Early Detection Of Prediabetes Research Articles

Estimation of Insulin Resistance in Obese Adults in Baghdad

Background Insulin works to control blood sugar levels by sending signals to liver, muscle and fat cells to bring in sugar out of the blood. Obesity, hyperinsulinemia, hyperglycemia, and hyperlipidemia are only a few of the interconnected metabolic disorders that are frequently linked to these diseases. A statistical procedure called the Homeometric Assessment Model (HOMA) is used to determine the insulin resistance and pancreatic cell activity. (HOMA - IR). Both are determined using insulin and fasting plasma glucose (FPG), but utilizing different formulas. Although investigations based on a modified version of HOMA using connective peptide concentrate (C-peptide) are shown, they are extremely scarce.
 Objective: A study of the effect and help (TyG & HOMA-IR) of knowing insulin resistance and early detection of prediabetes.
 Subjects, Material, and Method: Analytical cross-sectional and cohort designs are the two types of statistical designs. The study was conducted on 160 volunteers, recruited at the beginning of the study and chosen from an age group based on the study data and the preliminary analysis, with ages ranging from (40-70 years). They were separated into two groups: the first group includes 80 individuals, after adopting an average body mass index of more than 25, who suffer from insulin resistance, and the second group includes 80 healthy individuals who do not suffer from insulin resistance and whose body mass index is less than 25. It was determined Blood glucose, lipid profile, and HBA1C using Cobas c111 on serum samples from both groups. Fasting insulin was determined using Cobas E411 and serum glycine using ELISA kits.
 Results: After conducting the statistical procedures for the results of the subjects for each of TyG, HOMA - IR, it was found that there was a significant change and p- value (0,00).
 Conclusion: HOMA-IR has had an important role in the evaluation, detection and prognosis of prediabetes. It also helps detect early complications associated with T2DM and helps determine the best treatment options. It also found that the TyG index beats the HOMA-IR for predicting prediabetes. It has the best potential for early detection and prevention of prediabetes
 
 
 
 
 
 

Discrepancy in diagnoses of diabetes and prediabetes using fasting plasma glucose and glycosylated hemoglobin and the underdiagnosis by ICD-10 coding: data from a tertiary hospital in Thailand.

Early detection of prediabetes and diabetes better prevents long-term health complications. FPG and HbA1c levels are some common laboratory tests utilized as tools to diagnose diabetes and prediabetes, but the agreement rate between these two diagnostic tests varies, which could lead to underdiagnosis and thus undertreatment. This study aimed to analyze the agreement rate between FPG and HbA1c, as well as the physicians' accuracy of using these results to make a prediabetes or diabetes diagnosis through ICD-10 coding at a tertiary care hospital in Bangkok, Thailand. A cross-sectional descriptive study was conducted using secondary data collected in a tertiary hospital's check-up clinic from August 16, 2019 to June 30, 2022 to study the prevalence and diagnosis of diabetes and prediabetes, determined through FPG and HbA1c laboratory results. We analyzed the two laboratory tests' diagnosis agreement rate and the physicians' accuracy of diagnosing diabetes and prediabetes in ICD-10 coding using the FPG and HbA1c results. Among 8,024 asymptomatic participants, the period prevalence diagnosed through laboratory results was 5.8% for diabetes and 19.8% for prediabetes. Diabetes and prediabetes prevalence based on laboratory data differs from that of ICD-10 coding data. Specifically, 79.6% of diabetes patients and 32.3% of prediabetes patients were coded using the ICD-10 coding system. 4,094 individuals had both FPG and HbA1c data. The agreement rate for diagnosing diabetes and prediabetes between the two laboratory results is 89.5%, with Kappa statistics of 0.58. Using only one of the two laboratory results would have missed a substantial number of patients. Our findings highlight screening test discrepancies and underdiagnosis issues that impede diagnostic accuracy enhancement and refined patient management strategies. Early diagnoses of prediabetes and diabetes, especially before symptoms arise, could increase health consciousness in individuals, thereby enabling the implementation of lifestyle modifications and prevention of serious health complications. We emphasize the importance of diagnosing these conditions using both FPG and HbA1c, along with subsequent accurate ICD-10 coding. Even though some hospitals lack certified HbA1c testing, we suggest enhancing the availability of HbA1c testing, which could benefit many people in Thailand.Clinical trial registration:https://www.thaiclinicaltrials.org, identifier [TCTR20230824003].

