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JAMA Apr 2023Prediabetes, an intermediate stage between normal glucose regulation and diabetes, affects 1 in 3 adults in the US and approximately 720 million individuals worldwide. (Meta-Analysis)
Meta-Analysis Review
IMPORTANCE
Prediabetes, an intermediate stage between normal glucose regulation and diabetes, affects 1 in 3 adults in the US and approximately 720 million individuals worldwide.
OBSERVATIONS
Prediabetes is defined by a fasting glucose level of 100 to 125 mg/dL, a glucose level of 140 to 199 mg/dL measured 2 hours after a 75-g oral glucose load, or glycated hemoglobin level (HbA1C) of 5.7% to 6.4% or 6.0% to 6.4%. In the US, approximately 10% of people with prediabetes progress to having diabetes each year. A meta-analysis found that prediabetes at baseline was associated with increased mortality and increased cardiovascular event rates (excess absolute risk, 7.36 per 10 000 person-years for mortality and 8.75 per 10 000 person-years for cardiovascular disease during 6.6 years). Intensive lifestyle modification, consisting of calorie restriction, increased physical activity (≥150 min/wk), self-monitoring, and motivational support, decreased the incidence of diabetes by 6.2 cases per 100 person-years during a 3-year period. Metformin decreased the risk of diabetes among individuals with prediabetes by 3.2 cases per 100 person-years during 3 years. Metformin is most effective for women with prior gestational diabetes and for individuals younger than 60 years with body mass index of 35 or greater, fasting plasma glucose level of 110 mg/dL or higher, or HbA1c level of 6.0% or higher.
CONCLUSIONS AND RELEVANCE
Prediabetes is associated with increased risk of diabetes, cardiovascular events, and mortality. First-line therapy for prediabetes is lifestyle modification that includes weight loss and exercise or metformin. Lifestyle modification is associated with a larger benefit than metformin.
Topics: Adult; Female; Humans; Blood Glucose; Diabetes Mellitus; Glycated Hemoglobin; Metformin; Prediabetic State; Risk Factors; United States; Cardiometabolic Risk Factors; Risk Reduction Behavior; Healthy Lifestyle; Health Behavior
PubMed: 37039787
DOI: 10.1001/jama.2023.4063 -
Endocrinology and Metabolism Clinics of... Sep 2021Overt type 2 diabetes mellitus (T2DM) is preceded by prediabetes and latent diabetes (lasts 9-12 years). Key dysglycemia screening tests are fasting plasma glucose and... (Review)
Review
Overt type 2 diabetes mellitus (T2DM) is preceded by prediabetes and latent diabetes (lasts 9-12 years). Key dysglycemia screening tests are fasting plasma glucose and hemoglobin A. Screen-detected T2DM benefits from multifactorial management of cardiovascular risk beyond glycemia. Prediabetes is best addressed by lifestyle modification, with the goal of preventing T2DM. Although there is no trial evidence of prediabetes/T2DM screening effectiveness, simulations suggest that clinic-based opportunistic screening of high-risk individuals is cost-effective. The most rigorous extant recommendations are those of the American Diabetes Association and US Preventive Services Task Force, which advise opportunistic 3-yearly screening.
Topics: Blood Glucose; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Humans; Mass Screening; Prediabetic State
PubMed: 34399951
DOI: 10.1016/j.ecl.2021.05.002 -
Muscle & Nerve Mar 2021Diabetic peripheral neuropathy and metabolic syndrome (MetS) are both global health challenges with well-established diagnostic criteria and significant impacts on... (Review)
Review
Diabetic peripheral neuropathy and metabolic syndrome (MetS) are both global health challenges with well-established diagnostic criteria and significant impacts on quality of life. Clinical observations, epidemiologic evidence, and animal models of disease have strongly suggested MetS is associated with an elevated risk for cryptogenic sensory peripheral neuropathy (CSPN). MetS neuropathy preferentially affects small unmyelinated axons early in its course, and it may also affect autonomic and large fibers. CSPN risk is linked to MetS and several of its components including obesity, dyslipidemia, and prediabetes. MetS also increases neuropathy risk in patients with established type 1 and type 2 diabetes. In this review we present animal data regarding the role of inflammation and dyslipidemia in MetS neuropathy pathogenesis. Several studies suggest exercise-based lifestyle modification is a promising treatment approach for MetS neuropathy.
