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Obesity Facts 2013To verify in obese children whether or not the presence of (i) high waist-to-height ratio (WHtR), (ii) family history for type 2 diabetes (T2D) and (iii) acanthosis...
OBJECTIVE
To verify in obese children whether or not the presence of (i) high waist-to-height ratio (WHtR), (ii) family history for type 2 diabetes (T2D) and (iii) acanthosis nigricans (AN), singularly or together, might predict the occurrence of metabolic syndrome or prediabetes.
METHODS
1,080 Italian obese children (567 females) were enrolled. Blood pressure, fasting plasma glucose, insulin, and lipids were measured, and oral glucose tolerance test (OGTT) was performed. The WHtR was calculated, family history for T2D was assessed, and the presence of AN was noticed. The odds ratios for showing metabolic syndrome and/or prediabetes according to the presence of these features were calculated.
RESULTS
The prevalence of metabolic syndrome was 29.2%. AN (OR1.81; p = 0.002) and WHtR higher than 0.60 (OR 2.24; p < 0.0001) were the clinical signs linked to higher risk for showing metabolic syndrome, and the odds raised significantly when these elements occurred simultaneously (OR 3.34; p < 0.0001). T2D family history (OR 2.36; p = 0.01) and WHtR higher than 0.60 (OR 2.32; p = 0.009) were the two features associated with increased odds of showing prediabetes.
CONCLUSIONS
Three simple actions, i.e., looking at the patient, asking about T2D family history, and measuring WHtR, may represent a powerful tool in the hands of pediatricians to identify obese children with high cardiovascular and metabolic risk.
Topics: Acanthosis Nigricans; Adolescent; Age Factors; Analysis of Variance; Biomarkers; Blood Glucose; Blood Pressure; Body Height; Chi-Square Distribution; Child; Child, Preschool; Diabetes Mellitus, Type 2; Female; Glucose Tolerance Test; Humans; Insulin; Italy; Lipids; Logistic Models; Male; Medical History Taking; Metabolic Syndrome; Obesity; Odds Ratio; Physical Examination; Prediabetic State; Predictive Value of Tests; Prevalence; Risk Assessment; Risk Factors; Waist Circumference
PubMed: 23429241
DOI: 10.1159/000348625 -
International Angiology : a Journal of... Jun 2006The metabolic syndrome (MetS) is a cluster of cardiovascular risk factors, while prediabetes, identified by impaired fasting glucose (IFG) and/or impaired glucose... (Clinical Trial)
Clinical Trial Comparative Study
AIM
The metabolic syndrome (MetS) is a cluster of cardiovascular risk factors, while prediabetes, identified by impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), predicts future development of diabetes mellitus. Although MetS and prediabetes have a strong interrelation, it is unclear whether they denote the same risk for cardiovascular complications. The aim of the study was to compare overweight and obese individuals with MetS and prediabetes in terms of early carotid artery atheromatosis and renal dysfunction.
METHODS
A total of 524 overweight and obese (body mass index, BMI = or >27 kg/m2) adults, mean age 56.7+/-11.8 years, 264 men and 260 women, were studied. All participants underwent a thorough clinical and laboratory evaluation, including an oral glucose tolerance test. Carotid artery ultrasonography was performed and 24 h urine albumin excretion was measured. NCEP-ATP III and ADA criteria were used for the diagnosis of MetS and prediabetes.
RESULTS
Overall, 129 individuals (24.6%) had MetS without prediabetes and another 59 (11.3%) prediabetes without MetS. Individuals with prediabetes had lower albumin excretion (P=0.033) and more thickened common carotid intima-media in comparison to those with MetS (P=0.032). Furthermore, MetS was associated with higher C-reactive protein levels in comparison to prediabetes (P=0.05).
CONCLUSIONS
The MetS seems to have a more pronounced impact on early renal dysfunction than prediabetes, while the latter to early carotid artery structural changes.
Topics: Adult; Aged; Body Mass Index; C-Reactive Protein; Carotid Artery Diseases; Carotid Artery, Common; Female; Follow-Up Studies; Humans; Male; Metabolic Syndrome; Middle Aged; Prediabetic State; Prognosis; Retrospective Studies; Risk Factors; Ultrasonography, Doppler
PubMed: 16763536
DOI: No ID Found -
Journal of the American Board of Family... 2019Lifestyle change programs are an effective but underutilized approach to prevent or delay type 2 diabetes in people with prediabetes. Understanding clinician prediabetes...
