this article, we followed up on 208 nondiabetic subjects and examined their rates of progression to diabetes. We analyzed their likelihood of becoming diabetic according to their baseline FPG and HbA 1c concentrations. -Between 1988 and 1995, 2,877 Chinese subjects with risk factors for diabetes underwent screening. Of these, 2,250 had FPG Ͻ7.8 mmol/l and 2-h plasma glucose (PG) Ͻ11.1 mmol/l. Of these 2,250 subjects, 265 were randomly recruited for an annual oral glucose tolerance test (OGTT) until they progressed to develop diabetes. Of those 265 subjects, 57 had baseline FPG Ն7.0 mmol/l and were excluded from the present analysis. Hence, the progression of glucose tolerance in 208 subjects who were nondiabetic according to the new American Diabetes Association diagnostic criteria (FPG Ͻ7.0 mmol/l and 2-h PG Ͻ11.1 mmol/l) was examined RESULTS -Of the 208 nondiabetic subjects, 26 (12.5%) were men and 182 (87.5%) were women. After a mean follow-up of 1.60 ± 1.16 years (range 1-7, median 1), 44 (21.2%) progressed to develop diabetes and 164 (78.8%) remained nondiabetic. Those who were diabetic at the end of the study had a high likelihood ratio (LR) of 9.3 to have baseline FPG Ն6.1 mmol/l and baseline HbA 1c Ն6.1%. This was compared with a low LR of 0.6-1.1 in diabetic subjects who had either FPG Ͻ6.1 mmol/l or HbA 1c Ͻ6.1% or both at baseline. The crude rate of progression to diabetes was more than five times higher (44.1 vs. 8.1%) in those whose baseline FPG was Ն6.1 mmol/l and baseline HbA 1c was Ն6.1% compared with those whose baseline FPG was Ͻ6.1 mmol/l and baseline HbA 1c was Ͻ6.1%. RESEARCH DESIGN AND METHODSCONCLUSIONS -For Chinese subjects with risk factors for glucose intolerance, the use of paired FPG and HbA 1c values helped to identify potential diabetic subjects. Those with an FPG Ն6.1 mmol/l and HbA 1c Ն6.1% had a rate of progression to diabetes more than five times higher than those with an FPG Ͻ6.1 mmol/l and an HbA 1c Ͻ6.1% after a mean follow-up of 1.6 years. Those with an FPG Ն6.1 but Ͻ7.0 mmol/l, especially if their HbA 1c was Ն6.1%, should undergo an OGTT to confirm diabetes. Subjects with an FPG Ͻ6.1 mmol/l and/or an HbA 1c Ͻ6.1% should have regular screening using the paired values of FPG and HbA 1c .