Peran Calon Tenaga Kesehatan sebagai Kader Kesehatan Remaja Srikandi (Masyarakat Peduli Akan Diabetes Melitus)

The role of nursing students as future healthcare professionals is very important, as prediabetic patients can progress to diabetes without proper treatment. They are expected to become community health role models with knowledge and skills in early detection of prediabetes. The purpose of the Prediabetes Screening Training for Trainers is to train these students to become youth health cadres of SRIKANDI (Diabetes Concerned Community). The program aims to increase participants' knowledge level from 6.64 to 8.14 by leveraging 2 days of 300 minutes of lectures, discussions, simulation methods, and a website that provides educational materials and tools for diabetes risk prevention succeeded. These results demonstrate that 14 of the 45 students who participated in the training became educators under the SRIKANDI program and are committed to forming youth health cadres who can contribute to the prevention and early detection of prediabetes.

Predictors of Prediabetes and Undiagnosed Diabetes Mellitus Based on HbA1c Levels in Indonesia

Prediabetes and Undiagnosed Diabetes Mellitus (UDDM) are associated with an increased risk of diabetes complications and other cardiovascular diseases. Early detection of both health problems is expected to reduce the burden of non-communicable diseases in the future. The purpose of this study is to investigate predictors of prediabetes and UDDM based on HbA1c levels among population ≥ 15 years old in Indonesia. This cross-sectional study involved 6,065 respondents of Indonesian Family Life Survey 5 (IFLS 5) who met the inclusion and exclusion criteria. Data associated with sociodemographic characteristics, lifestyle risk factors, hypertension, and obesity were obtained. Prediabetes was defined as HbA1c between 5.7-6.4%, while diabetes was defined as HbA1c ≥ 6.5%. Multinomial logistic regression analysis was performed to estimate adjusted Odds Ratio (aOR). The results showed that predictors of prediabetes were age, gender, marital status, and obesity, while predictors of UDDM were age, hypertension, and obesity. Identification of risk factors and early detection of prediabetes and UDDM is important, so that appropriate intervention can be given immediately to prevent complications.

1302-P: Predicting Insulin Time-Course Profiles for Early Prediabetes Interception Using a Mechanistic Mathematical Model

Early detection of prediabetes using blood glucose remains difficult as individuals often present with slight elevations or even normoglycaemia. However, their insulin profiles usually show marked elevations, suggesting that insulin is a more sensitive biomarker for prediabetes. We developed a mechanistic whole-body model that can predict an individual’s insulin time-course and insulin sensitivity from a given glucose time-course. The model describes the absorption, distribution, metabolism and excretion of glucose and the relevant hormones, while various homeostatic processes such as insulin secretion were dynamically represented by sub-models. Matched glucose and insulin data were obtained from 7 oral glucose tolerance test studies. Model predictions of insulin time-course using glucose data as inputs were compared with observed data for validation (Fig 1). Both population and individual simulation results indicated robust prediction of insulin profiles and demonstrate that it is possible to utilize glucose data (easy to obtain) to predict insulin data (difficult to obtain) for prediabetes screening. Disclosure K.Hor cheng: None. J.C.Y.Chan: None.

Kegiatan Pengabdian Masyarakat dalam Rangka Peningkatan Kewaspadaan Masyarakat terhadap Penyakit Pre-Diabetes dan Diabetes Mellitus Tipe II dengan Edukasi dan Deteksi Dini Penyakit