PURPOSE
Lifestyle change programs are an effective but underutilized approach to prevent or delay type 2 diabetes in people with prediabetes. Understanding clinician prediabetes knowledge, attitudes, and practices can inform implementation efforts to increase lifestyle change program referrals.
METHODS
We surveyed clinicians at an academic family medicine clinic about their prediabetes knowledge, attitudes, and practices. From the same clinic, we reviewed electronic health records to assess prediabetes screening, diagnosis, and treatment coverage in the cohort of adults seen from 2015 to 2017.
RESULTS
Thirty-one clinicians (69.6%) completed the survey. Clinicians believed prediabetes was an important health issue (n = 29; 93.7%) and that prediabetes screening (n = 20, 64.5%) and diagnosis (n = 31, 100%) were important for prediabetes management. About half of the respondents (n = 14; 45.2%) reported familiarity with the National Diabetes Prevention Program (DPP). Electronic chart review included 15,520 adult patients. Most of the 5360 nondiabetic patients meeting US Preventive Services Task Force diabetes screening guidelines (n = 4068; 75.9%) received a hemoglobin A1c test. Of the 1437 patients with an A1c result diagnostic of prediabetes, 729 (50.7%) had the diagnosis in their chart. Prediabetes patients receiving point-of-care A1c testing instead of laboratory testing had 4.7 increased odds (95% CI, 3.5 to 6.4) of metformin prescription. No patients were referred to a DPP.
CONCLUSIONS
Clinicians' positive attitudes toward prediabetes screening, moderate knowledge of prediabetes management, and low awareness of DPPs were reflected by high diabetes screening coverage, limited prediabetes diagnosis, and no DPP referrals. We will tailor our implementation strategy to overcome these prediabetes care barriers.
Topics: Academic Medical Centers; Adult; Aged; Attitude of Health Personnel; Clinical Competence; Diabetes Mellitus, Type 2; Disease Progression; Electronic Health Records; Family Practice; Female; Humans; Male; Mass Screening; Middle Aged; Outpatient Clinics, Hospital; Physicians, Family; Prediabetic State; Referral and Consultation; Risk Reduction Behavior
PubMed: 31300570
DOI: 10.3122/jabfm.2019.04.180375 -
Epidemiology and Health 2020To investigate lifestyle-related predictors of prediabetes and diabetes in young adults aged 20-39 years using data from the 2014-2016 Korea National Health and...
OBJECTIVES
To investigate lifestyle-related predictors of prediabetes and diabetes in young adults aged 20-39 years using data from the 2014-2016 Korea National Health and Nutrition Examination Survey (KNHANES).
METHODS
This study is a cross-sectional, secondary analysis using the KNHANES data. Participants were classified into normal group (fasting plasma glucose [FPG] <100 mg/dL and/or hemoglobin A1c [HbA1c] <5.7%), prediabetes group (FPG 100-125 mg/dL and/or HbA1c 5.7-6.4%), and diabetes group (FPG ≥126 mg/dL and/or HbA1c ≥ 6.5%). The data were statistically analyzed using SPSS software.
RESULTS
Out of 4,190 participants, 27.7% of men and 16.3% of women were in the prediabetes group and 1.4% of men and 1.3% of women were in the diabetes group. Logistic regression confirmed that age and obesity are predictors of prediabetes and diabetes in both men and women. Additionally low physical activity and low education level are predictors of prediabetes in men and women, respectively (p<0.05).
CONCLUSIONS
This study has found that age and increased obesity are predictors of elevated blood glucose in young men and women in their 20s and 30s. A strategy to lower obesity by promoting physical activity in men in their 30s is essential to prevent metabolic syndrome and progression to prediabetes.
