Abnormal Fasting Glucose Research Articles

Newly detected diabetes mellitus patients with acute coronary syndrome have an adverse cardiometabolic profile similar to patients with prior diabetes and a more extensive ischemic myocardial insult

AimsThe impact of newly detected diabetes mellitus (NDDM) on metabolic parameters and extent of myocardial necrosis in patients with acute coronary syndrome (ACS) is not fully explored. We examined the impact of NDDM on cardiometabolic characteristics and myocardial necrosis in ACS patients. MethodsCALLINICUS-Hellas Registry is an ongoing prospective multicenter observational study evaluating the adherence to lipid-lowering therapy (LLT) among ACS patients in Greece. Three groups were created: a) patients with NDDM (abnormal fasting glucose, HbA1c ≥ 6.5 % and no previous history of DM), b) patients without known DM and HbA1c < 6.5 % (non-DM) and c) patients with prior DM. ResultsThe prevalence of NDDM among 1084 patients was 6.9 %. NDDM patients had lower HDL-C [38 (32–45) vs 42 (36–50) mg/dL] and higher triglycerides levels [144 (104–231) vs 115 (87–152) mg/dL] compared to non-DM patients (p < 0.05). NDDM patients featured both higher body mass index [29.5 (26.4–34.3) vs 27.1 (24.9–29.9) kg/m2] and waist circumference [107 (100–114) vs 98 (91–106) cm] compared to non-DM patients (p < 0.05). In addition, NDDM patients had more extensive myocardial necrosis than patients with prior DM. ConclusionsACS patients with NDDM have an adverse cardiometabolic profile similar to patients with prior DM and have more extensive myocardial insult.

Abstract P274: Beyond MVPA: Machine Learning Insights Into Activity Patterns and Cardiometabolic Health in the National Health and Nutrition Examination Survey (NHANES) 2003-2004

Physical activity (PA) and sedentary behavior (SB) volumes and patterns may be useful in identifying individuals who are at elevated cardiometabolic risk. Identifying individuals at risk will facilitate early interventions for prevention of cardiovascular diseases. The objective of this project is to identify important free-living physical activity patterns to classify cardiometabolic markers including insulin, plasma glucose, and triglyceride. Methods: We used cross-sectional NHANES 2003-2004 accelerometer, blood exam and demographic data. We included adults age ≥18 years who wore a hip-worn ActiGraph 7164 during waking hours for at least 4 days of 10 hours/day of wear time. We included PA and SB predictors including minutes per day (min/d) in sedentary time (0-99 counts per minute, cpm), light intensity PA (100-759 cpm), Lifestyle PA (760-2019 cpm), moderate to vigorous PA (MVPA, ≥2019 cpm), number of breaks in SB, and number of 30-min and 60-min SB, 10-min MVPA bouts etc. The cut points for cardiovascular disease risk were defined based on literature as: fasting serum insulin ≤ 5 μU/mL, plasma glucose ≤ 100 mg/dL and triglyceride &lt; 150 mg/dL. Three random forest (RF) classification models were developed for each cardiometabolic marker using age, body-mass-index, general health, and PA variables as predictors. Models were trained and tested using a 60% training - 40% testing split. We tuned the hyperparameters (final selection: number of trees = 500 and variables = 3) to find the model with the highest testing accuracy based on the out-of-bag error. The importance of each predictor was measured and ranked by the mean decrease in GINI index. Results: The three datasets include insulin (n = 2810, age=34 ±23, 50% females), glucose (n = 1852, age = 49±20, 51% females) and triglyceride (n = 3180, age=36 ±24, 50% females). For insulin model, the PA variables with largest mean decrease in GINI index were SB time, light intensity PA, MVPA, and SB bouts of 30-min. Similarly, time spent in Lifestyle PA, light intensity PA, number of SB breaks and SB bouts of 30-min were the most important variables for abnormal fasting glucose prediction. The number of sedentary breaks, light intensity PA, SB time and SB bouts of 30-min were the most important PA predictors for risk of high triglyceride. Both BMI and age were important demographic variables for prediction of increased risk in each model. The prediction accuracy and precision are as following: Insulin(73%; 76%), Plasma Glucose(68%; 58%), and Triglyceride(64%; 46%). Conclusion: Cardiometabolic markers using free-living PA has the potential to provide insights for classifying the risk for cardiovascular disease based on given physiological marker cut-off points. The time spent lower intensity PA patterns and the number of sedentary breaks, and 30-minutes bouts are important predictors for identifying individuals who may have increased cardiometabolic risk.

