e8 Care Volume 43, January 2020

COMMENT ON NORHAMMAR ET AL. Undetected Dysglycemia Is an Important Hao Li, Shen Tian, and Ling-quan Kong Risk Factor for Two Common Diseases, Myocardial Infarction and Periodontitis: A Report From the PAROKRANK Study. Diabetes Care 2019;42:1504–1511 Diabetes Care 2020;43:e8 | https://doi.org/10.2337/dc19-1802

Norhammar et al. (1) recently conducted ,6.1 mmol/L and a 2h-PG of ,7.8 MI through adjusting the classification a case-control study to determine the mmol/L (as shown in Fig. 2 of the 1999 re- of status is expected. relationship among previously unde- port of the WHO Consultation [2]), while tected dysglycemia ( and (IFG), with an diabetes), myocardial infarction (MI), FPG of $6.1 to ,7.0 mmol/L and a 2h-PG of Duality of Interest. No potential conflicts of and periodontitis. In this study, after ,7.8 mmol/L, belongs to prediabetes interest relevant to this article were reported. excluding individuals with established instead of NGT. IFG and/or IGT, together diabetes, all subjects were examined with diabetes, are classified as hypergly- References with an oral glucose tolerance test cemia or dysglycemia according to the 1. Norhammar A, Kjellstrom¨ B, Habib N, et al. and were categorized as having a glu- WHO definitions (2,3). IFG and IGT, Undetected dysglycemia is an important risk cose status of normal glucose tolerance known as prediabetes, represent a state factor for two common diseases, myocardial (NGT), impaired glucose tolerance (IGT), of disordered glucose metabolism inter- infarction and periodontitis: a report from the PAROKRANK study. Diabetes Care 2019;42: or diabetes by their 2-h postload glu- mediate between normoglycemia and 1504–1511 cose level. As detailed in Supplementary diabetes. Hence, the role of IFG as an 2. World Health Organization. Definition, diag- Table1of thearticle (1), participants who important risk factor for diabetes should nosis and classification of diabetes mellitus and hadafastingplasmaglucose(FPG)of,7.0 not be overlooked, and IFG should not its complications: report of a WHO consultation. fi mmol/L and a 2-h glucose (2h-PG) of ,7.8 be classified in the NGT group when Part 1: Diagnosis and classi cation of diabetes mellitus. Geneva, World Health Organization, mmol/L were categorized as having NGT, exploring the association between dys- 1999. Accessed 7 September 2019. Available and the authors declared that this catego- glycemia and MI. We should know how from https://apps.who.int/iris/handle/10665/ rization was made according to the World many participants in this study had IFG 66040 Health Organization (WHO) definition. But and whether these participants were 3. World Health Organization. Definition and Diagnosis of Diabetes Mellitus and Intermedi- as a matter of fact, in the 1999 WHO equally distributed in the control and ate Hyperglycaemia: Report of a WHO/IDF definition, NGT referred to a normoglyce- patient cohorts. Further analysis of the Consultation. Geneva, World Health Organization, mia state and was definedasanFPGof relationship between dysglycemia and 2006 COMMENTS AND RESPONSES – e-LETTERS

Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China Corresponding author: Ling-quan Kong, [email protected] © 2019 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.