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Maturitas Jun 2015The rates of long-term diabetes related complications have declined substantially over the past decade. On the contrary, the growth in the incidence of prediabetes is... (Review)
Review
The rates of long-term diabetes related complications have declined substantially over the past decade. On the contrary, the growth in the incidence of prediabetes is note-worthy - especially in the population 60 years and above. As a result, the focus is now shifting toward early identification and prevention of diabetes. Prediabetes is a high risk state in the continuum of glycemic progression and beta cell dysfunction toward the development of diabetes mellitus. Observational studies have shown association of prediabetes with increased incidence of vascular complications. Long-term prospective randomized clinical trials across the globe have demonstrated a reduction in progression of prediabetes when lifestyle modifications are adopted and these effects can last up to 20 years beyond the period of intervention. While there has been recent interest in using pharmacotherapy for diabetes prevention, they have not been shown to be superior to lifestyle changes. This review hopes to provide a concise summary for the interested reader.
Topics: Costs and Cost Analysis; Diabetes Mellitus; Humans; Prediabetic State; Risk
PubMed: 25911245
DOI: 10.1016/j.maturitas.2015.03.022 -
Annals of Medicine Dec 2014Reports on the association of prediabetes with all-cause mortality and cardiovascular mortality are inconsistent. Objective. To evaluate the risk of all-cause and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Reports on the association of prediabetes with all-cause mortality and cardiovascular mortality are inconsistent. Objective. To evaluate the risk of all-cause and cardiovascular mortality in association with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT).
METHODS
Prospective cohort studies with data on prediabetes and mortality were included. The relative risks (RRs) of all-cause and cardiovascular mortality were calculated and reported with 95% confidence intervals (95% CIs).
RESULTS
Twenty-six studies were included. The risks of all-cause and cardiovascular mortality were increased in participants with prediabetes defined as IFG of 110-125 mg/dL (IFG 110) (RR 1.12, 95% CI 1.05-1.20; and RR 1.19, 95% CI 1.05-1.35, respectively), IGT (RR 1.33, 95% CI 1.24-1.42; RR 1.23, 95% CI 1.11-1.36, respectively), or combined IFG 110 and/or IGT (RR 1.21, 95% CI 1.11-1.32; RR 1.21, 95% CI 1.07-1.36, respectively), but not when IFG was defined as 100-125 mg/dL (RR 1.07, 95% CI 0.92-1.26; and RR 1.16, 95% CI 0.94-1.42, respectively).
CONCLUSIONS
Prediabetes, defined as IFG 110, IGT, or combined IFG 110 and/or IGT, was associated with increased all-cause and cardiovascular mortality.
Topics: Blood Glucose; Cardiovascular Diseases; Cause of Death; Fasting; Glucose Tolerance Test; Humans; Prediabetic State; Risk Assessment
PubMed: 25230915
DOI: 10.3109/07853890.2014.955051 -
The Nurse Practitioner Dec 2018Prediabetes continues to be a national and worldwide health concern, affecting 84 million adults in the US. Early identification and intervention have been successful in...
Prediabetes continues to be a national and worldwide health concern, affecting 84 million adults in the US. Early identification and intervention have been successful in delaying and/or preventing the progression to type 2 diabetes mellitus (T2DM). Nonpharmacologic treatment of prediabetes is paramount, although pharmacologic treatment is appropriate in high-risk patients. In an attempt to curb the increasing prevalence of T2DM, recognizing the importance of identifying and managing prediabetes should remain in the national healthcare forefront.
Topics: Early Diagnosis; Humans; Mass Screening; Nursing Diagnosis; Prediabetic State; United States
PubMed: 30439773
DOI: 10.1097/01.NPR.0000547552.94259.6c -
The Journal of Family Practice Sep 2023While treatment with metformin or lifestyle modification reduces risk for T2D in patients with prediabetes, neither intervention ultimately offers a mortality benefit.
While treatment with metformin or lifestyle modification reduces risk for T2D in patients with prediabetes, neither intervention ultimately offers a mortality benefit.
Topics: Humans; Prediabetic State; Behavior Therapy; Life Style; Metformin
PubMed: 37729142
DOI: 10.12788/jfp.0652 -
Internal Medicine Journal Feb 2015Prediabetes is a serious condition that is associated with an increase in cardiovascular morbidity and mortality. (Comparative Study)
Comparative Study
BACKGROUND
Prediabetes is a serious condition that is associated with an increase in cardiovascular morbidity and mortality.
AIMS
We sought to explore the prevalence of prediabetes in patients admitted with acute coronary syndrome (ACS) who were not known to have diabetes and to determine the impact of prediabetes on in-hospital clinical outcomes versus non-diabetic patients.
