Long-Term Health Outcomes in Individuals With Confirmed Versus Unconfirmed Undiagnosed Diabetes Based on Oral Glucose Tolerance Test: Findings From the Tehran Lipid and Glucose Study

Journal of Diabetes Research

卷:2026

Research Article

Navid Ebrahimi¹  Samaneh Asgari¹  Maryam Tohidi¹  Davood Khalili¹  Fereidoun Azizi²  Sepideh Besarat¹  Farzad Hadaegh¹ 

[1] Prevention of Metabolic Disorders Research Center, Research Institute for Metabolic and Obesity Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran, sbmu.ac.ir

[2] Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran, sbmu.ac.ir

关键词: cardiovascular diseases;    glucose tolerance test;    longitudinal study;    type 2 diabetes mellitus;   

DOI  :  10.1155/jdr/4228661

 received in 2025-01-25, accepted in 2026-06-15,  发布年份 2026

来源: Hindawi Publishing Corporation

【 摘 要 】

BackgroundTo evaluate the prognostic performance of the single-sample confirmatory definition of undiagnosed diabetes on outcomes, including hypertension, chronic kidney disease (CKD), cardiovascular disease (CVD), and mortality, in the Tehran Lipid and Glucose Study cohort.MethodsAmong 6712 participants (3682 women) aged ≥ 30 years not on glucose-lowering medication, unconfirmed undiagnosed diabetes was defined as either fasting plasma glucose (FPG) ≥ 7 mmol/L or 2-h postload glucose (2-h PG) ≥ 11.1 mmol/L, whereas confirmed undiagnosed diabetes required both. Multivariable Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for each outcome.ResultsAt baseline, 3.6% and 3.3% of participants had confirmed or unconfirmed undiagnosed diabetes, respectively. During a median follow-up of over 10 years, both unconfirmed and confirmed undiagnosed diabetes were associated with a higher risk of developing treated diabetes, with HRs (95% CI) of 7.73 (6.35–9.44) and 17.30 (14.32–20.83), respectively. Confirmed undiagnosed diabetes was further associated with incident CKD (1.33 [1.02–1.73]), hypertension (1.26 [1.00–1.60]), first CVD (1.40 [1.01–1.93]), and hard CVD (1.65 [1.04–2.61]), whereas the association with all-cause mortality did not reach statistical significance (1.50 [0.96–2.33], p=0.07). Unconfirmed undiagnosed diabetes was only associated with treated diabetes and first CVD (1.53 [1.11–2.12]). Isolated FPG and 2-h PG elevations showed similar risks for treated diabetes (9.00 [6.26–13.00] and 7.40 [5.92–9.24], respectively), but only isolated FPG was significantly associated with first CVD (2.55 [1.50–4.31]) and hard CVD (2.43 [1.06–6.00]), comparable with confirmed undiagnosed diabetes.ConclusionsConfirmed undiagnosed diabetes was associated with a higher risk of cardiovascular and renal outcomes. The unconfirmed undiagnosed phenotype shared a similar CVD risk with confirmed diabetes but had a 50% lower risk of treated diabetes, with a stronger association observed for isolated FPG elevation than for isolated 2-h PG.

【 授权许可】

CC BY   
Copyright © 2026 Navid Ebrahimi et al. Journal of Diabetes Research published by John Wiley & Sons Ltd. 2026

【 图 表 】

Figure 8