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Journal of the American Board of Family... 2022Prediabetes is a serious public health concern, with 34.5% of US adults meeting the criteria for prediabetes. The American Diabetes Association has highlighted metformin...
PURPOSE
Prediabetes is a serious public health concern, with 34.5% of US adults meeting the criteria for prediabetes. The American Diabetes Association has highlighted metformin therapy as a consideration for individuals with BMI 35 kg/m, those aged 60 years, and women with a history of gestational diabetes. We examined metformin prescription rates among a national sample of commercially insured, higher risk patients with prediabetes.
METHODS
We gathered 2012 to 2018 demographic, laboratory, and prescription data for 53,551 patients with prediabetes from the IBM MarketScan research database. Our primary outcome was metformin prescription rates 1 or 3 years after a laboratory confirmation of prediabetes among patients who have a BMI 35 kg/m or are aged 60 years.
RESULTS
Overall, 2.4% (n = 1,124) of patients received a metformin prescription within 1 year of a laboratory confirmed prediabetes result, including 2.4% of patients aged 60 years and 10.4% of those with BMI 35 kg/m. By a 3 year follow-up, 4.1% (n = 1901) received a metformin prescription, including 3.9% of patients aged 60 years and 14.0% with BMI 35 kg/m. Patients who developed type 2 diabetes within the 1 (n = 2,769) or 3 year (n = 7,268) follow-up periods were excluded from analysis.
CONCLUSIONS
Few prediabetes patients who were either obese or aged 60 years received a metformin prescription between 2012 and 2018. Prescription rates increased slightly between 1 and 3 years after a prediabetes diagnosis, so strategies to support timely intervention among higher risk patients with prediabetes are critically needed.
Topics: Adult; Blood Glucose; Diabetes Mellitus, Type 2; Female; Humans; Hypoglycemic Agents; Metformin; Prediabetic State; Prescriptions
PubMed: 35896449
DOI: 10.3122/jabfm.2022.04.210485 -
Clinical and Experimental Dental... Feb 2021The aim of the study was to propose an efficient chairside clinical strategy for the identification of undiagnosed hyperglycaemia in periodontal clinics.
OBJECTIVE
The aim of the study was to propose an efficient chairside clinical strategy for the identification of undiagnosed hyperglycaemia in periodontal clinics.
MATERIAL AND METHODS
Α chairside system was used for assessment of glycated hemoglobin 1c (HbA1c) and active Matrix Metalloproteinase-8 levels (aMMP-8) were analyzed by immunotest in patients (n = 150) who fulfilled the criteria for screening of the Centers for Disease Control and Prevention. Full-mouth periodontal parameters were assessed and various data such as Body Mass Index (BMI), smoking and education were recorded.
RESULTS
Thirty-one patients out of 150 tested were found with unknown hyperglycaemia (20.7%). Regarding sex, education, parent with diabetes, normal BMI, smoking, age ≥45 years and prior testing for diabetes, no differences were observed between subjects displaying HbA1c < 5.7 and ≥5.7% (Pearson's Chi-square test, p > .05). Subgroups differed regarding BMI (kg/m ), tooth count, percentages of 4 and 5 mm pockets (Mann-Whitney and z-test, p < .05). The diagnostic performance for HbA1c ≥5.7 was tested by Receiving Operator Characteristic curves and Areas Under the Curve (AUC) for the following: age ≥ 45 years and BMI (AUC 0.651, p = .010), the above and aMMP-8 (AUC 0.660, p = .006), age ≥ 45 years, BMI and Stage of Periodontitis (AUC 0.711, p < .001) and age ≥ 45 years, BMI, aMMP-8 and stage of periodontitis (AUC 0.713, p < .001).
CONCLUSIONS
Findings of the study suggest that the combination of stage of periodontitis, increasing age, BMI and aMMP-8, without chairside HbA1c assessment appears to be a viable screening strategy for referring dental patients for testing for prediabetes/diabetes.
Topics: Glycated Hemoglobin; Humans; Hyperglycemia; Mass Screening; Middle Aged; Periodontitis; Prediabetic State; United States
PubMed: 33300692
DOI: 10.1002/cre2.338 -
Molecular Medicine (Cambridge, Mass.) Mar 2022Caloric restriction and exercise are lifestyle interventions that effectively attenuate cardiometabolic impairment. However, cardioprotective effects of long-term...
