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Journal of Clinical Research in... Dec 2017The Metabolic syndrome describes a clustering of typical cardiovascular risk factors. The syndrome is also known as "Insulin Resistance syndrome" as a substantial part... (Review)
Review
The Metabolic syndrome describes a clustering of typical cardiovascular risk factors. The syndrome is also known as "Insulin Resistance syndrome" as a substantial part of the pathophysiology is driven by resistance to the metabolic effects of insulin. The major cause of insulin resistance in childhood is a typical lipid partitioning pattern characterized by increased deposition of lipids within insulin responsive tissues, such as the liver and skeletal muscle and within the viscera. This lipid deposition pattern is also associated with infiltration of intra-abdominal tissues with cells of the immune system, inducing systemic, low-grade inflammation typically observed in insulin resistant obese children and adolescents. Several clues derived from a careful history and physical examination, along with a basic laboratory workup, provide clues in regards to risk stratification in obese children.
Topics: Child; Female; Humans; Insulin Resistance; Male; Metabolic Syndrome; Pediatricians; Pediatrics; Prediabetic State
PubMed: 29280741
DOI: 10.4274/jcrpe.2017.S005 -
Journal of Diabetes Science and... Mar 2019Real-time continuous glucose monitoring (RT-CGM) provides real time glucose readings to participants wearing the device. The ability to see changes in glucose has the... (Review)
Review
Real-time continuous glucose monitoring (RT-CGM) provides real time glucose readings to participants wearing the device. The ability to see changes in glucose has the potential to provide immediate feedback to users on food choices and physical activity. The National Diabetes Prevention Program is currently the only reimbursable intervention for diabetes prevention and weight loss. The purpose of this article is to review the CGM literature on measurements other than Hemoglobin A1c (HbA1c) changes and hypoglycemia and discuss RT-CGM potential use as a behavior modification tool for lifestyle changes and weight reduction in people with prediabetes and type 2 diabetes (T2D).
Topics: Blood Glucose; Blood Glucose Self-Monitoring; Diabetes Mellitus, Type 2; Diet, Healthy; Exercise; Feeding Behavior; Glycated Hemoglobin; Health Behavior; Health Knowledge, Attitudes, Practice; Healthy Lifestyle; Humans; Prediabetic State; Predictive Value of Tests; Risk Reduction Behavior; Treatment Outcome; Weight Loss
PubMed: 30066574
DOI: 10.1177/1932296818790994 -
The Indian Journal of Medical Research Nov 2014
Topics: Diabetes Mellitus; Humans; Physical Examination; Prediabetic State; Risk Factors
PubMed: 25579136
DOI: No ID Found -
Cardiovascular Diabetology Jan 2023Although a great deal of scientific evidence on the epidemiological risk factors for diabetes and prediabetes has been accumulated, there is still insufficient evidence...
BACKGROUND
Although a great deal of scientific evidence on the epidemiological risk factors for diabetes and prediabetes has been accumulated, there is still insufficient evidence to explore sex-related differences. The aim of this study was to examine sex-specific differences in the effect of the atherogenic index of plasma (AIP) on prediabetes and diabetes.
METHODS
This cross-sectional study included data from 10099 American adults. The exposure variable was the AIP, which was defined as log10 (triglycerides/high-density lipoprotein cholesterol). The outcome variables included prediabetes and diabetes defined by the 2013 American Diabetes Association guidelines.
RESULTS
The median age (mean ± SD) was 48.51 ± 18.42 years, and the average value (SD) of the AIP was - 0.09 (0.34). The prevalence of prediabetes was 40.24%, and that of diabetes was 21.32%. Overall, there was a significant positive association between the AIP and prediabetes and diabetes (per 1-unit increment in the AIP: OR, 2.49; 95% CI 1.75, 3.54). The multivariate logistic regression model demonstrated that for each unit increment in the AIP, the prediabetes and diabetes prevalence increased 4.96-fold among female participants (OR 4.96, 95% CI 2.68, 9.18) but not among male participants. We found that the AIP was not related to the prevalence of prediabetes or diabetes (OR 1.41; 95% CI 0.87, 2.29) among males. There was an interaction between sex and the AIP (P for interaction < 0.0001).
