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The American Journal of Clinical... Nov 2023A total of 374 million adults worldwide are living with prediabetes, 70% of whom will develop type 2 diabetes mellitus (T2DM) in their lifetime. Medical nutrition... (Meta-Analysis)
Meta-Analysis
BACKGROUND
A total of 374 million adults worldwide are living with prediabetes, 70% of whom will develop type 2 diabetes mellitus (T2DM) in their lifetime. Medical nutrition therapy (MNT) provided by a dietitian, such as that found in lifestyle interventions, has the potential to improve glycemic control and prevent progression to T2DM.
OBJECTIVES
The objective of this systematic review was to examine the effectiveness of MNT provided by a dietitian, compared with standard care, on glycemic, cardiometabolic, and anthropometric outcomes in adults with prediabetes.
METHODS
Searches were conducted for randomized controlled trials (RCTs) published between 1995 and 2022 using electronic databases MEDLINE, CINHAL, and Cochrane Central. The risk of bias was assessed using version 2 of the Cochrane risk-of-bias tool for RCTs. Meta-analyses were conducted using a random-effects model. The certainty of evidence was assessed for each outcome using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method, and a summary of findings table was created using the GRADEpro Guideline Development Tool.
RESULTS
Thirteen RCTs were included in the analysis, showcasing a variety of MNT interventions delivered by dietitians. Intervention durations ranged from 3 to 24 mo. Compared with standard care, MNT improved hemoglobin A1c (HbA1c) (mean difference [95% confidence interval]: -0.30% [-0.49, -0.12]) and fasting blood glucose (FBG) (-4.97 mg/dL [-6.24, -3.71]). Statistically significant improvements were found in anthropometrics (weight, body mass index, and waist circumference), cholesterol (total, high-, and low-density lipoproteins), and blood pressure (systolic and diastolic). No significant effect was found on T2DM or triglycerides. The certainty of evidence was moderate for FBG and low for HbA1c and incidence of T2DM.
CONCLUSIONS
In adults with prediabetes, MNT was effective in improving glycemic outcomes, anthropometrics, blood pressure, and most lipid levels. However, most studies had a risk of bias because of the randomization process or deviations from intended interventions. MNT plays a key role in improving cardiometabolic risk factors in adults with prediabetes.
TRIAL REGISTRATION NUMBER
This study was registered with the registration ID #351421, available from https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=351421.
Topics: Humans; Adult; Prediabetic State; Glycated Hemoglobin; Nutritionists; Diabetes Mellitus, Type 2; Nutrition Therapy
PubMed: 37689140
DOI: 10.1016/j.ajcnut.2023.08.022 -
Sexual Medicine Reviews Oct 2020Previous studies have shown a strong association between diabetes mellitus (DM) and the frequency and severity of some aspects of male sexual dysfunction (SD). The same...
INTRODUCTION
Previous studies have shown a strong association between diabetes mellitus (DM) and the frequency and severity of some aspects of male sexual dysfunction (SD). The same relationship with prediabetes (preDM) has been less well investigated.
AIM
To systematically review the current literature on the association between preDM and SD, focusing on erectile dysfunction (ED), sex steroid hormone alterations, and premature ejaculation (PE).
METHODS
The present review was conducted in accordance with the PRISMA declaration standards for systematic reviews. A systematic search for the terms "male sexual dysfunction," "prediabetes," "IFG or IGT," "glycemia," "ED," "ejaculation," and "hypoactive sexual desire disorder" was carried out in the PubMed and Embase databases.
MAIN OUTCOME MEASURE
Prevalence of SD in men with preDM and severity of ED, PE, and hormone alterations in men with preDM compared with controls.
RESULTS
12 studies reporting data on the association between SD and preDM were found in the literature. According to these studies, ED is more prevalent in men with preDM compared with controls, the severity of ED increases progressively as a function of impaired glucose metabolism, testosterone values and preDM are strongly correlated, men with preDM are at increased risk of testosterone deficiency and hypogonadism, men with hypogonadism have a higher prevalence of preDM, and the association between PE and preDM is controversial.
CONCLUSION
PreDM is a common and underdiagnosed clinical condition that is strongly associated with male SD. A detailed glucose metabolism investigation should be performed in every patient with SD to screen for glucose abnormalities and eventually to implement prevention program to decrease their chances of developing life-changing chronic illnesses. Boeri L, Capogrosso P, Ventimiglia E, et al. Sexual Dysfunction in Men with Prediabetes. Sex Med Rev 2019;8:622-634.