Analysis of depression incidence and influence factors among middle-aged and elderly diabetic patients in China: based on CHARLS data

BackgroundTo investigate the incidence of depression in middle-aged and elderly patients with diabetes in China and the influencing factors to provide a theoretical basis to improve the mental health of middle-aged and elderly patients with diabetes and formulate prevention, control, and intervention strategies.MethodsThe sample of this study was obtained from the China Health and Aging Tracking Survey (CHARLS) 2018 survey data, and middle-aged and older patients with diabetes(responding “Yes” to the questionnaire: “Have you ever been told by a doctor that you have diabetes or elevated blood glucose [including abnormal glucose tolerance and elevated fasting glucose]?”) aged ≥ 45 years were selected as study subjects (n = 2,613 ). Depressive symptoms of the study subjects were determined using the simplified version of the Depression Scale for Epidemiological Surveys scores(a score ≥ 10 was defined as depression), influence factors were analyzed using binary logistic regression, and proportion of depressive symptoms was standardized using the sex ratio of the seventh census.ResultsAmong the 2,613 middle-aged and elderly patients with diabetes, 1782 (68.2%) had depressive symptoms and 831 (31.8%) had no depressive symptoms. There were 481 (27.0%) patients aged 45−59 years, 978 (54.9%) aged 60−74 years, and 323 (18.1%) aged ≥ 75 years. The depression rate among middle-aged and elderly Chinese patients with diabetes after standardization correction was 67.5%. Binary logistic regression results showed that age, education level, life satisfaction, marital satisfaction, self-rated health grade, somatic pain, visual impairment, physical disability, and the presence of comorbid chronic diseases were factors that influenced the onset of depression in middle-aged and elderly Chinese patients with diabetes (P < 0.05).ConclusionAccording to a survey analysis of the CHARLS 2018 data, depression is influenced by a combination of factors among middle-aged and elderly patients with diabetes in China. Therefore, for this population, targeted prevention and control should be carried out for key populations, such as middle-aged and elderly people, poor physical health, and low life satisfaction and marital satisfaction, from various dimensions (e.g., demographic and sociological factors, physical health status, and life satisfaction and marital satisfaction).

Heart rate variability and fasting plasma glucose as trait marker of psychosis: A comparative study between drug naive patients with psychosis and healthy volunteers

Abstract: BACKGROUND: To date, mixed results have been obtained regarding the metabolic and cardiovascular changes in drug-naïve psychotic patients. Moreover, very few Indian studies are available on this subject. The current study adds to the Indian research on metabolic and cardiovascular factors associated with psychotic disorders. AIM: The aim of the study is to determine that metabolic abnormalities such as “impaired glucose tolerance, abnormal lipid profile, and cardiovascular risks are associated with the pathophysiology of the disease itself, i.e., psychosis. MATERIALS AND METHODS: The present study was a hospital-based cross-sectional study conducted over 2 years that included 30 drug-naïve psychotic patients as per ICD-10 DCR and 20 healthy volunteers. Purposive sampling was done. The patients and matched healthy volunteers fulfilling the inclusion and exclusion criteria were assessed to obtain the sociodemographic data, and a mental state examination was done. Positive and Negative Syndrome Scale was applied to patients only. The required investigations, such as lipid profile, sugar profile, body mass index, and electrocardiogram (ECG) for root mean square standard deviation (RMSSD) (heart rate variability [HRV]-time domain), heart rate, and corrected QT interval, were done in both the groups after obtaining written informed consent. The ECGs of all subjects in both groups were obtained mostly in the morning between 10 am and 12 am. The subjects were asked to avoid coffee and nicotine for 1 h before the ECG recording. The patient was asked to rest for 10 min before the recording and 1 min 6-lead ECG recording was obtained in a supine position at complete rest. RMSSD was calculated from the reading of lead II on 1 min resting ECG. RESULTS: Most of the metabolic and cardiovascular factors showed no statistically significant difference between the two groups except fasting blood sugar (FBS) (t = 0.843, P = 0.033), and median value of HRV (P = 0.008). Mean FBS was higher in the patient group compared to the control, and mean HRV was lower in the patient group compared to the control. CONCLUSION: The findings of the current study, in conjunction with the findings from other methodologically similar studies, suggest that lower HRV and abnormal fasting glucose may be associated with the psychopathology of psychotic illnesses.

Previous High-Intensity Breastfeeding Lowers the Risk of an Abnormal Fasting Glucose in a Subsequent Pregnancy Oral Glucose Tolerance Test.