CONCLUSIONS
This study showed that a higher AIP was significantly associated with an increased prevalence of prediabetes and diabetes, and the above relationships occurred only among women and not men.
Topics: Adult; Humans; Male; Female; Middle Aged; Aged; Prediabetic State; Cross-Sectional Studies; Nutrition Surveys; Atherosclerosis; Risk Factors; Triglycerides
PubMed: 36717829
DOI: 10.1186/s12933-023-01740-8 -
The American Journal of Cardiology Feb 2019Cardiovascular disease is a leading cause of death in patients with diabetes. Consequently, as antidiabetic medications have demonstrated cardiovascular benefit,... (Review)
Review
Cardiovascular disease is a leading cause of death in patients with diabetes. Consequently, as antidiabetic medications have demonstrated cardiovascular benefit, cardiologists have been asked to weigh in regarding antidiabetic therapy. The cardiologist's role will continue to grow as antidiabetic agents with cardiovascular benefit are being studied in prediabetes as part of an evolving clinical environment. Still, current guidelines primarily recommend high-intensity lifestyle intervention or metformin for diabetes prevention. Considering that many patients cared for by a cardiologist will have prediabetes, we propose herein that cardiologists can also facilitate diabetes prevention through direct intervention, referring patients to community-based high-intensity lifestyle interventions, and through advocacy, policy, and additional guideline development. The most important messaging for a patient is that avoiding new-onset diabetes can reduce microvascular disease, reduce healthcare cost, and improve health-related quality of life. Moreover, as the mortality risk of patients with a history of myocardial infarction and diabetes is almost double that of patients with a history of myocardial infarction who are free of diabetes, there is even more potential benefit in delaying and/or avoiding diabetes in patients with cardiovascular disease. Despite these important health advantages, the implementation of diabetes prevention strategies is lagging. The under implementation may be exaggerated by published opinions conflicting major guidelines in addition to conflicting guideline recommendations. In conclusion, we propose cardiologists can play a key role in preventing diabetes and aligning practice patterns with guideline recommendations among endocrinology, cardiology, and primary care stake holders.
Topics: Cost Savings; Diabetes Complications; Diabetes Mellitus, Type 2; Humans; Hypoglycemic Agents; Life Style; Metformin; Prediabetic State
PubMed: 30528418
DOI: 10.1016/j.amjcard.2018.10.032 -
Cardiovascular Diabetology Jun 2022Type 2 diabetes mellitus (T2DM) is often accompanied by undiagnosed dyslipidemia. Research on the association of unconventional lipid markers with prediabetes (pre-DM)...
Correlation between the triglyceride-to-high-density lipoprotein cholesterol ratio and other unconventional lipid parameters with the risk of prediabetes and Type 2 diabetes in patients with coronary heart disease: a RCSCD-TCM study in China.
OBJECTIVE
Type 2 diabetes mellitus (T2DM) is often accompanied by undiagnosed dyslipidemia. Research on the association of unconventional lipid markers with prediabetes (pre-DM) and T2DM simultaneously is limited in coronary heart disease (CHD) patients.
METHODS
This study included 28,476 patients diagnosed with CHD. Their lipid levels, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured, and non-traditional lipid parameters were calculated. The patients were divided into three groups based on the diabetic status including normoglycemic (NG), pre-DM, and T2DM. Multiple logistic regression was used to compare the association of TG/HDL-C and other non-traditional lipid parameters with pre-DM and T2DM. The tertiles of TG/HDL-C included T1 (TG/HDL-C < 1.10), T2 (1.10 ≤ TG/HDL-C ≤ 1.89) and T3 (TG/HDL-C > 1.89). Low and high TG/HDL-C was defined with sex-specific cutoff points.
RESULTS
Multiple logistic regression results showed that the non-traditional lipid parameters, including non-HDL-C, LDL-C/HDL-C, TC/HDL-C, non-HDL-C/HDL-C and TG/HDL-C, were all correlated with the risk of pre-DM and T2DM. Meanwhile TG/HDL-C showed the strongest correlation (odds ratio [OR]: 1.19; 95% confidence interval [CI] 1.16-1.23), (OR: 1.36; 95% CI 1.33-1.39). When dividing TG/HDL-C into tertiles, using T1 as a reference, T3 was observed to have the highest association with both pre-DM and T2DM (OR: 1.60; 95% CI 1.48-1.74), (OR: 2.79; 95% CI 2.60-3.00). High TG/HDL-C was significantly associated with pre-DM and T2DM (OR: 1.69; 95% CI 1.52-1.88), (OR: 2.85; 95% CI 2.60-3.12). The association of TG/HDL-C with T2DM and pre-DM existed across different sex, age, smoking, and drinking statuses.