BACKGROUND
Caloric restriction and exercise are lifestyle interventions that effectively attenuate cardiometabolic impairment. However, cardioprotective effects of long-term lifestyle interventions and short-term lifestyle interventions followed by weight maintenance in prediabetes have never been compared. High cardiorespiratory fitness (CRF) has been shown to provide protection against prediabetes and cardiovascular diseases, however, the interactions between CRF, prediabetes, caloric restriction, and exercise on cardiometabolic health has never been investigated.
METHODS
Seven-week-old male Wistar rats were fed with either a normal diet (ND; n = 6) or a high-fat diet (HFD; n = 30) to induce prediabetes for 12 weeks. Baseline CRF and cardiometabolic parameters were determined at this timepoint. The ND-fed rats were fed continuously with a ND for 16 more weeks. The HFD-fed rats were divided into 5 groups (n = 6/group) to receive one of the following: (1) a HFD without any intervention for 16 weeks, (2) 40% caloric restriction for 6 weeks followed by an ad libitum ND for 10 weeks, (3) 40% caloric restriction for 16 weeks, (4) a HFD plus an exercise training program for 6 weeks followed by a ND without exercise for 10 weeks, or (5) a HFD plus an exercise training program for 16 weeks. At the end of the interventions, CRF and cardiometabolic parameters were re-assessed. Then, all rats were euthanized and heart tissues were collected.
RESULTS
Either short-term caloric restriction or exercise followed by weight maintenance ameliorated cardiometabolic impairment in prediabetes, as indicated by increased insulin sensitivity, improved blood lipid profile, improved mitochondrial function and oxidative phosphorylation, reduced oxidative stress and inflammation, and improved cardiac function. However, these benefits were not as effective as those of either long-term caloric restriction or exercise. Interestingly, high-level baseline CRF was correlated with favorable cardiac and metabolic profiles at follow-up in prediabetic rats, both with and without lifestyle interventions.
CONCLUSIONS
Short-term lifestyle modification followed by weight maintenance improves cardiometabolic health in prediabetes. High CRF exerted protection against cardiometabolic impairment in prediabetes, both with and without lifestyle modification. These findings suggest that targeting the enhancement of CRF may contribute to the more effective treatment of prediabetes-induced cardiometabolic impairment.
Topics: Animals; Caloric Restriction; Cardiorespiratory Fitness; Cardiovascular Diseases; Male; Prediabetic State; Rats; Rats, Wistar
PubMed: 35272616
DOI: 10.1186/s10020-022-00458-9 -
Cells Apr 2024Prediabetes and colorectal cancer (CRC) represent compelling health burdens responsible for high mortality and morbidity rates, sharing several modifiable risk factors.... (Review)
Review
Prediabetes and colorectal cancer (CRC) represent compelling health burdens responsible for high mortality and morbidity rates, sharing several modifiable risk factors. It has been hypothesized that metabolic abnormalities linking prediabetes and CRC are hyperglycemia, hyperinsulinemia, and adipokines imbalance. The chronic stimulation related to these metabolic signatures can favor CRC onset and development, as well as negatively influence CRC prognosis. To date, the growing burden of prediabetes and CRC has generated a global interest in defining their epidemiological and molecular relationships. Therefore, a deeper knowledge of the metabolic impairment determinants is compelling to identify the pathological mechanisms promoting the onset of prediabetes and CRC. In this scenario, this review aims to provide a comprehensive overview on the metabolic alterations of prediabetes and CRC as well as an overview of recent preventive and therapeutic approaches for both diseases, focusing on the role of the metabolic state as a pivotal contributor to consider for the development of future preventive and therapeutic strategies.
Topics: Animals; Humans; Colorectal Neoplasms; Prediabetic State; Risk Factors
PubMed: 38667278
DOI: 10.3390/cells13080663 -
Frontiers in Endocrinology 2023The American Diabetes Association (ADA) recommends screening for prediabetes and diabetes (dysglycemia) starting at age 35, or younger than 35 years among adults with...
