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make worse or less effective; "His vision was impaired"
diminished in strength, quality, or utility; "impaired eyesight"
a monosaccharide sugar that has several forms; an important source of physiological energy

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〈健康・視力など〉‘を'損なう,〈判断力など〉‘を'弱める
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/03/09 00:54:36」(JST)

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Impaired fasting glucose (IFG), more commonly known as pre-diabetes refers to a condition in which the fasting blood glucose level is consistently elevated above what is considered normal levels; however, it is not high enough to be diagnosed as diabetes mellitus.^[1] This pre-diabetic state is associated with insulin resistance and increased risk of cardiovascular pathology, although of lesser risk than impaired glucose tolerance (IGT). IFG can progress to type 2 diabetes mellitus if lifestyle changes are not made. There is a 50% risk over 10 years of progressing to overt diabetes. A recent study cited the average time for progression as less than three years.^[2]

Fasting blood glucose levels are in a continuum within a given population, with higher fasting glucose levels corresponding to a higher risk for complications caused by the high glucose levels. Impaired fasting glucose is defined as a fasting glucose that is higher than the upper limit of normal, but not high enough to be classified as diabetes mellitus. Some patients with impaired fasting glucose can also be diagnosed with impaired glucose tolerance, but many have normal responses to a glucose tolerance test.

Signs and Symptoms

The World Health Organization (WHO) criteria for impaired fasting glucose differ from the American Diabetes Association (ADA) criteria, because the normal range of glucose is defined differently. The WHO has defined the upper limit of normal at under 110 mg/dL. However, fasting glucose levels 100 mg/dL and higher have been shown to increase complication rates significantly^{[citation needed]}, and the ADA has lowered the upper limit of normal accordingly, to a fasting glucose under 100 mg/dL.

WHO criteria: fasting plasma glucose level from 6.1 mmol/l (110 mg/dL) to 6.9 mmol/l (125 mg/dL).^[3]^[4]

ADA criteria: fasting plasma glucose level from 5.6 mmol/L (100 mg/dL) to 6.9 mmol/L (125 mg/dL).

Risk factors

IFG is a risk factor for mortality due to the serious complications of type 2 diabetes mellitus.^[5] Diabetes is a multi-factor disease and it can affect many areas of the body. The depositions of plaque in the arteries known as atherosclerosis are a potential risk that is elevated in diabetic individuals. This may lead to heart attack or stroke. Blindness is another concern associated with type 2 diabetes. It is cause by microvascular disease in which high blood glucose levels damage blood vessels in the retina by the formation of scar tissue or hemorrhage. Not only do these high levels cause vision loss, they may also cause sensory nerve damage (neuropathy). This presents as tingling, numbness or pain and in the most severe cases requires amputation. When these elevated levels of blood glucose are chronic there is a potential that irreversible kidney damage can occur. It is important that individuals with IFG or diabetes mellitus monitor their condition and make healthy lifestyle choices to reduce the onset of these life threatening symptoms. Pre-diabetic individuals who have abdominal obesity, high blood pressure, high LDL cholesterol, low HDL cholesterol, and high levels of triglycerides in the blood have an increased risk of developing type 2 diabetes mellitus. These risk factors are known collectively as the metabolic syndrome.^[1] Recent evidence suggests that, similar to diabetes mellitus, individuals with IFG have higher degree of periodontal inflammation.^[6]

Prevention

Main article: Prevention of diabetes mellitus type 2

With proper education, eating habits, physical activity, weight management, and lifestyle the risk of developing type 2 diabetes mellitus is reduced.^[7] Blood glucose levels can managed by the healthy eating and physical activity guidelines as an individual with normal blood glucose levels, however some minor modifications may be required. These variations depend on the individual, but it may include a slight decrease in the amount of carbohydrates consumed. The consumption of alcohol should also be limited, but moderate drinking is protective. Advice and guidelines about eating a nutritious, balanced meal can be found using Canada's Food Guide. Vegetables and fruit should be consumed in the largest proportions. Regular physical activity has the potential to reduce insulin resistance and help decrease elevated blood glucose levels.^[8]