CONCLUSION
Elevated non-traditional lipid parameters were significantly associated with pre-DM and T2DM in CHD patients, especially TG/HDL-C. High TG/HDL-C was the risk factor with a strong correlation with the risk of pre-DM and T2DM.
Topics: Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Coronary Disease; Diabetes Mellitus, Type 2; Female; Humans; Male; Prediabetic State; Risk Factors; Triglycerides
PubMed: 35659300
DOI: 10.1186/s12933-022-01531-7 -
Journal of Diabetes Investigation Sep 2017Peripheral neuropathy is a major cause of disability worldwide. Diabetes is the most common cause of neuropathy, accounting for 50% of cases. Over half of people with... (Review)
Review
Peripheral neuropathy is a major cause of disability worldwide. Diabetes is the most common cause of neuropathy, accounting for 50% of cases. Over half of people with diabetes develop neuropathy, and diabetic peripheral neuropathy (DPN) is a major cause of reduced quality of life due to pain, sensory loss, gait instability, fall-related injury, and foot ulceration and amputation. Most patients with non-diabetic neuropathy have cryptogenic sensory peripheral neuropathy (CSPN). A growing body of literature links prediabetes, obesity and metabolic syndrome to the risk of both DPN and CSPN. This association might be particularly strong in type 2 diabetes patients. There are no effective medical treatments for CSPN or DPN, and aggressive glycemic control is an effective approach to neuropathy risk reduction only in type 1 diabetes. Several studies suggest lifestyle-based treatments that integrate dietary counseling with exercise might be a promising therapeutic approach to early DPN in type 2 diabetes and CSPN associated with prediabetes, obesity and metabolic syndrome.
Topics: Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Humans; Metabolic Syndrome; Prediabetic State; Risk Factors
PubMed: 28267267
DOI: 10.1111/jdi.12650 -
Circulation Research Apr 2018The frequency of prediabetes is increasing as the prevalence of obesity rises worldwide. In prediabetes, hyperglycemia, insulin resistance, and inflammation and... (Review)
Review
The frequency of prediabetes is increasing as the prevalence of obesity rises worldwide. In prediabetes, hyperglycemia, insulin resistance, and inflammation and metabolic derangements associated with concomitant obesity cause endothelial vasodilator and fibrinolytic dysfunction, leading to increased risk of cardiovascular and renal disease. Importantly, the microvasculature affects insulin sensitivity by affecting the delivery of insulin and glucose to skeletal muscle; thus, endothelial dysfunction and extracellular matrix remodeling promote the progression from prediabetes to diabetes mellitus. Weight loss is the mainstay of treatment in prediabetes, but therapies that improved endothelial function and vasodilation may not only prevent cardiovascular disease but also slow progression to diabetes mellitus.
Topics: Angiotensin-Converting Enzyme Inhibitors; Animals; Blood Vessels; Cardiovascular Diseases; Combined Modality Therapy; Diabetes Mellitus, Type 2; Diet, Reducing; Disease Progression; Endothelium, Vascular; Extracellular Matrix; Fatty Acids, Nonesterified; Fibrinolysis; Glucose; Humans; Hyperglycemia; Hypoglycemic Agents; Inflammation; Insulin Resistance; Life Style; Metabolic Syndrome; Mice; MicroRNAs; Microcirculation; Muscle, Skeletal; Obesity; Prediabetic State; Risk; Weight Loss
PubMed: 29650631
DOI: 10.1161/CIRCRESAHA.118.311912 -
International Journal of Obesity (2005) Jun 2012Having demonstrated short-term weight loss with liraglutide in this group of obese adults, we now evaluate safety/tolerability (primary outcome) and long-term efficacy... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Having demonstrated short-term weight loss with liraglutide in this group of obese adults, we now evaluate safety/tolerability (primary outcome) and long-term efficacy for sustaining weight loss (secondary outcome) over 2 years.