Breastfeeding is associated with reduced lifetime cardiometabolic risk, but little is known regarding the metabolic benefit in a subsequent pregnancy. The primary aim of this study was to investigate the association between breastfeeding duration and intensity and next pregnancy oral glucose tolerance test (OGTT) results. A retrospective cohort study was conducted from March 2020 to October 2022. All multiparous women who met inclusion criteria and gave birth during the study period were eligible for inclusion. Analysis was stratified by risk for gestational diabetes (GDM). High GDM risk criteria included previous GDM and BMI > 35 kg/m2. The association between breastfeeding duration and high-intensity breastfeeding (HIBF) and subsequent pregnancy OGTT were assessed with multivariate logistic models adjusted for statistically and clinically relevant covariables. There were 5374 multiparous participants who met the inclusion criteria for analysis. Of these, 61.7% had previously breastfed for >6 months, and 43.4% were at high risk for GDM. HIBF was associated with 47% reduced odds of an abnormal fasting glucose in a subsequent pregnancy OGTT (aOR 0.53; 95%CI 0.38-0.75; p < 0.01). There was no association between HIBF and other glucose results on the OGTT. Women who smoked were least likely to breastfeed at high intensity (aOR 0.31; 95%CI 0.21-0.47; p < 0.01). South Asian women had 65% higher odds of HIBF than women who identified as White/European (aOR 1.65; 1.36-2.00; p < 0.01). This study highlights the importance of exclusive breastfeeding to potentially reduce the prevalence of GDM and may also translate into long-term reduction of cardiometabolic risk.

5 Poorer Memory Outcomes are Observed in Underinsured Latino Older Adults with Metabolic Syndrome

Objective:Metabolic Syndrome (MetS) is a constellation of deleterious cardiometabolic health conditions (e.g., diabetes, hypertension) that have been linked to cognitive impairment and accelerated cognitive decline in older adults. Research has shown that Latinos are at increased risk for developing MetS relative to non-Latino Whites and the prevention, maintenance, and treatment of cardiometabolic risk factors are largely contingent upon health insurance status. Within the United States there are considerable state-based differences in eligibility and access to health insurance coverage. Although Texas has the second largest population of Latinos, they are one of the most underinsured groups within the state. There is some evidence to suggest that inconsistent healthcare is associated with cognitive impairment among underserved/underprivileged groups. The current study sought to examine whether insurance status moderates the association between MetS and cognitive functioning in an effort to inform public health policy initiatives vital to reducing age-related health disparities amongst Latino older adults residing in Texas.Participants and Methods:The study sample included 850 primarily Spanish-speaking (67.6%) Latino older adults (mean age = 63.1±7.81) largely of Mexican origin/descent (95%) enrolled in the Health and Aging Brain Study-Health Disparities. All participants completed neuropsychological testing, a health exam, and questions about health insurance coverage. MetS status (MetS+ vs. MetS-) was determined by abnormal clinical abdominal obesity, triglycerides, high-density lipoprotein, blood pressure, and fasting glucose values. Health insurance status was determined by current enrollment in any private or public insurance plan. Cognition was assessed with Digit Span, Logical Memory I and II, Trail Making Test (A and B), Spanish-English Verbal Learning Test, and Letter Fluency (FAS). Raw scores were converted to z-scores which were subsequently averaged into two distinct memory and executive functioning composite scores. ANCOVAs controlling for age, sex, education, APOE e4 positivity, annual income, and primary language status were used examine health insurance status x MetS interactions on cognitive composites.Results:Approximately 54.6% of the sample met clinical criteria for MetS+ and 23.6% endorsed having no health insurance. There were no significant group differences in the proportion of MetS+ and MetS- individuals with and without health insurance (X 2 = .002, p =.96). Results revealed there was a significant MetS x health insurance status interaction on the memory composite (F = 5.39, p = .02). Post-hoc comparisons revealed that Latino older adults without health insurance demonstrated poorer memory performance relative to those with health insurance in the MetS+ group (p=.02). In contrast, there were no significant differences in memory performance across insurance status in the MetS- group (p=.35). Finally, there was no significant MetS x health insurance interaction on executive functioning (p=.60).Conclusions:Findings revealed that health insurance coverage differentially impacts memory, but not executive functioning, amongst Latinos with MetS+. Underinsured Latinos with chronic cardiometabolic health conditions may be at risk for poor memory outcomes and increasing access to affordable healthcare could help mitigate the adverse effects of MetS+ on memory. Future studies examining the relationship between health insurance, MetS status, and neuroimaging markers may yield additional insight into mechanisms underlying age-related dementia disparities.

Assessment of Biochemical Parameters in 8- and 9-Year-Old Children with Excessive Body Weight Participating in a Year-Long Intervention Program.