Topics: Bariatric Surgery; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Diet Therapy; Disease Progression; Dyslipidemias; Exercise; Humans; Hypoglycemic Agents; Metabolic Syndrome; Obesity; Peripheral Nervous System Diseases; Prediabetic State; Risk Factors; Small Fiber Neuropathy; Topiramate
PubMed: 33098165
DOI: 10.1002/mus.27086 -
JAMA Apr 2023
Topics: Humans; Blood Glucose; Prediabetic State
PubMed: 37039802
DOI: 10.1001/jama.2023.4406 -
Medicina (Kaunas, Lithuania) Aug 2019Diabetes, a silent killer, is one of the most widely prevalent conditions of the present time. According to the 2017 International Diabetes Federation (IDF) statistics,... (Review)
Review
Diabetes, a silent killer, is one of the most widely prevalent conditions of the present time. According to the 2017 International Diabetes Federation (IDF) statistics, the global prevalence of diabetes among the age group of 20-79 years is 8.8%. In addition, 1 in every 2 persons is unaware of the condition. This unawareness and ignorance lead to further complications. Pre-diabetes is the preceding condition of diabetes, and in most of the cases, this ultimately leads to the development of diabetes. Diabetes can be classified into three types, namely type 1 diabetes, type 2 diabetes mellitus (T2DM) and gestational diabetes. The diagnosis of both pre-diabetes and diabetes is based on glucose criteria; the common modalities used are fasting plasma glucose (FPG) test and oral glucose tolerance test (OGTT). A glucometer is commonly used by diabetic patients to measure blood glucose levels with fast and rather accurate measurements. A few of the more advanced and minimally invasive modalities include the glucose-sensing patch, SwEatch, eyeglass biosensor, breath analysis, etc. Despite a considerable amount of data being collected and analyzed regarding diabetes, the actual molecular mechanism of developing type 2 diabetes mellitus (T2DM) is still unknown. Both genetic and epigenetic factors are associated with T2DM. The complications of diabetes can predominantly be classified into two categories: microvascular and macrovascular. Retinopathy, nephropathy, and neuropathy are grouped under microvascular complications, whereas stroke, cardiovascular disease, and peripheral artery disease (PAD) belong to macrovascular complications. Unfortunately, until now, no complete cure for diabetes has been found. However, the treatment of pre-diabetes has shown significant success in preventing the further progression of diabetes. To prevent pre-diabetes from developing into T2DM, lifestyle intervention has been found to be very promising. Various aspects of diabetes, including the aforementioned topics, have been reviewed in this paper.
Topics: Adult; Aged; Blood Glucose; Diabetes Complications; Diabetes Mellitus, Type 2; Female; Glucose Tolerance Test; Humans; Hyperglycemia; Insulin Resistance; Male; Middle Aged; Prediabetic State; Risk Factors; Translational Research, Biomedical
PubMed: 31470636
DOI: 10.3390/medicina55090546 -
European Heart Journal Jan 2020
Review
Topics: Cardiology; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Europe; Humans; Practice Guidelines as Topic; Prediabetic State; Societies, Medical
PubMed: 31497854
DOI: 10.1093/eurheartj/ehz486 -
Current Medical Research and Opinion Sep 2019Prediabetes is defined as a state of abnormal glucose homeostasis where blood glucose levels are elevated above those considered normal, but not as high as those... (Review)
Review
Prediabetes is defined as a state of abnormal glucose homeostasis where blood glucose levels are elevated above those considered normal, but not as high as those required for a diagnosis of diabetes. As a condition intermediate between normal glucose homeostasis and the pathological condition of diabetes, the characterization of prediabetes as a distinct pathogenic condition is controversial. Emerging evidence suggests that the condition of prediabetes is associated with pathophysiological changes in several tissues and organs, which would support its recognition as a distinct pathological entity; the recent inclusion of prediabetes and associated billable conditions in the most recent ICD-10 codes provides additional credence to this position. This minireview summarizes our understanding of prediabetes and provides evidence that it should be considered a distinct and important clinical entity.
Topics: Blood Glucose; Cost of Illness; Humans; Life Style; Prediabetic State; Prevalence
PubMed: 30935247
DOI: 10.1080/03007995.2019.1601455 -
Journal of Translational Medicine Jul 2023Diagnosis and intervention of prediabetes is an emerging method for preventing diabetic progression and complications. Periodontitis has been reported to strongly...
BACKGROUND
Diagnosis and intervention of prediabetes is an emerging method for preventing diabetic progression and complications. Periodontitis has been reported to strongly correlate with the dysregulation of glucose metabolism. Nonetheless, the relationship between periodontal status and the prevalence of prediabetes as well as its prognosis remains elusive. This study aimed to investigate the association of periodontitis with the prevalence of prediabetes and furtherly explore the all-cause mortality of different periodontal status among patients with prediabetes.