References

^ ^a ^b Thompson, Janice Manore, Melinda Sheeshka, Judy (2010), Nutrition a functional approach, Toronto, Ontaria: Pearson Canada, pp. 141–144
^ Nichols GA, Hillier TA, Brown JB (2007). "Progression From Newly Acquired Impaired Fasting Glusose to Type 2 Diabetes". Diabetes Care 30 (2): 228–233. doi:10.2337/dc06-1392. PMID 17259486. http://care.diabetesjournals.org/cgi/content/full/30/2/228.
^ .World Health Organization. "Definition, diagnosis and classification of diabetes mellitus and its complications: Report of a WHO Consultation. Part 1. Diagnosis and classification of diabetes mellitus". http://www.who.int/diabetes/publications/en/. Retrieved 2007-05-29.
^ "Diagnosis and classification of diabetes mellitus". Diabetes Care 28 Suppl 1: S37–42. 2005. PMID 15618111.
^ Barr EL, Zimmet PZ, Welborn TA, et al. (2007). "Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance: the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab)". Circulation 116 (2): 151–7. doi:10.1161/CIRCULATIONAHA.106.685628. PMID 17576864.
^ Zadik Y, Bechor R, Galor S, Levin L (May 2010). "Periodontal disease might be associated even with impaired fasting glucose". Br Dent J 208 (10): e20. doi:10.1038/sj.bdj.2010.291. PMID 20339371. http://www.nature.com/bdj/journal/v208/n10/full/sj.bdj.2010.291.html.
^ Stychar, Irene et al (2006), "Physician Treatment Practices for Patients With Fasting Plasma Glucose Levels Between 6.1 and 6.9 mmol/L", Canadian Journal of Diabetes 30 (2): 138–145, http://www.diabetes.ca/files/CJDJune06--I.%20Strychar.pdf
^ Canadian Diabetes Association (2011), Prevention and Management, http://www.diabetes.ca/research/prevention/, retrieved 2011-11-10

UpToDate Contents

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1. 2型糖尿病の予防 prevention of type 2 diabetes mellitus
2. 2型糖尿病のスクリーニング screening for type 2 diabetes mellitus
3. 成人における糖尿病の臨床症状および診断 clinical presentation and diagnosis of diabetes mellitus in adults
4. 2型糖尿病の危険因子 risk factors for type 2 diabetes mellitus
5. 小児および思春期における2型糖尿病の疫学、症状、および診断 epidemiology presentation and diagnosis of type 2 diabetes mellitus in children and adolescents

English Journal

Impact of chronic and low cadmium exposure of rats: sex specific disruption of glucose metabolism.

Jacquet A1, Arnaud J2, Hininger-Favier I1, Hazane-Puch F3, Couturier K1, Lénon M1, Lamarche F1, Ounnas F1, Fontaine E2, Moulis JM4, Demeilliers C5.
Chemosphere.Chemosphere.2018 Sep;207:764-773. doi: 10.1016/j.chemosphere.2018.05.099. Epub 2018 May 20.
PMID 29859488

Fetuin-B links nonalcoholic fatty liver disease to type 2 diabetes via inducing insulin resistance: Association and path analyses.

Li Z1, Lin M2, Liu C3, Wang D4, Shi X2, Chen Z2, Liu Y2, Yang S5, Li X6.
Cytokine.Cytokine.2018 Aug;108:145-150. doi: 10.1016/j.cyto.2018.03.023. Epub 2018 Mar 30.
PMID 29609136

Delivery of an LGA infant and the maternal risk of diabetes: A prospective cohort study.

Hakkarainen H1, Huopio H2, Cederberg H3, Voutilainen R4, Heinonen S5.
Primary care diabetes.Prim Care Diabetes.2018 Aug;12(4):364-370. doi: 10.1016/j.pcd.2018.04.002. Epub 2018 May 4.
PMID 29735430

Japanese Journal

Impact of one-hour postchallenge glucose on the relationship between insulin sensitivity and secretion

, , , , ,
Endocrine Journal advpub(0), 2015
… The impact of postchallenge glucose on the relationship between insulin sensitivity (SI) and secretion (β) is unknown. …
NAID 130005074106

Relationship between serum secreted frizzled-related protein 4 levels and the first-phase of glucose-stimulated insulin secretion in individuals with different glucose tolerance

, , , , , ,
Endocrine Journal advpub(0), 2015
… In a cross-sectional clinical study, 56 subjects with type 2 diabetes mellitus (T2DM), 52 subjects with impaired glucose tolerance (IGT) and 42 normal glucose tolerance (NGT) subjects were enrolled to investigate the relationship between SFRP4 levels and the first-phase of glucose-stimulated insulin secretion, glucose metabolism and inflammation. …
NAID 130005074104

遺伝子改変マウスを用いた消化管味覚生理研究の最前線

野村政壽,川原佑太
薬学雑誌. 乙号 135(6), 763-767, 2015
… Nutrients including amino acids, fatty acids and glucose in the digest have been shown to act on the neuroendocrine cells in the gastrointestinal (GI) tract, and thereby play important roles in energy homeostasis. … It has been proposed that the T1R2/T1R3 receptor complex acts as sweet sensor in the intestine, and plays a pivotal role in sensing sugars and maintaining glucose homeostasis through incretin secretion. …
NAID 130005071777

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リンク元	「空腹時高血糖」「空腹時血糖異常」「空腹時血中ブドウ糖不良」「IFG」「impaired fasting glycemia」
関連記事	「impair」「impaired」「fasting glucose」「fasting」