METHODS
Prospectively, we enrolled 200 patients not known to have diabetes or prediabetes, admitted with ACS. Laboratory tests included fasting plasma glucose (FPG), 2-h plasma glucose (2hPG) after 75 g glucose, HbA1c and lipid profile. Electrocardiogram and echocardiography were done. The primary end-point was in-hospital major adverse cardiovascular events (MACE).
RESULTS
Mean age was 50.9 ± 6.8 years (70.5% males). The prevalence of patients with diabetes and patients with prediabetes was 24.5% and 20% respectively. Newly discovered diabetic patients were excluded. Compared with patients without diabetes, prediabetic patients had a higher body mass index (BMI) (P = 0.002) and a longer hospital stay (P = 0.09). In-hospital MACE occurred in 10 (25%) patients with prediabetes versus six (5.4%) in patients without diabetes (P = 0.001). In-hospital MACE correlated with prediabetes (r = 0.28, P < 0.001), BMI (r = 0.14, P = 0.093), FPG (r = 0.19, P = 0.014), 2hPG (r = 0.19, P = 0.017) and HbA1c (r = 0.19, P = 0.019). Multivariate regression analysis identified prediabetes as the only independent predictor of in-hospital MACE.
CONCLUSIONS
Prediabetes is common in patients presenting with ACS who are not previously known to have diabetes. Prediabetic patients had worse in-hospital clinical outcomes compared with patients without diabetes.
Topics: Acute Coronary Syndrome; Adult; Age Distribution; Australia; Blood Glucose; Cohort Studies; Comorbidity; Diabetes Mellitus, Type 2; Electrocardiography; Female; Follow-Up Studies; Glucose Tolerance Test; Glycated Hemoglobin; Hospitalization; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prediabetic State; Prevalence; Prospective Studies; Severity of Illness Index; Sex Distribution; Statistics, Nonparametric; Survival Rate
PubMed: 25443454
DOI: 10.1111/imj.12651 -
Metabolic Syndrome and Related Disorders Jun 2013The adherence to the Mediterranean Diet (Med Diet) seems to reduce the incidence of metabolic syndrome. The present study aimed to explore whether the adherence to the...
BACKGROUND
The adherence to the Mediterranean Diet (Med Diet) seems to reduce the incidence of metabolic syndrome. The present study aimed to explore whether the adherence to the overall Med Diet pattern and to specific Med Diet items is associated with the presence of metabolic syndrome, impaired fasting glucose (IFG), insulin resistance (IR), and microinflammation in subjects free of diabetes and cardiovascular diseases.
MEASUREMENTS
Each patient underwent clinical assessment. Adherence to the Med Diet was measured by a previously validated 14-item questionnaire. Metabolic syndrome was defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria; IR was defined by homeostasis model assessment of insulin resistance (HOMA-IR); inflammation was assessed through a high-sensitivity C-reactive protein (hsCRP) assay.
RESULTS
A total of 120 subjects (64.2% women, mean age 59.8±10.2 years) were enrolled at this study. Subjects with lower Med Diet pattern adherence exhibited higher occurrence of metabolic syndrome and all its components and higher HOMA-IR and hsCRP values (P for all <0.0001). Subjects with metabolic syndrome were less likely to consume olive oil (P=0.002) and vegetables (P=0.023). By multivariable analyses, the overall Med Diet score was found to be strongly and inversely associated with the presence of metabolic syndrome [B=-0.066; 95% confidence interval (CI) -0.105 to -0.028; P=0.001], IFG (B=-0.076; 95% CI -0.114 to -0.038; p<0.0001), high HOMA-IR (B=-0.071; 95% CI -0.108 to -0.034; P<0.0001) and high hsCRP (B=-0.082; 95% CI -0.125 to -0.045; P<0.0001). None of specific Med Diet items independently predicted metabolic syndrome, IFG, and high HOMA-IR. Instead, the consumption of white meat over red meat (B=-0.324; 95% CI -0.467 to -0.178; P<0.0001) was found to be inversely associated with increased hsCRP.
CONCLUSIONS
The inverse associations between adherence to Med Diet and the prevalence of metabolic syndrome and prediabetes may be due more to the effects of the entire dietary pattern rather than to individual food components. Metabolic syndrome-related microinflammation may further be linked to specific Med Diet components.
Topics: Adult; Aged; C-Reactive Protein; Diet Records; Diet, Mediterranean; Female; Humans; Incidence; Inflammation; Male; Metabolic Syndrome; Middle Aged; Prediabetic State; Surveys and Questionnaires
PubMed: 23451814
DOI: 10.1089/met.2012.0168 -
Acta Diabetologica Apr 2017We sought to investigate temporal trends in prediabetes prevalence among US adolescents using two definitions and evaluate relationships with obesity and a MetS-severity...
AIMS
We sought to investigate temporal trends in prediabetes prevalence among US adolescents using two definitions and evaluate relationships with obesity and a MetS-severity score.
