Physiological variables and diabetic status. Findings in Tecumseh, Mich.

A random sample of 568 participants in the Tecumseh, Mich, study, aged 30 to 59 years, was stratified according to blood glucose concentration to select a high proportion of diabetics. Subjects were categorized as overt diabetics, chemical or probable diabetics, or nondiabetics. Diabetic groups and nondiabetics were compared for levels of blood glucose, plasma insulin, serum cholesterol, serum triglyceride, blood pressure, and contours of glucose and insulin curves. Overt diabetics had high mean fasting blood glucose levels. Challenged diabetics had significantly higher concentrations of all variables except cholesterol than nondiabetics, even after adjustment for age and adiposity. Glucose intolerance, adiposity, and sex influenced variables independently. Risk of atherosclerosis is partly attributable to persistent hyperglycemia and related metabolic abnormalities in overt diabetics. Postchallenge diabetics have subtle hyperglycemia but a high frequency of other risk factors. Recent developments suggest that control of blood glucose may become feasible and useful in the prevention of cardiovascular disease in overt and challenged diabetics.