Topics: Diabetes Mellitus; Humans; Male; Prediabetic State; Prevalence; Risk Factors; Severity of Illness Index; Sexual Dysfunction, Physiological
PubMed: 30852183
DOI: 10.1016/j.sxmr.2018.11.008 -
Journal of Diabetes Investigation Aug 2022Obstructive sleep apnea (OSA) is related to prediabetes and diabetes. Whether patients with OSA have a higher risk of prediabetes/diabetes remains unclear. We aimed to... (Meta-Analysis)
Meta-Analysis
AIMS/INTRODUCTION
Obstructive sleep apnea (OSA) is related to prediabetes and diabetes. Whether patients with OSA have a higher risk of prediabetes/diabetes remains unclear. We aimed to carry out a meta-analysis of published studies to evaluate the relationships between OSA and prediabetes and diabetes, and the impact of the severity of OSA on diabetes.
MATERIALS AND METHODS
The PubMed, EMBASE and Cochrane databases were searched from January 2011 to July 2021. The associations between OSA and impaired fasting glucose, impaired glucose tolerance, impaired glucose regulation and diabetes mellitus were analyzed. We estimated the pooled odds ratios using fixed or random effects models. We included 25 studies comprising a total of 154,948 patients with OSA and risk factors for prediabetes/diabetes (20 and 16, respectively) in the analysis.
RESULTS
OSA was associated with a higher risk of impaired fasting glucose, impaired glucose tolerance, impaired glucose regulation and diabetes mellitus in the cohort studies and cross-sectional studies. The pooled odds ratios were 2.34 (95% confidence interval [CI] 1.16-4.72), 1.58 (95% CI 1.15-2.15), 1.65 (95% CI 1.12-2.42), 2.15 (95% CI 1.68-2.75) and 3.62 (95% CI 2.75-4.75), respectively. Subgroup analyses were based on the proportions of men and women. The results showed that OSA was a risk factor, and there was no significant difference between the two groups. The risk of diabetes increased with the severity of OSA.
CONCLUSIONS
The risk of developing prediabetes and diabetes was higher in patients with OSA.
Topics: Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Glucose; Glucose Intolerance; Humans; Male; Prediabetic State; Sleep Apnea, Obstructive
PubMed: 35302714
DOI: 10.1111/jdi.13793 -
Frontiers in Endocrinology 2021Diabetes has been associated with the increased risk of erectile dysfunction (ED). However, previous studies evaluating the association between prediabetes and ED showed... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Diabetes has been associated with the increased risk of erectile dysfunction (ED). However, previous studies evaluating the association between prediabetes and ED showed inconsistent results. We performed a meta-analysis of observational studies to systematically evaluate the above association.
METHODS
Relevant observational studies were retrieved by search of PubMed, Embase, and Web of Science databases. A random-effect model which incorporated the potential intra-study heterogeneity was used for the meta-analysis. Subgroup analyses were performed to evaluate the influences of study characteristics on the outcome.
RESULTS
Nine studies (five matched case-control studies and four cross-sectional studies) were included. Age were adjusted or matched in all of the studies. Pooled results showed that compared to men with normoglycemia, men with prediabetes were associated with higher prevalence of ED (odds ratio = 1.62, 95% confidence interval: 1.28 to 2.07, P < 0.001; I = 78%). Subgroup analyses showed that the association was not significantly affected by definition of prediabetes, diagnostic tool for ED, or controlling of additional variables besides age (both P for subgroup difference > 0.05). However, the association between prediabetes and ED seemed to be stronger in case-control studies than that in cross-sectional studies, and in studies with younger men (mean age < 50 years) than in those with older men (mean age ≥ 50 years; both P for subgroup difference < 0.05).
CONCLUSIONS
Prediabetes is associated with higher prevalence of ED, which may be independent of age of the males and may be stronger in young men.
Topics: Blood Glucose; Erectile Dysfunction; Fasting; Glucose Intolerance; Glycated Hemoglobin; Humans; Male; Prediabetic State
PubMed: 35082752
DOI: 10.3389/fendo.2021.733434 -
BMJ Open Sep 2020The purpose of this paper is to perform a systematic review and meta-analysis in order to summarise the prevalence of diabetes and pre-diabetes and their associated risk... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The purpose of this paper is to perform a systematic review and meta-analysis in order to summarise the prevalence of diabetes and pre-diabetes and their associated risk factors in Bangladesh.
DESIGN
Systematic review and meta-analysis.
PARTICIPANTS
General population of Bangladesh.
DATA SOURCES
PubMed, Medline, Embase, Bangladesh Journals Online, Science Direct, Scopus, Cochrane Library and Web of Science were used to search for studies, published between 1st of January 1995 and 31st of August 2019, on the prevalence of diabetes and pre-diabetes and their associated risk factors in Bangladesh. Only articles published in the English language articles were considered. Two authors independently selected studies. The quality of the articles was also assessed.