Pre-diabetes and type 2 diabetes mellitus are two conditions associated with impaired glucose metabolism in the body, in which blood sugar levels become higher than normal. Pre-diabetes is a condition that often doesn't cause symptoms, so it's often not diagnosed early. However, pre-diabetes can be a risk factor for type 2 diabetes mellitus, heart disease, and stroke. Community outreach, education, and early detection of prediabetes and type 2 diabetes mellitus have an important role in efforts to prevent and control these diseases. Community outreach and education can increase awareness about prediabetes and type 2 diabetes mellitus and the risk factors that influence the occurrence of these conditions. This community service activity was carried out in May 2023 by involving 52 productive age respondents. All respondents attended a series of counseling, physical examinations, and supporting examinations related to diabetes mellitus and its complications. The results of this community service revealed that 8 (15.4%) respondents had a GDP ≥ 126 mg/dL and 22 (42.3%) respondents had a GDP 100 - 125 mg/dL. Checking blood sugar levels regularly can also help in early detection of disease. By raising awareness and promoting early detection, it can help reduce the burden of disease and the costs incurred by individuals and society as a whole. In addition, preventing prediabetes and type 2 diabetes mellitus can also help prevent more serious complications such as heart disease, stroke and kidney failure. By preventing or controlling prediabetes and type 2 diabetes mellitus, people can maintain a better quality of life and avoid complications that can affect quality of life. This can help increase the productivity and welfare of society as a whole.

Non-Laboratory-Based Risk Prediction Tools for Undiagnosed Pre-Diabetes: A Systematic Review.

Early detection of pre-diabetes (pre-DM) can prevent DM and related complications. This review examined studies on non-laboratory-based pre-DM risk prediction tools to identify important predictors and evaluate their performance. PubMed, Embase, MEDLINE, CINAHL were searched in February 2023. Studies that developed tools with: (1) pre-DM as a prediction outcome, (2) fasting/post-prandial blood glucose/HbA1c as outcome measures, and (3) non-laboratory predictors only were included. The studies' quality was assessed using the CASP Clinical Prediction Rule Checklist. Data on pre-DM definitions, predictors, validation methods, performances of the tools were extracted for narrative synthesis. A total of 6398 titles were identified and screened. Twenty-four studies were included with satisfactory quality. Eight studies (33.3%) developed pre-DM risk tools and sixteen studies (66.7%) focused on pre-DM and DM risks. Age, family history of DM, diagnosed hypertension and obesity measured by BMI and/or WC were the most common non-laboratory predictors. Existing tools showed satisfactory internal discrimination (AUROC: 0.68-0.82), sensitivity (0.60-0.89), and specificity (0.50-0.74). Only twelve studies (50.0%) had validated their tools externally, with a variance in the external discrimination (AUROC: 0.31-0.79) and sensitivity (0.31-0.92). Most non-laboratory-based risk tools for pre-DM detection showed satisfactory performance in their study populations. The generalisability of these tools was unclear since most lacked external validation.

GlucoScreen

Blood glucose measurement is commonly used to screen for and monitor diabetes, a chronic condition characterized by the inability to effectively modulate blood glucose that can lead to heart disease, vision loss, and kidney failure. Early detection of prediabetes can forestall or reverse more serious illness if healthy lifestyle adjustments or medical interventions are made in a timely manner. Current diabetes screening methods require visits to a healthcare facility and use of over-the-counter glucose-testing devices (glucometers), both of which are costly or inaccessible for many populations, reducing the chances of early disease detection. We therefore developed GlucoScreen, a readerless glucose test strip that enables affordable, single-use, at-home glucose testing, leveraging the user's touchscreen cellphone for reading and displaying results. By integrating minimal, low-cost electronics with commercially available blood glucose testing strips, the GlucoScreen prototype introduces a new type of low-cost, battery-free glucose testing tool that works with any smartphone, obviating the need to purchase a separate dedicated reader. Our key innovation is using the phone's capacitive touchscreen for the readout of the minimally modified commercially available glucose test strips. In an in vitro evaluation with artificial glucose solutions, we tested GlucoScreen with five different phones and compared the findings to two common glucometers, AccuChek and True Metrix. The mean absolute error (MAE) for our GlucoScreen prototype was 4.52 mg/dl (Accu-Chek test strips) and 3.7 mg/dl (True Metrix test strips), compared to 4.98 mg/dl and 5.44 mg/dl for the AccuChek glucometer and True Metrix glucometer, respectively. In a clinical investigation with 75 patients, GlucoScreen had a MAE of 10.47 mg/dl, while the AccuChek glucometer had a 9.88 mg/dl MAE. These results indicate that GlucoScreen's performance is comparable to that of commonly available over-the-counter blood glucose testing devices. With further development and validation, GlucoScreen has the potential to facilitate large-scale and lower cost diabetes screening. This work employs GlucoScreen's smartphone-based technology for glucose testing, but it could be extended to build other readerless electrochemical assays in the future.