Topics: Adult; Cross-Sectional Studies; Diabetes Mellitus; Female; Humans; Life Style; Male; Nutrition Surveys; Prediabetic State; Republic of Korea; Risk Factors; Young Adult
PubMed: 32192277
DOI: 10.4178/epih.e2020014 -
The Review of Diabetic Studies : RDS 2018The aim of this study was to explore the differences in OXT levels in metabolic syndrome (MetS) subjects, newly diagnosed type 2 diabetes mellitus (T2D), and prediabetes...
OBJECTIVES
The aim of this study was to explore the differences in OXT levels in metabolic syndrome (MetS) subjects, newly diagnosed type 2 diabetes mellitus (T2D), and prediabetes subjects vs. MetS subjects without glucose intolerance (non-diabetic MetS). It was also intended to determine the relationship between plasma OXT levels and inflammatory markers in those subjects.
METHODS
Along with 45 lean and normoglycemic controls, a total of 190 MetS subjects (61 men, 129 women) were enrolled. Colorimetric enzymatic assays of the following components were performed: plasma OXT, high-sensitivity C-reactive protein (hs-CRP), macrophage chemoattractant protein 1 (MCP-1), plasminogen activator inhibitor 1 (PAI-1), matrix metalloproteinase 9 (MMP-9), resistin, adiponectin, leptin, macrophage migration inhibitory factor (MIF), tumor necrosis factor α (TNF-α), thrompospondin 1 (TSP-1), interleukin 10 (IL-10), interleukin 6 (IL-6), and glucagon.
RESULTS
hsCRP, PAI-1, resistin, leptin-to-adiponection-ratio (LAR), TNF-α, TSP-1, and MIF were significantly higher in both MetS groups (prediabetic and T2DM) than in MetS-only subjects. Leptin and MMP-9 were significantly higher in the MetS-T2DM group (but not in MetS-prediabetics) vs. MetS-only subjects. Conversely adiponectin, OXT, MCP-1, and IL-10 were significantly lower in both MetS groups (prediabetic and T2DM) than in MetS-only subjects. There was no marked discrepancy in either glucagon or IL-6 levels among the three MetS groups. In the entire MetS study population, OXT correlated substantially and proportionally with MCP-1, IL-10, and IL-6; it correlated negatively with HbA1c, fasting plasma glucose (FPG), PAI-1, MMP-9, TNF-α, TSP-1, resistin, adiponectin, leptin, LAR, and MIF. No association could be observed between OXT and glucagon.
CONCLUSIONS
OXT may be a substantial surrogate predictive/prognostic tool and putative pharmacotherapeutic target in metabolic anomalies and related disorders.
Topics: Adult; Biomarkers; Female; Glucose Intolerance; Humans; Inflammation; Inflammation Mediators; Male; Metabolic Syndrome; Middle Aged; Oxytocin; Prediabetic State
PubMed: 29590229
DOI: 10.1900/RDS.2017.14.364 -
Journal of Diabetes and Its... Aug 2023To evaluate retention and outcomes of insured adults with prediabetes who enrolled or did not enroll in National Diabetes Prevention Programs (NDPPs).
AIMS
To evaluate retention and outcomes of insured adults with prediabetes who enrolled or did not enroll in National Diabetes Prevention Programs (NDPPs).
METHODS
Between 2015 and 2019, 776 University of Michigan employees, dependents, and retirees with prediabetes and overweight or obesity enrolled in one-year NDPPs.
RESULTS
Enrollees attended a median of 18 sessions. Median retention was 38 weeks. Retention was associated with older age, greater initial weight loss, and physical activity. At both 1- and 2-years, body mass index, triglycerides, and HbA1c were significantly improved among enrollees. After adjusting for age group, sex, and race, the odds of developing diabetes based on HbA1c ≥6.5 % was 40 % lower at 1-year and 20 % lower at 2-years, and the odds of self-reported diabetes was 57 % lower at 1-year and 46 % lower at 2-years in enrollees compared to non-enrollees. Enrollees who disenrolled before completing the core curriculum had higher odds and enrollees who completed the NDPP had lower odds of developing diabetes that non-enrollees.
CONCLUSIONS
In this population with prediabetes, NDPP retention was generally good, risk factors were improved, and diabetes was delayed or prevented for up to two years.