METHODS
We evaluated data from 5418 non-Hispanic white, non-Hispanic black, and Hispanic adolescents aged 12-19 participating in the National Health and Nutrition Examination Survey 1999-2014 with complete data regarding MetS and hemoglobin A1c (HbA1c). Prediabetes status was defined by American Diabetes Association (ADA) criteria: fasting glucose 100-125 mg/dL or HbA1c 5.7%-6.4%. MetS severity was assessed with a MetS-severity Z-score.
RESULTS
Prevalence of prediabetes as defined by HbA1c abnormalities significantly increased from 1999-2014, while prevalence of prediabetes as defined by fasting glucose abnormalities showed no significant temporal trend. There were variations in these trends across different racial/ethnic groups. MetS Z-score was overall more strongly correlated with HbA1c, fasting insulin, and the homeostasis model of insulin resistance than was BMI Z-score. These correlations were true in each racial/ethnic group with the exception that in non-Hispanic white adolescents, in whom the MetS Z-score was not significantly correlated with HbA1c measurements.
CONCLUSION
We found conflicting findings of temporal trends of US adolescent prediabetes prevalence based on the ADA's prediabetes criteria. The increasing prevalence of prediabetes by HbA1c assessment is concerning and raises the urgency for increased awareness and appropriate measures of prediabetes status among physicians and patients.
Topics: Adolescent; Black or African American; Child; Female; Glycated Hemoglobin; Hispanic or Latino; Humans; Insulin Resistance; Male; Metabolic Syndrome; Nutrition Surveys; Obesity; Prediabetic State; Prevalence; United States; White People; Young Adult
PubMed: 28070750
DOI: 10.1007/s00592-016-0958-6 -
JPMA. the Journal of the Pakistan... Apr 2022Prediabetes is often considered as the link between normoglycaemia and diabetes. Though a lot of emphasis is given to an individual after the development of diabetes,...
Prediabetes is often considered as the link between normoglycaemia and diabetes. Though a lot of emphasis is given to an individual after the development of diabetes, pre-diabetes is often not adequately addressed in clinical practice. Given a distinct diagnostic criterion, its association with metabolic complications, an opportunity to prevent further progression to diabetes and the large number of people affected with it, makes it a subject of great importance and opportunity. In this brief manuscript we compare and contrast prediabetes with diabetes mellitus. We also describe a pragmatic approach to address a patient with prediabetes.
Topics: Counseling; Diabetes Mellitus; Diabetes Mellitus, Type 2; Humans; Mentoring; Prediabetic State
PubMed: 35614621
DOI: 10.47391/JPMA.22-29 -
The Journal of Clinical Endocrinology... Jul 2021
Topics: Humans; Insulin Resistance; Prediabetic State
PubMed: 33765140
DOI: 10.1210/clinem/dgab198 -
Clinical Endocrinology May 2021To investigate changes in glycaemic status in women with polycystic ovary syndrome (PCOS). (Observational Study)
Observational Study
OBJECTIVE
To investigate changes in glycaemic status in women with polycystic ovary syndrome (PCOS).
DESIGN
Longitudinal observational study.
PATIENTS
Women with PCOS who underwent baseline and follow-up screening tests for diabetes (n = 262). Four patients with type 2 diabetes (T2DM) at baseline and 6 patients who were taking drugs at the final follow-up were excluded.
MEASUREMENTS
Changes in glycaemic classification based on fasting glucose, haemoglobin A1c and oral glucose tolerance test.
RESULTS
The median length of follow-up was 2.9 years. The mean age and body mass index in the normoglycaemia group (n = 202) were 23.0 years and 21.6 kg/m , while it was 23.6 years and 22.9 kg/m in the prediabetes group (n = 50). In the normoglycaemia group, 38 (18.8%) and 2 (1.0%) developed prediabetes and T2DM, respectively. In the prediabetes group, 22 (44.0%) remained in the same category, 6 (12.0%) developed T2DM, while 22 (44.0%) achieved normoglycaemia. The incidence rate of T2DM was 9.3 per 1,000 person-years, which was significantly higher than that of the female population of similar age, and the incidence was higher in women with fasting glucose ≥ 5.6 mmol/L at baseline than in women with < 5.6 mmol/L.
CONCLUSIONS
About 20% of normoglycaemic women had developed prediabetes or T2DM after a median time of 2.9 years. Meanwhile, nearly half of prediabetes women achieved normoglycaemia. Higher baseline fasting glucose levels were associated with an increased incidence of T2DM. Our results are the first to evaluate glycaemic status changes using all three parameters in patients with PCOS.
Topics: Blood Glucose; Diabetes Mellitus, Type 2; Female; Glucose Tolerance Test; Humans; Polycystic Ovary Syndrome; Prediabetic State; Republic of Korea
PubMed: 33440048
DOI: 10.1111/cen.14416