RESULTS
Out of 996 potentially relevant studies, 26 population-based studies, which together involved a total of 80 775 individuals, were included in the meta-analysis. The pooled prevalence of diabetes in the general population was 7.8% (95% CI: 6.4-9.3). In a sample of 56 452 individuals, the pooled prevalence of pre-diabetes was 10.1% (95% CI: 6.7-14.0; 17 studies). The univariable meta-regression analyses showed that the prevalence of diabetes is associated with the factors: the year of study, age of patients and presence of hypertension. The prevalence of diabetes was significantly higher in urban areas compared with rural areas, while there was no significant gender difference.
CONCLUSIONS
This meta-analysis suggests a relatively high prevalence of pre-diabetes and diabetes in Bangladesh, with a significant difference between rural and urban areas. The main factors of diabetes include urbanisation, increasing age, hypertension and time period. Further research is needed to identify strategies for early detecting, prevention and treatment of people with diabetes in the population.
PROSPERO REGISTRATION NUMBER
CRD42019148205.
Topics: Bangladesh; Diabetes Mellitus; Humans; Hypertension; Prediabetic State; Prevalence
PubMed: 32907898
DOI: 10.1136/bmjopen-2019-036086 -
Diabetes, Obesity & Metabolism May 2024To evaluate the effect of metformin on cancer incidence in subjects with overweight/obesity and/or prediabetes/diabetes. (Meta-Analysis)
Meta-Analysis
AIM
To evaluate the effect of metformin on cancer incidence in subjects with overweight/obesity and/or prediabetes/diabetes.
MATERIALS AND METHODS
We searched MEDLINE, Embase and CENTRAL for randomized controlled trials (RCTs) in adults with overweight/obesity and/or prediabetes/diabetes that compared metformin to other interventions for ≥24 weeks. Independent reviewers selected and extracted data including population and intervention characteristics and new diagnoses of cancer. We used the RoB 2.0 risk-of-bias tool and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework to assess risk of bias and certainty of evidence.
RESULTS
From 14 895 records after removal of duplicates, 27 trials were included, providing a total of 10 717 subjects in the metformin group and 10 003 in the control group, with 170 and 208 new cases of cancer, respectively. Using a random-effects model, the relative risk was 1.07 (95% confidence interval 0.87-1.31), with similar results in subgroup analyses by study duration or effect of control intervention on weight. Risk of bias in most studies was low, and no evidence of publication bias was found. Trial sequential analysis provided evidence that the cumulative sample size was large enough to exclude a significant effect of metformin on cancer incidence.
CONCLUSIONS
Metformin did not reduce cancer incidence in RCTs involving subjects with overweight/obesity and/or prediabetes/diabetes.
Topics: Adult; Humans; Metformin; Overweight; Prediabetic State; Obesity; Neoplasms
PubMed: 38389430
DOI: 10.1111/dom.15509 -
Primary Care Diabetes Dec 2022To assess the impact of the obesity epidemic on type 2 diabetes (T2D), prediabetes and glycometabolic indices in children and adolescents. (Meta-Analysis)
Meta-Analysis Review
AIM
To assess the impact of the obesity epidemic on type 2 diabetes (T2D), prediabetes and glycometabolic indices in children and adolescents.
METHODS
We searched four electronic databases (PubMed, Embase, Cochrane and Web of Science). Cross-sectional or cohort studies that reported on obesity and the prevalence of T2D or prediabetes in children and adolescents were reviewed. The study design, sample size and clinical outcomes were extracted from each study. The prevalence of T2D and prediabetes from the studies were pooled using meta-analysis methods.
RESULTS
Meta-analysis of 228184 participants showed that the prevalence of T2D was 1.3% (95% confidence interval (CI), 0.6-2.1%) in obese subjects, which was 13 times that in normal weight subjects (0.1%, 95% CI, 0.01-0.2%). The prevalence of prediabetes in obese subjects was 3 times that in normal subjects at 17.0% (13.0-22.0%) vs. 6.0% (0.01-11.0%). Moreover, BMI was positively correlated with the prevalence of T2D, prediabetes and glycometabolic indices in obese children and adolescents.
CONCLUSION
The pooled results confirm that obesity in children and adolescents leads to statistically significant increases in the prevalence of T2D and prediabetes and in glycometabolic indicator levels.
Topics: Adolescent; Child; Humans; Diabetes Mellitus, Type 2; Prediabetic State; Blood Glucose; Pediatric Obesity; Cross-Sectional Studies
PubMed: 36184528
DOI: 10.1016/j.pcd.2022.09.006 -
Clinical Autonomic Research : Official... Aug 2019Diabetic neuropathy is a common and disabling disorder, and there are currently no proven effective disease-modifying treatments. Physical activity and dietary... (Review)
Review
PURPOSE
Diabetic neuropathy is a common and disabling disorder, and there are currently no proven effective disease-modifying treatments. Physical activity and dietary interventions in patients with diabetes and diabetic neuropathy have multiple beneficial effects and are generally low risk, which makes lifestyle interventions an attractive treatment option. We reviewed the literature on the effects of physical activity and dietary interventions on length-dependent peripheral neuropathy and cardiac autonomic neuropathy in diabetes.