INTRODUCTION
The American Diabetes Association (ADA) recommends screening for prediabetes and diabetes (dysglycemia) starting at age 35, or younger than 35 years among adults with overweight or obesity and other risk factors. Diabetes risk differs by sex, race, and ethnicity, but performance of the recommendation in these sociodemographic subgroups is unknown.
METHODS
Nationally representative data from the National Health and Nutrition Examination Surveys (2015-March 2020) were analyzed from 5,287 nonpregnant US adults without diagnosed diabetes. Screening eligibility was based on age, measured body mass index, and the presence of diabetes risk factors. Dysglycemia was defined by fasting plasma glucose ≥100mg/dL (≥5.6 mmol/L) or haemoglobin A1c ≥5.7% (≥39mmol/mol). The sensitivity, specificity, and predictive values of the ADA screening criteria were examined by sex, race, and ethnicity.
RESULTS
An estimated 83.1% (95% CI=81.2-84.7) of US adults were eligible for screening according to the 2023 ADA recommendation. Overall, ADA's screening criteria exhibited high sensitivity [95.0% (95% CI=92.7-96.6)] and low specificity [27.1% (95% CI=24.5-29.9)], which did not differ by race or ethnicity. Sensitivity was higher among women [97.8% (95% CI=96.6-98.6)] than men [92.4% (95% CI=88.3-95.1)]. Racial and ethnic differences in sensitivity and specificity among men were statistically significant (=0.04 and =0.02, respectively). Among women, guideline performance did not differ by race and ethnicity.
DISCUSSION
The ADA screening criteria exhibited high sensitivity for all groups and was marginally higher in women than men. Racial and ethnic differences in guideline performance among men were small and unlikely to have a significant impact on health equity. Future research could examine adoption of this recommendation in practice and examine its effects on treatment and clinical outcomes by sex, race, and ethnicity.
Topics: Adult; Male; Humans; Female; United States; Prediabetic State; Health Equity; Diabetes Mellitus; Ethnicity; Risk Factors
PubMed: 37900145
DOI: 10.3389/fendo.2023.1279348 -
Journal of Diabetes Research 2021Metformin is the most widely preferred first-line oral antidiabetic agent that results in clear benefits in blood sugar regulation and diabetes-related complications....
OBJECTIVES
Metformin is the most widely preferred first-line oral antidiabetic agent that results in clear benefits in blood sugar regulation and diabetes-related complications. This study is aimed at assessing the effect of metformin on anthropometric, hormonal, and biochemical parameters in patients with prediabetes or insulin resistance.
METHODS
A prepoststudy was conducted among 52 patients with prediabetes or insulin resistance who met the inclusion criteria. Weight, body mass index (BMI), and waist circumference were measured before and 12 months after metformin treatment. Serum concentrations of sex steroids, gonadotropins, and lipids were also assessed. Homeostasis model assessment (HOMA) index and quantitative sensitivity check (QUICKI) index scores were calculated before metformin treatment and after 12 months of use.
RESULTS
After 12 months of metformin treatment, female patients had significant reduction in weight, BMI, and waist circumference after adjusting for age. Metformin use for 12 months resulted in significant reduction in mean fasting blood glucose and HbA1c in females only. Total cholesterol decreased significantly among men only and serum HDL-C showed a significant rise among females only. Serum LDL-C and triglycerides did not change significantly in females and males. Our study did now significant changes in ACTH and cortisol levels in both females and males after metformin treatment. Metformin use resulted in significant increase in luteinizing hormone (LH) and progesterone levels in males, while it was associated with significant increase in prolactin, follicular stimulating hormone (FSH), and dehydroepiandrostenedione-sulphate (DHEA-S) levels and significant decrease in total testosterone level in females.
CONCLUSION
Metformin treatment in females with prediabetes reduces BMI, waist circumference, fasting blood glucose, and HbA1c. The changes in the studied parameters differed significantly according to sex.
Topics: Adult; Anthropometry; Biomarkers; Blood Glucose; Female; Glycated Hemoglobin; Hormones; Humans; Hypoglycemic Agents; Lipids; Male; Metformin; Middle Aged; Prediabetic State; Time Factors; Treatment Outcome
PubMed: 34950736
DOI: 10.1155/2021/8275303 -
Cardiovascular Diabetology May 2024The relationship between the triglyceride-glucose (TyG) index and the risk of cardiovascular disease (CVD) in the U.S. population under 65 years of age with diabetes or...