METHODS
The dateset from the National Health and Nutrition Examination Survey (NHANES) was utilized for our study. Participants were divided into two groups (with or without periodontitis) and further assigned into subgroups by different grades of periodontitis to analyze the association between periodontitis and prevalence of prediabetes. Then we analyzed the association between all-cause mortality and periodontitis among patients with prediabetes. Weighted multivariate logistic/Cox regression models were adopted in our study.
RESULTS
A total of 15390 participants were included and divided into a periodontitis group (n = 5033) and a nonperiodontitis group (n = 10357). The results showed that participants with periodontitis had a higher risk of prediabetes. After adjusting for covariables, more severe periodontitis was positively related to prediabetes (moderate vs. no periodontitis: OR = 1.46, 95% CI: 1.29-1.65; severe vs. no periodontitis: OR = 1.62, 95% CI 1.31-2.01). Furtherly, we explored the association between all-cause mortality and periodontal status among patients diagnosed with prediabetes (n = 4518) and found that severe (HR = 1.806, 95% CI 1.19-2.74) and moderate periodontitis (HR = 2.42, 95% CI 1.95-3.01) were associated with elevated all-cause mortality among patients with prediabetes.
CONCLUSIONS
In general, the results suggest that periodontitis is positively associated with the prevalence and mortality of prediabetes. These results suggest that good management of periodontal status could be a potential strategy to reduce the occurrence and development of prediabetes.
Topics: Humans; Prediabetic State; Nutrition Surveys; Prevalence; Periodontitis; Prognosis
PubMed: 37475034
DOI: 10.1186/s12967-023-04340-y -
Vnitrni Lekarstvi 2022Prediabetes is defined as impaired fasting glucose or impaired glucose tolerance. It often appears as a part of metabolic syndrome and then represents high...
Prediabetes is defined as impaired fasting glucose or impaired glucose tolerance. It often appears as a part of metabolic syndrome and then represents high cardiometabolic risk. The cornestones of prediabetes management and Type 2 diabetes and cardiovascular disease prevention are weight reduction and regular physical activity. Suitable drugs for prediabetic patients are mentioned.
Topics: Blood Glucose; Diabetes Mellitus, Type 2; Glucose; Humans; Metabolic Syndrome; Prediabetic State
PubMed: 36208920
DOI: No ID Found -
Journal of Cardiovascular Pharmacology... 2022The obesity pandemic is accompanied by increased risk of developing metabolic syndrome (MetS) and related conditions: non-alcoholic fatty liver disease... (Review)
Review
Glucagon-Like Peptide-1 Receptor Agonists and Dual Glucose-Dependent Insulinotropic Polypeptide/Glucagon-Like Peptide-1 Receptor Agonists in the Treatment of Obesity/Metabolic Syndrome, Prediabetes/Diabetes and Non-Alcoholic Fatty Liver Disease-Current Evidence.
The obesity pandemic is accompanied by increased risk of developing metabolic syndrome (MetS) and related conditions: non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH), type 2 diabetes mellitus (T2DM) and cardiovascular (CV) disease (CVD). Lifestyle, as well as an imbalance of energy intake/expenditure, genetic predisposition, and epigenetics could lead to a dysmetabolic milieu, which is the cornerstone for the development of cardiometabolic complications. Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RAs promote positive effects on most components of the "" and consequently help reduce the need for polypharmacy. In this review, we highlight the main pathophysiological mechanisms and risk factors (RFs), that could be controlled by GLP-1 and dual GIP/GLP-1 RAs independently or through synergism or differences in their mode of action. We also address the evidence on the use of GLP-1 and dual GIP/GLP-1 RAs in the treatment of obesity, MetS and its related conditions (prediabetes, T2DM and NAFLD/NASH). In conclusion, GLP-1 RAs have already been established for the treatment of T2DM, obesity and cardioprotection in T2DM patients, while dual GIP/GLP-1 RAs appear to have the potential to possibly surpass them for the same indications. However, their use in the prevention of T2DM and the treatment of complex cardiometabolic metabolic diseases, such as NAFLD/NASH or other metabolic disorders, would benefit from more evidence and a thorough clinical patient-centered approach. There is a need to identify those patients in whom the metabolic component predominates, and whether the benefits outweigh any potential harm.
Topics: Humans; Non-alcoholic Fatty Liver Disease; Diabetes Mellitus, Type 2; Glucagon-Like Peptide-1 Receptor; Metabolic Syndrome; Prediabetic State; Glucagon-Like Peptide 1; Obesity; Glucose; Peptides
PubMed: 36546652
DOI: 10.1177/10742484221146371