Longitudinal association of inflammatory markers with markers of glycaemia and insulin resistance in European children.

Subclinical systemic inflammation may lead to development of type 2 diabetes, but there has been no investigation into its relationship with early progression of glycaemic deterioration and insulin resistance, especially in younger population. In this study we assessed longitudinal associations of pro- and anti-inflammatory markers with markers that evaluate glycaemia and insulin resistance. This study includes 6537 initially nondiabetic children (mean age at baseline=6.2years) with repeated measurements from the IDEFICS/I.Family cohort study (mean follow-up=5.3years) from eight European countries. Markers of inflammation were used as independent variables and markers of glycaemia/insulin resistance as dependent variables. Associations were examined using two-level growth model. Models were adjusted for sex, age, major lifestyle, metabolic risk factors, early life markers, and other inflammatory markers in final model. Children with 6years of follow-up showed that a one-unit increase in z-score of leptin level was associated with 0.38 (95% CI=0.32 to 0.44) unit increase in HOMA-IR z-scores. Leptin continued to be associated with HOMA-IR even when analysis was limited to children with no overall obesity, no abdominal obesity, and low to normal triglyceride levels. An inverse association was observed between IL-15 and HOMA-IR (β=-0.11, 95% CI=-0.15 to -0.07). IL-15 should be evaluated further in the prevention or treatment of prediabetes whereas leptin may prove to be useful in early detection of prediabetes via their association with markers of insulin resistance in European children.

Unmasking the Therapeutic Potential of Biomarkers in Type-1 Diabetes Mellitus

Diabetes mellitus is one of the most widely spread disorders affecting millions of people every year. Uncontrolled or chronic diabetes may lead to diabetes-associated complications. Conventional therapies often fail to define clear parameters and do not provide early detection of diabetes and pre-diabetes. Thus, there is a need to find a diagnostic method that can non-invasively help detect and prevent diabetes and associated complications. To combat this challenge, biomarkers' use has gained importance in the early detection of pre-diabetes and diabetes-associated complications. Detailed analyses from research and review articles were performed to elucidate the true potential of biomarkers in early detection, disease pathogenesis, risk prediction, and therapeutic monitoring in diabetes and associated complications. This review discusses the type of biomarkers, the progress, challenges, and short-coming related to biomarkers implications. This review also discusses the future directions in developing type-1 diabetes biomarkers focusing on genetic, transcriptomic, and proteomic aspects. From the findings from the available data on research and development carried out in biomarker research, significant improvements and conclusive studies have been conducted to confirm the beneficial clinical effect in early detection of diabetes using the biomarkers. The data from these studies promise novel biomarkers' implication in detecting pre-diabetes, which may help reduce the mortality and morbidity associated with diabetes and associated complications.

Early Detection of Prediabetes and T2DM Using Wearable Sensors and Internet-of-Things-Based Monitoring Applications.

Prediabetes and type 2 diabetes mellitus (T2DM) are one of the major long-term health conditions affecting global healthcare delivery. One of the few effective approaches is to actively manage diabetes via a healthy and active lifestyle. This research is focused on early detection of prediabetes and T2DM using wearable technology and Internet-of-Things-based monitoring applications. We developed an artificial intelligence model based on adaptive neuro-fuzzy inference to detect prediabetes and T2DM via individualized monitoring. The key contributing factors to the proposed model include heart rate, heart rate variability, breathing rate, breathing volume, and activity data (steps, cadence, and calories). The data was collected using an advanced wearable body vest and combined with manual recordings of blood glucose, height, weight, age, and sex. The model analyzed the data alongside a clinical knowledgebase. Fuzzy rules were used to establish baseline values via existing interventions, clinical guidelines, and protocols. The proposed model was tested and validated using Kappa analysis and achieved an overall agreement of 91%. We also present a 2-year follow-up observation from the prediction results of the original model. Moreover, the diabetic profile of a participant using M-health applications and a wearable vest (smart shirt) improved when compared to the traditional/routine practice.