The association between the triglyceride-glucose index and the risk of cardiovascular disease in US population aged ≤ 65 years with prediabetes or diabetes: a population-based study.
BACKGROUND
The relationship between the triglyceride-glucose (TyG) index and the risk of cardiovascular disease (CVD) in the U.S. population under 65 years of age with diabetes or prediabetes is unknown. The purpose of this study was to investigate the relationship between baseline TyG index and CVD risk in U.S. patients under 65 years of age with diabetes or prediabetes.
METHODS
We used data from the 2003-2018 National Health and Nutrition Examination Survey (NHANES). Multivariate regression analysis models were constructed to explore the relationship between baseline TyG index and CVD risk. Nonlinear correlations were explored using restricted cubic splines. Subgroup analysis and interaction tests were also conducted.
RESULTS
The study enrolled a total of 4340 participants with diabetes or pre-diabetes, with a mean TyG index of 9.02 ± 0.02. The overall average prevalence of CVD was 10.38%. Participants in the higher TyG quartiles showed high rates of CVD (Quartile 1: 7.35%; Quartile 2: 10.04%; Quartile 3: 10.71%; Quartile 4: 13.65%). For CVD, a possible association between the TyG index and the risk of CVD was observed. Our findings suggested a linear association between the TyG index and the risk of CVD. The results revealed a U-shaped relationship between the TyG index and both the risk of CVD (P nonlinear = 0.02583) and CHF (P nonlinear = 0.0208) in individuals with diabetes. Subgroup analysis and the interaction term indicated that there was no significant difference among different stratifications. Our study also revealed a positive association between the TyG index and comorbid MetS in the U.S. population under 65 years of age with prediabetes or diabetes.
CONCLUSIONS
A higher TyG index was linked to an increased likelihood of CVD in the U.S. population aged ≤ 65 years with prediabetes and diabetes. Besides, TyG index assessment will contribute to more convenient and effective screening of high-risk individuals in patients with MetS. Future studies should explore whether interventions targeting the TyG index may improve clinical outcomes in these patients.
Topics: Humans; Prediabetic State; Female; Male; Cardiovascular Diseases; United States; Middle Aged; Blood Glucose; Nutrition Surveys; Risk Assessment; Triglycerides; Biomarkers; Diabetes Mellitus; Prevalence; Adult; Cross-Sectional Studies; Heart Disease Risk Factors; Prognosis; Age Factors; Risk Factors; Predictive Value of Tests
PubMed: 38741118
DOI: 10.1186/s12933-024-02261-8 -
Indian Pediatrics Jul 2023The rising trends of obesity, metabolic syndrome and diabetes in adults are worrisome globally. The majority of antecedents to adult non-communicable diseases begin in...
The rising trends of obesity, metabolic syndrome and diabetes in adults are worrisome globally. The majority of antecedents to adult non-communicable diseases begin in childhood. Type 2 diabetes is recognized as one of the major diseases that contribute to the NCD burden in childhood. Recently, the US Preventive Services Task Force (USPSTF) and the International Society for Pediatric and Adolescent Diabetes (ISPAD) released their guidelines on diagnosis and management of prediabetes and diabetes in children targeted screening for youth-onset type 2 diabetes is suggested in at-risk children (obese, positive family history of type 2 diabetes, etc.), while the role of screening asymptomatic children is not substantiated. Obesity and insulin resistance are important risk factors for type 2 diabetes. The cutoffs of fasting plasma glucose for the diagnosis of prediabetes and diabetes are >100 to 125 and ≥126 mg/dL, respectively. This update briefly summarizes the recommendations on screening for youth-onset prediabetes and type 2 diabetes.
Topics: Adult; Humans; Adolescent; Child; Prediabetic State; Diabetes Mellitus, Type 2; Metabolic Syndrome; Risk Factors; Obesity; Mass Screening
PubMed: 37424124
DOI: No ID Found -
Frontiers in Endocrinology 2023This study aimed to investigate the effect of sarcopenia, osteoporosis, and osteosarcopenia on spine fracture in patients with prediabetes.
