Study Finds Fasting Plasma Glucose Level Is Associated With Development of Diabetes

Fasting plasma glucose (FPG), age level, body mass index (BMI), and being male were associated with the development of diabetes, according to results of a study published in JAMA Network Open. Investigators state that the results contribute to the understanding of diabetes and highlight the variation in diabetes risk in commonly measured clinical variables.¹

Fasting plasma glucose is associated with development of diabetes, indicating it as a risk factor. | Image credit: WrightStudio | stock.adobe.com

Data from the Rochester Epidemiology Project (REP) showed that from 1983 to 1995, 10.3% of people aged 40 years and older in Olmsted County, Minnesota developed diabetes after a median follow-up time of 9 years. In this study, FPG was a major risk factor for developing diabetes, even for those who had an FPG level within the normal range at baseline. However, the study did not find the cumulative association of additional variables of diabetes. Investigators of the current study aimed to determine the 10-year cumulative risk for the incidence of diabetes in a contemporary REP cohort, including age, sex, BMI, and initial FPG level.^1,2

In the study, investigators included data from January 1, 1966, until the present, including details on population size, demographics, and socioeconomic status. Individuals included were aged 18 to 65 years from Olmsted County, Minnesota, with at least 2 FPG tests between January 1, 2005, and December 31, 2017. A diabetes diagnosis was defined as an FPG level of 126 mg/dL or higher.¹

In total, 44,992 individuals with a mean age of 43.7 years and 57.8% women were included in the study. Approximately 87.1% were White, 4.1% were Asian, 4.3% were Black, and 4.5% identified as another race or ethnicity. The median follow-up was 6.8 years. Approximately 8.6% of individuals developed diabetes, accounting for 7.1% of all women and 10.7% of all men. The Kaplan-Meier 10-year cumulative risk of incidence was approximately 12.8%, according to the study authors.¹

Investigators found that reduced or elevated FPG levels were associated with an increased risk compared to FPG of 80 to 94 mg/dL. Furthermore, male sex was associated with an increased risk compared with females, and any abnormal BMI was associated with an increased risk compared with a BMI between 19.5 to 24.9. Furthermore, investigators noted that increasing age of 60 years or older was associated with an increased risk of developing diabetes.¹

Furthermore, investigators found that there was a significant additive association of variables, particularly for FPG level and BMI. For example, a women who was aged between 55 to 59 years and had a BMI of 18.5 to 24.9 and FPG level of 95 to 99 mg/dL has an estimated 10-year diabetes risk of approximately 7%, but the risk would be approximately 13% for the same women if the BMI was 30 to 34.9 and 28% if the FPG level increased to 105 to 109 mg/dL, according to the study results.¹

The study authors concluded that the results “facilitate lifestyle and pharmacologic interventions to treat those at highest risk of diabetes to reduce future morbidity and mortality” and call for further research to validate this risk as a tool for other populations.¹

REFERENCES

1. Egan AM, Wood-Wentz CM, Mohan S, Bailey KR, Vella A. Baseline Fasting Glucose Level, Age, Sex, and Body Mass Index and the Development of Diabetes in US Adults. JAMA Netw Open. 2025;8(1):e2456067. doi:10.1001/jamanetworkopen.2024.56067

2. Dinneen SF, Maldonado D 3rd, Leibson CL, et al. Effects of changing diagnostic criteria on the risk of developing diabetes. Diabetes Care. 1998;21(9):1408-1413. doi:10.2337/diacare.21.9.1408