Modern Aspects of the Clinic, Diagnosis and Treatment of Prediabetes

Prediabetes is a common violation of carbohydrate metabolism, the medical and social relevance of which is due to the negative impact on the incidence of type 2 diabetes mellitus (DM) and cardiovascular disease (CVD). The analyzed literature emphasizes the presence of a close pathogenetic relationship between type 2 DM/prediabetes and CVD. This relationship becomes even more relevant, taking into account, on the one hand, the persistent upward trend in the prevalence of carbohydrate metabolism disorders in the population, and on the other hand, the fact that in patients with dysglycemia it is cardiovascular complications that are the main cause of death. However, while the significance of type 2 DM as a risk factor for CVD is widely known and its presence immediately stratifies most patients to a group of high or very high cardiovascular risk, the contribution of prediabetes to the development of CVD remains underestimated among the therapeutic and cardiological communities. The high prevalence of prediabetes creates prerequisites for a further increase in the incidence of type 2 DM and CVD in the Russian Federation, which requires doctors of various specialties to be wary of early detection of prediabetes, since timely preventive measures can significantly reduce the risk of type 2 DM and its complications in the future. Currently, the effectiveness of both non-drug and drug strategies in preventing the development of type 2 DM in people with prediabetes has been confirmed, more and more data are accumulating about the possibility of effective prevention of CVD in prediabetes. According to modern research, the primary role of measures to actively change lifestyle in the treatment and prevention of prediabetes is emphasized, at the same time, the effectiveness of these measures can be reduced due to insufficient commitment of the patients themselves to their independent long-term implementation. Therefore, the strategy of prescribing metformin for the prevention of type 2 diabetes is absolutely justified if the doctor and patient recognize the inefficiency or inability to follow the recommendations for active lifestyle changes for a long time. The article presents the data on the etiology, epidemiology, diagnosis, and approaches to the management of patients with prediabetes from the standpoint of modern recommendations.

Prevalence of Pre-diabetes and its associated risk factors: A cross-sectional study in West Tripura district of India

Background: Early detection of Pre-diabetes and controlling the risk factors may delay the development of Diabetes and related complications. Objectives: To estimate the prevalence of Pre-diabetes in West Tripura district of India and to study it’s associations with selected risk factors. Methods: This community based cross-sectional study was conducted in West Tripura district of India, during 1st January 2018 to 31st December 2019 among 320 individuals selected by multistage sampling. Fasting blood sugar was tested for diagnosing Pre-diabetes. Data entry and analysis were performed using SPSS-24. Result: Prevalence of Pre-diabetes in West Tripura district was 19.4%, 28.1% were hypertensive and 32.5% had high BMI. Multivariable logistic regression has identified age ≥40 yr (OR: 20.62, 95% CI: 4.97 – 85.49) higher socioeconomic status (OR: 4.99, 95% CI: 1.95 – 12.72), family history of diabetes (OR: 9.72, 95% CI: 2.51 – 37.61), higher BMI (OR: 2.79, 95% CI: 1.32 – 5.89) and physical inactivity (OR: 3.52, 95% CI: 1.66 – 7.46) as the predictors of Pre-diabetes. Conclusion: West Tripura district of India has higher prevalence of pre-diabetes than the national average. Age ≥40 yr, higher socioeconomic status, family history of diabetes, higher BMI and physical inactivity were identified as significant predictors of Pre-diabetes in this region.