OBJECTIVE
This study aimed to investigate the effect of sarcopenia, osteoporosis, and osteosarcopenia on spine fracture in patients with prediabetes.
METHODS
We collected and analyzed the data from the U.S. National Health and Nutrition Examination Surveys during the period from 2009 to 2018. Bone mineral density and the skeletal muscle mass index (SMI) were measured with dual-energy X-ray absorptiometry (DXA). The diagnosis of spine fracture was based on DXA and history.
RESULTS
People with prediabetes were more likely to develop sarcopenia than normal glucose tolerance subjects (OR 1.33, 95% CI 1.07-1.66), while there was no significant increase of osteoporosis in prediabetes (OR 0.91, 95% CI 0.78-1.05). The SMI was independently associated with osteoporosis in prediabetes adults (OR 0.65, 95% CI 0.50-0.85). Both sarcopenia and osteoporosis were positively associated with spine fracture in prediabetes (OR 4.44, 95% CI 1.76-11.21, and OR 2.90, 95% CI 1.85-4.56, respectively). The risk of spine fracture was substantially higher in the presence of osteosarcopenia (OR 6.63; 95% CI, 1.34-32.94) than in the presence of sarcopenia or osteoporosis alone in prediabetes.
CONCLUSION
In adults with prediabetes, both sarcopenia and osteoporosis are risk factors for spine fracture, and the combination of sarcopenia and osteoporosis further increases the prevalence of spine fracture.
Topics: Humans; Adult; Sarcopenia; Spinal Fractures; Prediabetic State; Osteoporosis; Bone Density
PubMed: 37152953
DOI: 10.3389/fendo.2023.1163029 -
Cardiovascular Diabetology Mar 2024In this study, we evaluated the lipidome alterations caused by type 1 diabetes (T1D) and type 2 diabetes (T2D), by determining lipids significantly associated with...
BACKGROUND
In this study, we evaluated the lipidome alterations caused by type 1 diabetes (T1D) and type 2 diabetes (T2D), by determining lipids significantly associated with diabetes overall and in both sexes, and lipids associated with the glycaemic state.
METHODS
An untargeted lipidomic analysis was performed to measure the lipid profiles of 360 subjects (91 T1D, 91 T2D, 74 with prediabetes and 104 controls (CT)) without cardiovascular and/or chronic kidney disease. Ultra-high performance liquid chromatography-electrospray ionization mass spectrometry (UHPLC-ESI-MS) was conducted in two ion modes (positive and negative). We used multiple linear regression models to (1) assess the association between each lipid feature and each condition, (2) determine sex-specific differences related to diabetes, and (3) identify lipids associated with the glycaemic state by considering the prediabetes stage. The models were adjusted by sex, age, hypertension, dyslipidaemia, body mass index, glucose, smoking, systolic blood pressure, triglycerides, HDL cholesterol, LDL cholesterol, alternate Mediterranean diet score (aMED) and estimated glomerular filtration rate (eGFR); diabetes duration and glycated haemoglobin (HbA1c) were also included in the comparison between T1D and T2D.
RESULTS
A total of 54 unique lipid subspecies from 15 unique lipid classes were annotated. Lysophosphatidylcholines (LPC) and ceramides (Cer) showed opposite effects in subjects with T1D and subjects with T2D, LPCs being mainly up-regulated in T1D and down-regulated in T2D, and Cer being up-regulated in T2D and down-regulated in T1D. Also, Phosphatidylcholines were clearly down-regulated in subjects with T1D. Regarding sex-specific differences, ceramides and phosphatidylcholines exhibited important diabetes-associated differences due to sex. Concerning the glycaemic state, we found a gradual increase of a panel of 1-deoxyceramides from normoglycemia to prediabetes to T2D.
CONCLUSIONS
Our findings revealed an extensive disruption of lipid metabolism in both T1D and T2D. Additionally, we found sex-specific lipidome changes associated with diabetes, and lipids associated with the glycaemic state that can be linked to previously described molecular mechanisms in diabetes.
Topics: Male; Female; Humans; Diabetes Mellitus, Type 2; Diabetes Mellitus, Type 1; Lipidomics; Prediabetic State; Cholesterol, HDL; Ceramides; Phosphatidylcholines
PubMed: 38553758
DOI: 10.1186/s12933-024-02202-5