Childhood obesity represents a significant challenge both clinically and socio-economically. This study aimed to assess specific biochemical parameters, particularly glucose, insulin and lipid profile, before and after a year-long intervention program in 8- and 9-year-old children with excessive body weight living in Szczecin, Poland from 2016 to 2018. The research comprised two phases: screening in elementary schools and intervention in the outpatient clinic of the clinical Pomeranian Medical University hospital. Out of 11,494 8- to 9-year-olds in Szczecin, 42.54% (4890) participated in the screening. In the intervention phase, 515 children were examined. Anthropometric measurements were recorded at each visit, and blood samples were collected during the first and fourth visits. In the statistical analysis, the Kolmogorov-Smirnov, t-Student and ANOVA tests were employed (with statistical significance when p ≤ 0.05). Results highlighted a significant proportion of children exhibiting disruptions in carbohydrate and lipid metabolism. A total of 8.6% of participants had elevated total cholesterol, 9.7% had reduced HDL, 13.4% had elevated LDL, and 21.2% had elevated triglycerides. Initially, abnormal fasting glucose was detected in 4.7% of children, and elevated insulin levels in 3.1%. Metabolic disorders persisted post-intervention despite BMI improvement. The results emphasize the necessity for prolonged programs with frequent follow-ups targeting weight normalization in children.

Different subtypes of gestational diabetes mellitus are associated with distinct perinatal outcomes in twin pregnancies

AimsTo determine whether different gestational diabetes mellitus (GDM) subtypes are associated with distinct perinatal outcomes in twin pregnancies. MaterialsThis retrospective cohort study enrolled women with twin pregnancies who gave birth at a tertiary hospital between January 2017 and December 2022. GDM was diagnosed by the IADPSG diagnostic criteria. Three subtypes of GDM were defined as only abnormal fasting glucose (OAFG) values, only abnormal post-load glucose (OAPG) values and abnormal combined fasting and post-load glucose (ACFPG) values. Logistic regression or generalized estimation equation models were used to test the correlation of subtypes of GDM and perinatal outcomes. ResultsGDM with OAPG had a slightly higher risk for preterm delivery (PTD) at <37 gestational weeks (aOR 1.22, 95 %CI 1.01–1.47) and neonatalintensivecareunit (NICU) admission (aOR 1.31, 95 %CI 1.09–1.57). GDM with ACFPG were associated with PTD at <37 gestational weeks (aOR 1.42, 95 %CI 1.06–1.89) and PTD at <34 gestational weeks (aOR 1.65, 95 % CI 1.14–2.39). GDM with OAFG had a lower risk of being small-for-gestational age (SGA) (aOR 0.48, 95 % CI 0.26–0.92). ConclusionsDifferent subtypes of GDM are associated with distinct perinatal outcomes. Only abnormal fasting glucose levels may be responsible for reduced the risk of SGA neonates.

Metabolic Profile of Patients with Smith-Magenis Syndrome: An Observational Study with Literature Review.

Background: Smith-Magenis syndrome (SMS) is caused by either interstitial deletions in the 17p11.2 region or pathogenic variants in the RAI1 gene and is marked by a distinct set of physical, developmental, neurological, and behavioral features. Hypercholesterolemia has been described in SMS, and obesity is also commonly found. Aim: To describe and characterize the metabolic phenotype of a cohort of SMS patients with an age range of 2.9-32.4 years and to evaluate any correlations between their body mass index and serum lipids, glycated hemoglobin (HbA1c), and basal insulin levels. Results: Seven/thirty-five patients had high values of both total cholesterol and low-density lipoprotein cholesterol; 3/35 had high values of triglycerides; none of the patients with RAI1 variants presented dyslipidemia. No patients had abnormal fasting glucose levels. Three/thirty-five patients had HbA1c in the prediabetes range. Ten/twenty-two patients with 17p11.2 deletion and 2/3 with RAI1 variants had increased insulin basal levels. Three/twenty-three patients with the 17p11.2 deletion had prediabetes. Conclusion: Our investigation suggests that SMS 'deleted' patients may show a dyslipidemic pattern, while SMS 'mutated' patients are more likely to develop early-onset obesity along with hyperinsulinism.

Multidirectional pharmacological effects of saponins in light of clinical trials: a systematic review of literature

Introduction: Saponins are secondary metabolites widely distributed in higher plants with multidirectional pharmacological effects. We distinguish between steroidal and triterpenoidal saponins, which are composed of glycone and aglycone. The varied medicinal properties of saponins are influenced by the presence of different substituents in the polycyclic aglycone, e.g. hydroxyls, hydroxymethyls, carboxyls and acyl groups, as well as the difference in bonding, composition and number of sugar chains. It is noteworthy that foods rich in these compounds can reduce the risk of developing various diseases, and the isolation of these compounds from the plant matrix provides new opportunities to create potential and effective drugs.&#x0D; Purpose of the work: Conduct a literature review on the basis of available clinical studies on the pharmacological effects of saponins extracted from medicinal plants and their potential application in medicine.&#x0D; Materials and methods: The work was based on a literature review of available medical publications from clinical trials conducted for the multidirectional therapeutic effects of saponins. Reports available in publications and scientific studies posted in medical information databases such as Pubmed and Google Scholar were summarised.&#x0D; Results: Clinical studies confirm the pharmacological effect of saponins in the treatment of sports injuries and trauma, type II diabetes, abnormal glycemic state fasting glucose, ischemic heart disease, pancytopenia and aplastic anemia.&#x0D; Conclusions: With the advancement of scientific research on saponins, it is possible to use them to produce potential drugs and dietary supplements with pharmacological effects. However, before saponins can be used for medical treatment, further research on their efficacy and safety is needed.&#x0D;

Validation of "Life's Essential 8" Metrics With Cardiovascular Structural Status in Children: The PROC Study in China.

Background Life's Essential 8 (LE8) metrics for cardiovascular health (CVH) aid primordial prevention in US populations. Methods and Results We conducted a child cohort study (PROC [Beijing Child Growth and Health Cohort]) with baseline (2018-2019) and follow-up (2020-2021) assessments, enrolling disease-free 6- to 10-year-old children from 6 elementary schools in Beijing. We collected LE8-assessed components via questionnaire surveys and 3 cardiovascular structural parameters by 2-dimensional M-mode echocardiography: left ventricular mass (LVM), LVM index, and carotid intima-media thickness. Compared with 1914 participants (mean age, 6.6 years) at baseline, we saw lower mean CVH scores at follow-up (n=1789; 8.5 years). Among LE8 components, diet presented the lowest perfect-score prevalence (5.1%). Only 18.6% of participants had physical activity ≥420 min/wk, 55.9% had nicotine exposure, and 25.2% had abnormal sleep duration. Prevalence of overweight/obesity was 26.8% at baseline and 38.2% at follow-up. We noted optimal blood lipid scores in 30.7%, while 12.9% of children had abnormal fasting glucose. Normal BP was 71.6% at baseline and 60.3% at follow-up. LVM (g), LVM index (g/m2.7), and carotid intima-media thickness (mm) were significantly lower in children with high (56.8, 33.2, 0.35) or moderate CVH scores (60.6, 34.6, 0.36), compared with children with low CVH scores (67.9, 37.1, 0.37). Adjusting for age/sex, LVM (β=11.8 [95% CI, 3.5-20.0]; P=0.005), LVM index (β=4.4 [95% CI, 0.5-8.3]; P=0.027), and carotid intima-media thickness (β=0.016 [95% CI, 0.002-0.030]; P=0.028) were higher in the low-CVH group. Conclusions CVH scores were suboptimal, declining with age. LE8 metrics indicated worse CVH in children with abnormal cardiovascular structural measurements, suggesting the validity of LE8 in assessing child CVH. Registration URL: https://www.chictr.org.cn/index.html; Unique identifier: ChiCTR2100044027.

Glucose intolerance in pregnancy and risk of early-onset type 2 diabetes: a population-based cohort study