Relationship between uric acid and creatinine in pre-diabetic and diabetic patients: Vidarbha region of Maharashtra

Prediabetes is a glucose homeostasis condition characterized by decreased absorption to glucose or reduced fasting glucose. Both of these are reversible stages of intermediate hyperglycaemia providing an increased type II DM risk. Pre-diabetes can therefore be viewed as a significant reversible stage which could lead to type II DM, and early detection of prediabetes may contribute to type II DM prevention. Prediabetes patients are at high risk for potential type II diabetes, and 70 percent of them appear to develop Type II diabetes within 10 years. The present study includes total 200 subjects that include 100 Prediabetic patients, 50 T2DM patients and 50 healthy individual. Blood samples were collected from the subjects were obtained for FBS, PPBS, Uric acid and Creatinine estimation, from OPD and General Medicine Wards. Present study showed low levels of Serum Uric Acid in prediabetic and T2DM patients were decreased as compared to control group, while the level of creatinine in prediabetic and diabetic were elevated as compared to control group, were not statically significant. Serum Uric Acid was high in control group and low in prediabetic and diabetic patients. Serum creatinine was declined in control group and increased in prediabetic and diabetic patients with increasing Fasting blood glucose level.

1294-P: Detection and Intervention of Prediabetes in a Large Urban Health System: Systematic Failure or Looming Opportunity?

Efficient early detection of prediabetes is critical in order to intervene and reduce conversion to T2DM since lifestyle interventions and/or metformin are proven to reduce progression. Retrospective data from a nationally-ranked tertiary academic medical center were analyzed to determine diagnosis rates, frequency of lifestyle and prescription interventions, and to assess characteristics of patients who were most likely to be clinically identified or treated. Data from the EpicCare EMR were analyzed using the University of Kansas Medical Center i2b2-based clinical data repository (HERON). Data were collected for 69,781 patients established in academically affiliated primary care clinics between 2015 and 2017. After excluding for previous diabetes/prediabetes diagnoses or use of glucose lowering agents, 46,855 patients remained to assess for incident prediabetes (ADA criteria). Clinical recognition of the prediabetes diagnosis, nutrition or weight management referral, and metformin prescription were assessed. Incident prediabetes occurred in 2,581 patients (5%). Thirty eight percent of those received a charted prediabetes diagnosis, 9% received either a referral to nutrition or weight management, and 4% received a metformin prescription. Females (OR 1.57) or those who had higher BMI (OR 1.02) or A1c values (OR 5.67) had higher odds of receiving clinical recognition (p<0.0001). We conclude that relatively few people with prediabetes are clinically noted and even fewer receive interventions that may reduce the conversion to T2DM. There are gender and weight biases; patients with higher BMI, higher A1c values, and females were more likely to have documentation for diagnosis and treatment for prediabetes. These low rates of recognition and treatment are likely to be similar among health care systems across the country. The low rates of recognizing, documenting, and intervening are opportunities to better utilize the EMR and reduce conversion to T2DM. Disclosure E. Newbold: None. S.E. Carlson: Advisory Panel; Self; DSM. Other Relationship; Self; MeadJohnson Nutrition (RB). D.K. Sullivan: None. D.C. Robbins: None. A. Beltramo: None. M. Lowrance: None. L.R. Waitman: None.

Pre-diabetes: Diagnostic Criteria And Therapeutic Approach

Pre-diabetes is defined as Impaired Fasting Glucose (IFG) or Impaired Glucose Tolerance (IGT) after a standard OGTT test. It is a high risk state not only because it may lead to diabetes, but also because of the associated complications such as vascular complications, nephropathy, and neuropathy that have been reported in people with Pre-diabetes. Pathophysiology of pre-diabetes state is linked to two main factors, insulin resistance and the relative deficiency of beta cells, these two mechanisms will eventually lead to abnormal glucose level. Pre-diabetes increases the risk of both microvascular and macrovascular complications. It is also an independent risk for stroke and cardiovascular disease. Early detection of pre-diabetes by screening can help in preventing vascular complications, and helps in changing the natural history of this disease by improving the islet cell function. Lifestyle modification like weight reduction and exercise reduces the risk of T2DM whereas pharmacological treatment with Metformin, Acarbose, Voglibose and Orlistat have all demonstrated significant reductions in progression to T2DM with very few adverse effects. In this review, we shall discuss and highlight the evidences that support the benefits of early intervention in Pre-diabetes and determine the cost effectiveness of lifestyle modification and drug treatment.
 JCMCTA 2018 ; 29 (2) : 68-75