Topics: Adult; Humans; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Nitro Compounds; Prediabetic State; Male; Female
PubMed: 37459781
DOI: 10.1016/j.jdiacomp.2023.108527 -
Diabetes & Vascular Disease Research 2020The present study aims to investigate the relationship between cardiac autonomic function (CAF) and glucose variability (GV) and HOMA-IR in subjects with prediabetes and...
AIMS
The present study aims to investigate the relationship between cardiac autonomic function (CAF) and glucose variability (GV) and HOMA-IR in subjects with prediabetes and normal glucose tolerance (NGT).
MATERIAL AND METHODS
Ninety-two subjects (59 with prediabetes and 33 with NGT), of mean age 50.3 ± 11.5 years, mean BMI 30.4 ± 6.0 kg/m, were included in this cross-sectional study. Glucose tolerance was assessed by OGTT according to WHO 2006 criteria. Glucose, HbA1c, insulin, oxLDL, and 3-Nitrotyrosine were measured. CGM was performed with a blinded sensor (FreeStyle Libre Pro). CAF was assessed by ANX-3.0 technology.
RESULTS
GV indices were increased in prediabetes. CAF was suppressed in subjects with any stage of dysglycemia. The prevalence of cardiac autonomic dysfunction was higher in prediabetes -20.3% as compared to NGT -3.0%, = 0.028. HOMA-IR [OR 1.5 (95% CI: 1.1-2.1), = 0.010] and time in target range [OR 0.8 (95% CI: 0.67-0.97), = 0.021] were found to be predictive variables for impaired CAF. Sympathetic and parasympathetic activity negatively correlated with mean glycemia and GV indices and were independently related to JINDEX in prediabetes ([1, 47] = 5.76, = 0.021 and [1, 47] = 5.94, = 0.019, respectively); and to time above target range in NGT ([1, 18] = 4.48, = 0.049 and [1, 18] = 4.65, = 0.046, respectively).
CONCLUSION
CAF is declined in prediabetes and seems to be related to GV and HOMA-IR at early stages of dysglycemia.
Topics: Adult; Autonomic Nervous System; Biomarkers; Blood Glucose; Case-Control Studies; Cross-Sectional Studies; Female; Heart; Heart Rate; Humans; Male; Middle Aged; Prediabetic State
PubMed: 32985241
DOI: 10.1177/1479164120958619 -
BMJ (Clinical Research Ed.) Jan 2015To evaluate potential linear and non-linear dose-response relations between blood glucose and risk of pancreatic cancer. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate potential linear and non-linear dose-response relations between blood glucose and risk of pancreatic cancer.
DESIGN
Systematic review and dose-response meta-analysis of prospective observational studies.
DATA SOURCES
Search of PubMed, Scopus, and related reviews before 30 November 2013 without language restriction.
ELIGIBILITY CRITERIA
Prospective studies evaluating the association between blood glucose concentration and pancreatic cancer. Retrospective and cross sectional studies excluded to avoid reverse causality.
DATA EXTRACTION AND SYNTHESIS
Two reviewers independently extracted relevant information and assessed study quality with the Newcastle-Ottawa scale. Random effects dose-response meta-analysis was conducted to assess potential linear and non-linear dose-response relations.
RESULTS
Nine studies were included for analysis, with a total of 2408 patients with pancreatic cancer. There was a strong linear dose-response association between fasting blood glucose concentration and the rate of pancreatic cancer across the range of prediabetes and diabetes. No non-linear association was detected. The pooled rate ratio of pancreatic cancer per 0.56 mmol/L (10 mg/dL) increase in fasting blood glucose was 1.14 (95% confidence interval 1.06 to 1.22; P<0.001) without significant heterogeneity. Sensitivity analysis excluding blood glucose categories in the range of diabetes showed similar results (pooled rate ratio per 0.56 mmol/L increase in fasting blood glucose was 1.15, 95% confidence interval 1.05 to 1.27; P=0.003), strengthening the association between prediabetes and pancreatic cancer.
CONCLUSIONS
Every 0.56 mmol/L increase in fasting blood glucose is associated with a 14% increase in the rate of pancreatic cancer. As prediabetes can be improved or even reversed through lifestyle changes, early detection of prediabetes coupled with lifestyle changes could represent a viable strategy to curb the increasing incidence of pancreatic cancer.