The risk of type 2 diabetes among women with glucose intolerance during pregnancy that does not meet gestational diabetes criteria requires further investigation. We aimed to explore the associations between various degrees of gestational glucose intolerance and the risk of type 2 diabetes in young adulthood. For this population-based cohort study, the national Israeli conscription database was linked to Maccabi Healthcare Services (MHS), the second-largest state-mandated health provider in Israel. We included 177 241 women who underwent a pre-recruitment evaluation at adolescence (age 16-20 years), 1 year before mandatory military service, and later underwent, from Jan 1, 2001, to Dec 31, 2019, two-step gestational diabetes screening with a 50 g glucose challenge test (GCT) based on a threshold of 140 mg/dL (7·8 mmol/L), followed as needed by a 100 g oral glucose tolerance test (OGTT). Abnormal OGTT values were defined according to the Carpenter-Coustan thresholds: 95 mg/dL (5·3 mmol/L) or higher in the fasting state; 180 mg/dL (10·0 mmol/L) or higher at 1 h; 155 mg/dL (8·6 mmol/L) or higher at 2 h; and 140 mg/dL (7·8 mmol/L) or higher at 3 h. The primary outcome was incident type 2 diabetes in the MHS diabetes registry. Cox proportional hazards models were applied to estimate adjusted hazard ratios (HRs) with 95% CIs for incident type 2 diabetes. During a cumulative follow-up of 1 882 647 person-years, and with a median follow-up of 10·8 (IQR 5·2-16·4) years, 1262 women were diagnosed with type 2 diabetes. Crude incidence rates of type 2 diabetes were 2·6 (95% CI 2·4-2·9) per 10 000 person-years in women with gestational normoglycaemia, 8·9 (7·4-10·6) per 10 000 person-years in women with an abnormal GCT and normal OGTT, 26·1 (22·4-30·1) per 10 000 person-years in women with one abnormal OGTT value (in the fasting state or 1 h, 2 h, or 3 h post-challenge), and 71·9 (66·0-78·3) per 10 000 person-years in women with gestational diabetes. After adjustment for sociodemographic characteristics, adolescent BMI, and age at gestational screening, the risk of type 2 diabetes was higher, compared to the gestational normoglycaemia group, in women with an abnormal GCT and normal OGTT (adjusted hazard ratio [HR] 3·39 [95% CI 2·77-4·16]; p<0·0001), in women with one abnormal OGTT value (9·11 [7·64-10·86]; p<0·0001), and in women with gestational diabetes (24·84 [21·78-28·34]; p<0·0001). The risk of type 2 diabetes was modestly increased in women with isolated elevated fasting glucose (adjusted HR 11·81 [95% CI 8·58-16·25]; p<0·0001), and in women with gestational diabetes and an abnormal fasting glucose (38·02 [32·41-44·61]; p<0·0001). Gestational glucose intolerance, including conditions not meeting gestational diabetes criteria of the two-step strategy, confers a high risk of type 2 diabetes in young adulthood. These conditions should be recognised as risk factors for type 2 diabetes, especially among women with abnormal fasting glucose concentrations during pregnancy. None.

Short Mediterranean diet screener detects risk of prediabetes in Taiwan, a cross-sectional study

We aimed to determine whether the 14-item Mediterranean diet adherence screener (MEDAS) is suitable in Taiwan and associate the MEDAS score with the risk of prediabetes. In this cross-sectional study 346 patients were recruited between 2014 and 2019 at Taipei Tzu Chi Hospital. The MEDAS score was obtained with a 14-item MEDAS used in the PREDIMED trial. The blood glucose level is measured by fasting glucose and HbA1c. The results of the screener were analyzed for internal consistency and compared with the blood glucose level using multivariate regression models. The MEDAS score was significantly (p = 0.001) and inversely associated with both measures of blood glucose level. Adjusted data (95% CI) showed that each additional point in the MEDAS score decreases the risk of prediabetes with abnormal fasting glucose (> 100 mg/dL) level by 60% and the risk of prediabetes with abnormal HbA1c (> 5.7%) by 22.4%. Consuming at least 3 servings of legumes each week was significantly (p = 0.007) related to a lower risk of prediabetes under logistic regression. A higher score on the 14-item MEDAS screener was significantly associated with a lower risk of prediabetes.

Dietary Inflammatory Index (DII)® and Metabolic Syndrome in the Selected Population of Polish Adults: Results of the PURE Poland Sub-Study.

The aim of the study was to assess the relationship between the inflammatory potential of the diets of residents of Lower Silesia, based on the Dietary Inflammatory Index (DII), with the incidence of metabolic syndrome (MetS) and its components. Diets were characterized according to DII terciles. The study group consisted of 1570 individuals enrolled in the Polish arm of the Prospective Urban and Rural Epidemiological (PURE) study. Participants' diets in DII T1 (most anti-inflammatory diet) had the highest intake of vegetables (except for potatoes), fruits, nuts and seeds, low-calorie beverages, tea, and coffee (all p &lt; 0.001). On the other hand, participants' diets in DII T3 (most pro-inflammatory diet) contained a lot of whole-fat products, refined cereals, fats (except for vegetable oils), fruit juices, red meat, processed meat/meat products, sugar-sweetened beverages, sweets, sugar, and honey (all p &lt; 0.001). Overall, we did not find an increased prevalence of MetS and its individual components in DII tercile 3 (T3) compared to DII tercile 1 (T1), except for an increased prevalence of abnormal TG in DII T3 compared to T1 (OR 1.34; 95% CI = 1.01 to 1.78) in the crude model. In the adjusted model, a lower prevalence of abnormal fasting glucose (FG) was found in DII T2 compared to DII T1 (OR 0.71; 95% CI = 00.54 to 0.94). Results of this study are informative and provide an important basis for further research on the quality of diet and nutrition.

Gestational diabetes mellitus- can we do better with postpartum diabetes screening?