Faktor Perilaku dan Gaya Hidup yang Mempengaruhi Status Prediabetes Pasien Puskesmas Pati II

Background: Prediabetes status describes as the condition of blood glucose level above normal but insufficient to be diagnosed as diabetes. The stage of prediabetes is a critical condition of blood glucose level, but could reverse to be normal again if healthy lifestyle is routinely performed. In USA one of three people diagnosed with prediabetes. But most people did not realize that they had prediabetes history. The increasing number of prediabetes occurs due to the absence of typical symptoms. If prediabetes detected earlier, the rate of diabetes mellitus could be prevented. This study aims to examine some behaviors that affect the prediabetes status of patients in Pati II health center. Method: This is an explanatory research with cross sectional approach. Samples were rucruited using inclusion criteria such as aged 40–59 years, not diagnosed as diabetes, abdominal circumference more than 90 for men and 80 for women. There were 117 respondents involved in this study. Results: This research showed that the number of respondents with prediabetes status was 39.3%. Respondents with blood glucose level ranged more than 200 mg/dl were 6%. The variables that influence the prediabetes status of the respondents were Body Mass Index with OR 3.591 (p value 0.011), diet pattern with OR 2.435 (p value 0.044), and smoking habit or passive smoking with OR 2.493 (p value 0.046). This study recommends to prevent the prediabetes to be diabetes, needed the socialization of healthy lifestyle to the community and early detection of prediabetes. Early prevention includes changes to people healthy lifestyles such as maintaining healthy body weight, doing physical activity routinely, healthy eating patterns, avoiding cigarette smoke and smoking habits.Keywords: prediabetes, BMI, diet, smoking

Inflammation, coagulation, endothelial dysfunction and oxidative stress in prediabetes — Biomarkers as a possible tool for early disease detection for rural screening

ObjectivesThis study aims to increase understanding of the connection between oxidative stress and inflammation in diabetes disease progression to provide a basis for investigating improved diagnostic possibilities, treatment and prevention of prediabetes. Design and methodsDifferences in the level of biochemical markers of oxidative stress (erythrocyte GSH/GSSG and urinary 8-isoprostane), inflammation (CRP, IL-6), endothelial dysfunction (plasma homocysteine, urinary 8-hydroxy-2-deoxy-guanosine) and coagulation/fibrinolysis (C5a, D-Dimer) were determined in prediabetes and control subjects. ResultsWhile no difference was found in the 8-isoprostane levels between the two groups, the erythrocyte GSH/GSSG ratio was significantly reduced in the prediabetes group compared to control, indicating increased oxidative stress in the prediabetic state. Both urinary 8-OHdG and surprisingly also plasma homocysteine were significantly elevated in the prediabetes group, indicating endothelial dysfunction. The inflammation markers were slightly elevated in the prediabetic subjects and the same trend was found for the coagulation/fibrinolysis markers C5a and D-Dimer. These results were however not significant. ConclusionsThe small elevation of blood glucose levels in the prediabetic state may have a detectable influence on endothelial function as indicated by changes to 8-OHdG, indicating an increased DNA-damage and homocysteine release from endothelial cells. Increased oxidative stress as indicated by the reduced GSH/GSSG ratio is likely to be the link between the moderate hyperglycaemia in prediabetes and pathological changes in endothelial function, which in the long-term may promote atherogenesis and result in the development of cardiovascular disease. Early detection of prediabetes is essential to avoid diabetes development and the associated complications like cardiovascular disease. The GSH/GSSG ratio and biomarkers like urinary 8-OHdG and plasma homocysteine offer a possible tool for the assessment of prediabetes in prevention screenings.

Consenso sobre la detección y el manejo de la prediabetes. Grupo de Trabajo de Consensos y Guías Clínicas de la Sociedad Española de Diabetes

In Spain, according to the Di@bet.es study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality.The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria.

Consenso sobre la detección y el manejo de la prediabetes. Grupo de Trabajo de Consensos y Guías Clínicas de la Sociedad Española de Diabetes

In Spain, according to the Di@bet.es study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality.The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria.