Characterization of left ventricular mass in individuals at risk for type 2 diabetes identified by HbA1c levels according to the American Diabetes Association Criteria

Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) are two dysglycemic disorders that have been referred to as categories of increased risk for type 2 diabetes (T2DM) as well as for cardiovascular disease [1]. Recently, the American Diabetes Association (ADA) has proposed a glycated hemoglobin (HbA1c) value of 5.7–6.4% (39–46 mmol/mol) as a new indicator of prediabetes in addition to IFG and IGT [2]. The three glycemic parameters used as measures of dysglycemia, i.e. fasting plasma glucose (FPG), 2-h post-challenge glucose (2-h PG), and HbA1c reflect different features of glucose metabolism with FPG reflecting steady-state glucose metabolism, 2-h PG being an indicator of glycemic response to meal, and HbA1c, an indicator of average blood glucose concentrations over 2–3 months, capturing both fasting and post-meal glycemia. There is evidence that FPG and 2-h PG in the range diagnostic for IFG and IGT have an impact on cardiac geometry and function and are associated with left ventricular hypertrophy (LVH), a well-established predictor of cardiovascular morbidity and mortality.