METHODS
The electronic database PubMed was systematically searched for original human and mouse model studies examining the effect of either dietary or physical activity interventions in subjects with diabetes, prediabetes, or metabolic syndrome.
RESULTS
Twenty studies are included in this review. Fourteen studies were human studies and six were in mice. Studies were generally small with few controlled trials, and there are no widely agreed upon outcome measures.
CONCLUSIONS
Recent research indicates that dietary interventions are effective in modifying diabetic neuropathy in animal models, and there are promising data that they may also ameliorate diabetic neuropathy in humans. It has been known for some time that lifestyle interventions can prevent the development of diabetic neuropathy in type 2 diabetes mellitus subjects. However, there is emerging evidence that lifestyle interventions are effective in individuals with established diabetic neuropathy. In addition to the observed clinical value of lifestyle interventions, there is emerging evidence of effects on biochemical pathways that improve muscle function and affect other organ systems, including the peripheral nerve. However, data from randomized controlled trials are needed.
Topics: Animals; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Diet, Healthy; Exercise; Humans; Overweight; Risk Reduction Behavior
PubMed: 31076938
DOI: 10.1007/s10286-019-00607-x -
Obesity (Silver Spring, Md.) Jun 2023This systematic scoping review aimed to map and synthesize research on feasibility of time-restricted eating (TRE) in individuals with overweight, obesity, prediabetes,... (Review)
Review
OBJECTIVE
This systematic scoping review aimed to map and synthesize research on feasibility of time-restricted eating (TRE) in individuals with overweight, obesity, prediabetes, or type 2 diabetes, including recruitment rate, retention rate, safety, adherence, and participants' attitudes, experiences, and perspectives.
METHODS
The authors searched MEDLINE, Embase, and Cumulative Index to Nursing and Allied Health Literature from inception to November 22, 2022, supplemented by backward and forward citation search.
RESULTS
From 4219 identified records, 28 studies were included. In general, recruitment was easy and median retention rate was 95% among studies with <12 weeks duration and 89% among studies ≥12 weeks. Median (range) adherence to the target eating window for studies <12 and ≥12 weeks was 89% (75%-98%) and 81% (47%-93%), respectively. Variation in adherence among participants and studies was considerable, indicating that following TRE was difficult for some people and that intervention conditions influenced adherence. These findings were supported by qualitative data synthetized from seven studies, and determinants of adherence included calorie-free beverages outside the eating window, provision of support, and influence on the eating window. No serious adverse events were reported.
CONCLUSIONS
TRE is implementable, acceptable, and safe in populations with overweight, obesity, prediabetes, or type 2 diabetes, but it should be accompanied by support and options for individual adjustments.
Topics: Humans; Overweight; Diabetes Mellitus, Type 2; Prediabetic State; Feasibility Studies; Obesity
PubMed: 37203334
DOI: 10.1002/oby.23743 -
Diabetes & Vascular Disease Research 2022Certain sleep behaviours increase risk of type 2 diabetes mellitus (T2DM) in the general population, but whether they contribute to the progression from pre-diabetes to... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Certain sleep behaviours increase risk of type 2 diabetes mellitus (T2DM) in the general population, but whether they contribute to the progression from pre-diabetes to T2DM is uncertain. We conducted a systematic review to assess this.
METHODS
Structured searches were performed on bibliographic databases (MEDLINE, EMBASE and CINAHL) from inception to 26/04/2021 for longitudinal studies/trials consisting of adults⩾18 years with pre-diabetes and sleep behaviours (short or long sleep duration (SD), late chronotype, insomnia, obstructive sleep apnoea, daytime napping and/or night-shift employment) that reported on incident T2DM or glycaemic changes. The Newcastle-Ottawa Scale was used for quality assessment.
RESULTS
Six studies were included. Meta-analysis of three studies ( = 20,139) demonstrated that short SD was associated with greater risk of progression to T2DM, hazard ratio (HR) 1.59 (95% CI 1.29-1.97), I heterogeneity score 0%, < 0.0001, but not for long SD, HR 1.50 (0.86-2.62), I heterogeneity 77%, = 0.15. The systematic review showed insomnia and night-shift duty were associated with higher progression to T2DM. Studies were rated as moderate-to-high quality.
CONCLUSIONS
Progression from pre-diabetes to T2DM increases with short SD, but only limited data exists for insomnia and night-shift duty. Whether manipulating sleep could reduce progression from pre-diabetes to T2DM needs to be examined.
Topics: Adult; Diabetes Mellitus, Type 2; Habits; Humans; Prediabetic State; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 35616501
DOI: 10.1177/14791641221088824