Patients with gestational diabetes mellitus (GDM) are at risk for developing type-2 DM. Pregnancy and the postpartum period are a window of opportunity for medical intervention which may improve patients’ future health. The standard recommendation following GDM is a 75-gram oral glucose tolerance test (OGTT) 6-12 weeks postpartum. At our hospital, fasting glucose (FG) is obtained from all parturients with GDM 24-48 hours postpartum. We sought to compare the correlation between the postpartum FG value and the results of the OGTT 6-12 weeks postpartum. We reviewed computerized medical records of all patients with a diagnosis of GDM who gave birth at our institution during 2021, and performed an OGTT 6-12 weeks postpartum. We examined the strength of FG as a predictor for an abnormal OGTT. A total of 319 patients met our inclusion criteria. FG was normal in 261 cases (82%), and abnormal in 58 (18%). Most patients had a normal OGTT (229, 72%), however, postpartum OGTT was abnormal in 90 patients (28%). Of them, 84 (93%) were diagnosed with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), and only 6 patients (7%) were found to have overt DM. A univariate analysis showed a significant correlation between abnormal FG and pathological postpartum OGTT (p=0.001, Pearson’s correlation 0.186). A multivariate analysis also demonstrated FG as a good predictor for IFG or IGT with an adjusted odds ratio (OR) of 1.028 (p=0.048, CI 1.000-1.056). FG as a predictor for overt DM had an adjusted OR of 1.126 (p=0.012, CI 1.026-1.235). Postpartum FG had modest sensitivity for IGT and for DM (31% and 33% respectively). However, the specificity was high for both (87% and 82% respectively), with a negative predictive value (NPV) of 76% for IGF or IGT and 98% for DM. Fasting glucose 24-48 hours postpartum is a good predictor of a pathological OGTT 6-12 weeks postpartum. As the compliance for completing an OGTT is low, we may consider using FG as a tool for predicting future DM.

Prevalence of preeclampsia and uterine arteries resistance in the different phenotypes of gestational diabetes mellitus

AimsThis study aims to investigate the different phenotypes of Gestational Diabetes Mellitus (GDM), in correlation to preeclampsia and uterine arteries resistance. MaterialsThis is a prospective cohort study including women with and without GDM per the IADPSG criteria. Three phenotypes of GDM emerged, women with only abnormal fasting (AF) glucose levels, women with only abnormal post-load (AP) glucose levels at 60′ and/or 120′ and women with abnormal combined (AC) fasting and post-load glucose values. All women underwent uterine arteries doppler examination in the three trimesters and assessed for preeclampsia development. Linear regression was used to express the trajectories of uterine arteries resistance throughout the pregnancy. Results6928 pregnant women were included, 5274 without GDM and 1654 with GDM. 546, 781 and 327 of GDM pregnancies presented with AF, AP and AC phenotypes respectively. Prevalence of preeclampsia was 17.9%, 26.8% and 30% in the AF, AP and AC phenotypes respectively (p < 0.001). In women who developed preeclampsia, AC phenotype presented with statistically different trajectory of Uterine Arteries Pulsatility Index Percentiles b = 0.129 than women without GDM and women with AP GDM phenotype b = −0.015 and b = −0.016 respectively. ConclusionsThe combined abnormal phenotype presents with the highest rate of preeclampsia and the most distinct pattern of uterine arteries resistance.

PREVALENCE AND PATTERN OF DYSLIPIDAEMIA AND ASSOCIATED FACTORS IN NAÏVE TYPE 2 DIABETES MELLITUS PATIENTS: A CROSS-SECTIONAL STUDY FROM WESTERN UTTAR PRADESH

Objective: The present study was conducted with an objective to study prevalence and pattern of dyslipidemia in newly diagnosed type 2 diabetes mellitus patients. Methods: From August 2021 to March 2022, 161 participants participated in the trial. After a night of fasting, skilled medical laboratory technicians drew 5 ml of blood from each study subject and performed anthropometric measurements on them. Results: 110 patients, or 68.9% of the entire group, had dyslipidemia. About 3.7% (n=6) of the individuals had atherogenic dyslipidemia. Among 2.5% and 23.6% of the participants, high TC (total cholesterol) and low HDL (high-density lipoprotein), respectively, were found to be isolated dyslipidemias. Significantly more hypertensives (77.9%), people with abnormal fasting glucose levels (80.2%), those with elevated postprandial glucose levels (78.8%), and people with larger waist circumference had dyslipidemia (76.0%). Conclusion: Our study showed that diabetic patients have a significant prevalence of dyslipidemia. The main public health issue in underdeveloped nations is dyslipidemia, which also serves as a standalone risk factor for developing cardiovascular disease (CVD). In addition, it complicates the progression of CVD in diabetic individuals and raises mortality when combined with other risk factors like high blood pressure.

Association of long-term exposure to PM2.5 in workplace with fasting plasma glucose among asymptomatic adults: A multicenter study in North China.

