Isolated post-challenge hyperglycaemia confirmed as a risk factor for mortality

Aims/hypothesis. The aim of this study was to examine the possible link bet ween isolated post-challenge hyperglycaemia (2-h post-challenge plasma gluc ose greater than or equal to 11.1 mmol/l, and fasting plasma glucose < 7.0 mmol/l) and mortality. Methods. The data from three population based longitudinal studies (in Maur itius, Fiji and Nauru) were pooled and mortality rates were determined in 9 179 people who were followed for between 5 and 12 years. Results. There were 595 people with previously diagosed diabetes, and 799 w ith newly diagnosed diabetes, of whom 243 (31) had isolated post-challenge hyperglycaemia. In comparison with people without diabetes, people with iso lated post-challenge hyperglycaemia had an increased risk of all-cause mort ality [Cox proportional hazards ratio (95% CI): 2.7 (1.8-3.9) - men; 2.0 (1 .3-3.3) - women], and of cardiovascular mortality [2.3 (1.2;1.2) - men; 2.6 (1.3-5.1) - women]. In addition, men with isolated post-challenge hypergly caemia had a high risk of cancer death [8.0 (3.6-17.9)]. Conclusion/interpretation. These data show that isolated post-challenge hyp erglycaemia, which can only be identified by the 2-h glucose, is common, an d at least doubles the mortality risk. This should be considered in the des ign of screening programmes that use only fasting glucose.