LBODP060 Abnormal Endothelial Dysfunction Is Already Present Among Individuals With Pre-impaired Glucose Tolerance (Pre-IGT)

Abstract

Abstract Pre-impaired glucose tolerance (pre-IGT) is the stage of compensated hyperinsulinemia and the earliest stage of dysmetabolism in the pathophysiology of type 2 diabetes mellitus (DM). Endothelial dysfunction is a critical pathogenic process for the development of macrovascular and microvascular complications due to uncontrolled hyperglycemia among patients with type 2 diabetes mellitus. In pre-IGT, the main problem is hyperinsulinemia on a background of normal blood sugar. C-peptide, a segment cleaved off from pro-insulin and is equimolar to insulin has been shown to cause intima media thickening when present in increased amount. We hypothesize that in high risk individuals with prolonged hyperinsulinemia, endothelial dysfunction is already present in the prediabetes state. This study was undertaken to determine the following: (1) prevalence of endothelial dysfunction among individuals with pre-IGT and (2) correlation of FMD with levels of blood sugar, serum insulin, HbA1c, BMI, systolic BP and diastolic BP. This is a cross-sectional analytical study of adult patients with risk factors for developing diabetes [first-degree relative with type 2 DM, obesity, history of gestational diabetes, and polycystic ovary syndrome (PCOS)]. Patients diagnosed with pre-IGT underwent brachial artery flow-mediated dilatation. Statistical analysis were conducted using STATA 13.1. Of the 40 high risk individuals, 25 (62.5%) was diagnosed with pre-IGT. Of the 25 individuals with pre-IGT, 19 underwent brachial FMD and abnormal FMD was already demonstrated in four. Although statistically not significant, FMD had positive correlation with 2-hr serum insulin levels and systolic and diastolic blood pressure levels, and no correlation with BMI and blood sugar values. However, as previously shown, the mean 2-hour blood sugar of the individuals with pre-IGT had statistically higher levels than those with normoinsulinemic normoglycemia (NN) (pre-IGT; 107.40 vs. NN; 75 mg/dL, p=0. 001). Our study has shown that as early as the pre-IGT stage, endothelial dysfunction has already developed. This calls for a robust early identification and management of high-risk individuals for type 2 diabetes mellitus. Presentation: No date and time listed