The impacts of long-term high exposure to PM2.5 in workplace on glucose metabolism in asymptomatic working adults (AWAs) have rarely been explored. To assess the relationship between long-term exposure to workplace PM2.5 and glucose metabolism in asymptomatic general working adults in heavily polluted regions. We used the baseline data of the asymptomatic working participants from the Beijing-Tianjin-Hebei Medical Examination Cohort, which recruited adults undergoing medical examinations. A machine learning-based spatial-temporal model was used to estimate daily average PM2.5 concentrations in the participants' workplaces. We assessed the association of long-term PM2.5 concentrations (three years prior to the interview) and fasting plasma glucose (FPG) using generalized linear mixed-effects models (GLMM) with inclusion of potential confounders. Stratified analyses by sex, age, BMI and smoking status, and two pollutant models were further performed. A total of 37,619 individuals were interviewed and 28,865 were included in the analyses. The mean FPG was 5.20 (0.96) mmol/L, and the estimated three-year average concentration of PM2.5 exposure was 69.51 (6.92) μg/m3. We detected a significant association of long-term exposure to workplace PM2.5 and FPG, a 10µg/m3 increase in the long-term workplace PM2.5 exposure was associated with 0.075 (95%CI: 0.050-0.100) mmol/L elevated FPG and 25% (OR=1.25, 95%CI: 1.05-1.50) elevated odds of abnormal fasting glucose metabolism with control of the potential confounding. The detected association between workplace PM2.5 and FPG metabolism remained significant in males, individuals aged>44years, overweight and/or obese people, both smokers and non-smokers, and when NO2, SO2, O3, and CO were included in the model. Long-term exposure to workplace PM2.5 was associated with elevated FPG and/or odds of abnormal glucose metabolism among AWAs. Male, middle-aged, overweight and/or obese AWAs were more susceptible to workplace PM2.5 regardless of smoking status.

Glucose tolerance test with a single abnormal value in pregnancy and the risk of type-2 diabetes mellitus.

To evaluate the association between a single abnormal value on a 3-h 100g oral glucose tolerance test (OGTT) results and future type-2 diabetes mellitus (Type-2 DM). Retrospective cohort study of women between 18 and 45years of age who underwent a 3-h OGTT during pregnancy and delivered in a tertiary medical center between 2007 and 2014. The women were followed for a median period of 64months postpartum. According to OGTT values, women were divided into three groups: normoglycemic (normal OGTT), single abnormal OGTT value (SAV) and gestational diabetes mellitus (two or more abnormal OGTT values, GDM). General pre-pregnancy characteristics, cardiovascular risk factors and future diagnosis of Type-2 DM, as the primary outcome, were recorded. During the study period, 5295 women underwent an OGTT and were followed for a median period of 64months (interquartile range of 32). The cohort was divided as following: 3639 (68.73%) were normoglycemic, 854 (16.13%) had a SAV in theOGTT and 802 (15.15%) were diagnosed with GDM. Compared with normoglycemic controls, women with SAV and GDM tended to be older (32.20, 33.10 and 31.35years for SAV, GDM and controls, respectively, p < 0.001); with higher rates of pre-pregnancy obesity (18.62%, 20.77% and 13.22% for SAV, GDM and controls, respectively, p < 0.001), pre-pregnancy hyperlipidemia (13.35%, 15.30% and 10.52% for SAV, GDM and controls, respectively, p = 0.021) and pre-pregnancy chronic hypertension (5.50%, 4.43% and 3.18% for SAV, GDM and controls, respectively, p = 0.01). Post-pregnancy Type-2 DM was diagnosed at a higher rate among women with SAV or GDM (2.69% for SAV, 7.39% for GDM and 0.66% for normoglycemic controls, p < 0.001). Using a cox proportional hazard regression, SAV and GDM were significantly and independently associated with a higher rate of future overt type-2 diabetes (adjusted aOR 3.59 for SAV and 11.38 for GDM, p < 0.001). In a sub-analysis of the OGTT values, overall, abnormal fasting glucose had the highest correlation with developing future Type-2 DM (8.95% compared with 6.02% for OGTT_60, 6.03% for OGTT_120 and 7.35% for OGTT_180, p < 0.001). A predictive model, combining multiple risk factors, as pre-pregnancy obesity and hypertension with SAV complicating the index pregnancy showed a risk as high as 3.40% for developing future Type-2 DM. SAV is independently associated with a significant higher rate of future Type-2 DM, as early as 5years following the index pregnancy.

Tailored notification encouraging examinees with abnormal glucose levels in health checkups to seek medical care.

The online version contains supplementary material available at 10.1007/s13340-021-00534-1.