DESIGN
A randomized, double-blind, placebo-controlled 20-week study with 2-year extension (sponsor unblinded at 20 weeks, participants/investigators at 1 year) in 19 European clinical research centers.
SUBJECTS
A total of 564 adults (n=90-98 per group; body mass index 30-40 kg m(-2)) enrolled, 398 entered the extension and 268 completed the 2-year trial. Participants received diet (500 kcal deficit per day) and exercise counseling during 2-week run-in, before being randomly assigned (with a telephone or web-based system) to once-daily subcutaneous liraglutide (1.2, 1.8, 2.4 or 3.0 mg, n=90-95), placebo (n=98) or open-label orlistat (120 mg × 3, n=95). After 1 year, liraglutide/placebo recipients switched to liraglutide 2.4 mg, then 3.0 mg (based on 20-week and 1-year results, respectively). The trial ran from January 2007-April 2009 and is registered with Clinicaltrials.gov, number NCT00480909.
RESULTS
From randomization to year 1, liraglutide 3.0 mg recipients lost 5.8 kg (95% confidence interval 3.7-8.0) more weight than those on placebo and 3.8 kg (1.6-6.0) more than those on orlistat (P0.0001; intention-to-treat, last-observation-carried-forward). At year 2, participants on liraglutide 2.4/3.0 mg for the full 2 years (pooled group, n=184) lost 3.0 kg (1.3-4.7) more weight than those on orlistat (n=95; P<0.001). Completers on liraglutide 2.4/3.0 mg (n=92) maintained a 2-year weight loss of 7.8 kg from screening. With liraglutide 3.0 mg, 20-week body fat decreased by 15.4% and lean tissue by 2.0%. The most frequent drug-related side effects were mild to moderate, transient nausea and vomiting. With liraglutide 2.4/3.0 mg, the 2-year prevalence of prediabetes and metabolic syndrome decreased by 52 and 59%, with improvements in blood pressure and lipids.
CONCLUSION
Liraglutide is well tolerated, sustains weight loss over 2 years and improves cardiovascular risk factors.
Topics: Adolescent; Adult; Aged; Analysis of Variance; Anti-Obesity Agents; Double-Blind Method; Drug Administration Schedule; Europe; Exercise Therapy; Female; Glucagon-Like Peptide 1; Humans; Liraglutide; Male; Middle Aged; Obesity; Prediabetic State; Risk Reduction Behavior; Treatment Outcome; Weight Loss; Young Adult
PubMed: 21844879
DOI: 10.1038/ijo.2011.158 -
Colombia Medica (Cali, Colombia) Dec 2017The prevalence of Prediabetes in Colombia is high, and despite being recognized and categorized in the main Medical Guidelines and included in the International... (Review)
Review
The prevalence of Prediabetes in Colombia is high, and despite being recognized and categorized in the main Medical Guidelines and included in the International Classification of Diseases in Colombia, knowledge and awareness of it is limited amongst healthcare professionals and in the community. Our expert group recommends that educational programs emphasize a global approach to risk which includes a recognition of the importance of prediabetes and its evaluation along with and other risk factors such as a family history of DM2, overweight and obesity, dislipidemia and hypertension. Studies conducted in Colombia demonstrate the value of the FINDRIS questionnaire as a tool to identify subjects at risk of prediabetes and DM2, and we recommend that it should be systematic applied throughout the country as part of government policy. Prediabetes progresses to DM2 at an annual rate of 10%, but it has also been shown that prediabetes is an independent risk factor for cardiovascular outcomes. On this basis, the Committee recommends that once prediabetes is detected and diagnosed, immediate management of the disease begins through lifestyle changes, with follow up assessments performed at 3 and 6 months. If the patient does not respond with a weight loss of at least 5% and if the HbA1C values are not normalized, pharmacological management should be initiated with a metformin dose of 500 mg / day, increasing up to 1,500 - 1,700 mg / day, according to tolerance.
Topics: Cardiovascular Diseases; Colombia; Consensus; Diabetes Mellitus, Type 2; Disease Progression; Humans; Hypoglycemic Agents; Life Style; Metformin; Practice Guidelines as Topic; Prediabetic State; Prevalence; Risk Factors; Weight Loss
PubMed: 29662261
DOI: 10.25100/cm.v43i4.3662