Topics: Biometry; Blood Glucose; Early Diagnosis; Health Behavior; Humans; Hyperglycemia; Observational Studies as Topic; Pancreatic Neoplasms; Prediabetic State; Risk Factors; Statistics as Topic
PubMed: 25556126
DOI: 10.1136/bmj.g7371 -
International Journal of Obesity (2005) Mar 2017It remains unknown whether obese individuals with more components of the metabolic syndrome and/or prediabetes demonstrate altered activation of brain centers in...
Obese individuals with more components of the metabolic syndrome and/or prediabetes demonstrate decreased activation of reward-related brain centers in response to food cues in both the fed and fasting states: a preliminary fMRI study.
It remains unknown whether obese individuals with more components of the metabolic syndrome and/or prediabetes demonstrate altered activation of brain centers in response to food cues. We examined obese individuals with prediabetes (n=26) vs obese individuals without prediabetes (n=11) using fMRI. We also performed regression analyses on the basis of the number of MetS components per subject. Obese individuals with prediabetes have decreased activation of the reward-related putamen in the fasting state and decreased activation of the salience- and reward-related insula after eating. Obese individuals with more components of MetS demonstrate decreased activation of the putamen while fasting. All these activations remain significant when corrected for BMI, waist circumference (WC), HbA1c and gender. Decreased activation in the reward-related central nervous system areas among the obese is more pronounced in subjects with prediabetes and MetS. Prospective studies are needed to quantify their contributions to the development of prediabetes/MetS and to study whether they may predispose to the exacerbation of obesity and the development of comorbidities over time.
Topics: Brain; Brain Mapping; Cues; Fasting; Female; Food; Glycated Hemoglobin; Humans; Magnetic Resonance Imaging; Male; Metabolic Syndrome; Middle Aged; Obesity; Photic Stimulation; Prediabetic State; Prospective Studies; Reward; Risk Factors; Waist Circumference
PubMed: 28017966
DOI: 10.1038/ijo.2016.231 -
PloS One 2020Diabetes is a progressive disease, and thus, it is important to prevent diabetes at the prediabetes stage. Although the loss of muscle strength and prediabetes are...
BACKGROUND
Diabetes is a progressive disease, and thus, it is important to prevent diabetes at the prediabetes stage. Although the loss of muscle strength and prediabetes are associated, few studies have examined relative handgrip strength (RHGS), which can be an indicator of both muscle strength and adiposity. Therefore, our study aimed to examine the association between RHGS and prediabetes (HbA1c level >5.7%) stratified by sex due to sex differences in strength.
METHODS
We analyzed data from the 2016-2018 Korean National Health and Nutrition Examination Survey. Prediabetes was defined using the HbA1c cut-off level of 5.7-6.4%, identified by the American Diabetes Association. RHGS was calculated as the maximal absolute handgrip strength of both hands divided by body mass index and was divided into sex-specific quartiles. Multiple logistic regression analysis was performed to determine the association between sex-specific RHGS and prediabetes.
RESULTS
Among the total participants, 13,384 did not have diabetes. In men, the low and mid-low RHGS groups had increased odds of prediabetes (low group, odds ratio [OR]: 1.42, 95% confidence interval [CI]: 1.10-1.82; mid-low group, OR: 1.32, 95% CI: 1.04-1.67). However, no significant differences were observed between the corresponding female groups. Moreover, central obesity and lower RHGS were strongly associated with prediabetes in men (low group, OR: 2.40, 95% CI: 1.52-3.80; mid-low group, OR: 2.00, 95% CI: 1.26-3.17; mid-high group, OR: 1.76, 95% CI: 1.11-2.81), and a trend was observed (p = 0.0026).
CONCLUSION
RHGS could be a practical and inexpensive tool for predicting diabetes in men. Programs aimed at preventing diabetes need to include exercise routines for improving muscle strength, and further research through longitudinal studies is required to investigate the causality of RHGS on the risk of prediabetes.
Topics: Adult; Female; Hand Strength; Health Surveys; Humans; Male; Middle Aged; Prediabetic State; Republic of Korea; Sex Characteristics; Young Adult
PubMed: 33002067
DOI: 10.1371/journal.pone.0240027