High Prevalence Of Prediabetes Research Articles

Risk Factors of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Resource-Constrained Setting of a Primary Care Clinic in Eastern Nigeria

Background: As the case detection of pre-diabetes(PD) increases worldwide, screening for its risk factors which overlap with those of type 2 diabetes mellitus(DM) is an important primary care challenge that is often neglected especially in under-resourced setting. Aim: This study was designed to determine the prevalence and risk factors of pre-diabetes among adult Nigerians with essential hypertension in a resource-constrained setting of a primary care clinic in Eastern Nigeria. Materials and Methods: A cross-sectional study carried out on 320 consecutive adult Nigerians with essential hypertension who were screened for PD and 106 of them who had PD and met the inclusion criteria were age and sex matched with 106 non-hypertensive and non-diabetic control. Demographic and some risk factors of PD were obtained using a pretested, structured and interviewer-administered questionnaire. Pre-diabetes was defined as fasting plasma glucose of 100-125 mg/dL and /or plasma glucose level of 140-199 mg/dL two hours after a 75g oral glucose load. Results: One hundred and six (33.1%) out of the 320 hypertensive patients screened had PD. Obesity (P=0.001), positive family history of DM (P=0.001) and inadequate physical activity (P=0.001) were significantly associated with PD. The most significant predictor of PD was obesity(OR=12.50(2.38-34.48), P=0.001).The obese patients were twelve and half times more likely to have PD compared to their non-obese counterparts. Conclusion: There was high prevalence of PD in adult hypertensive study population. Obesity, family history of DM and inadequate physical activity were proximate independent risk factors. The presence of these risk factors should therefore provide guide for screening adult Nigerians with essential hypertension for PD in primary care.

Abstract 143: Baseline Pre-Diabetes Boosts Future Stroke Risk

Background: Recent national US estimates indicate that up to 35% of adults have pre-diabetes. Pre-diabetes is defined as impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), and has been associated with modest increase of cardiovascular events. However, the role of pre-diabetes in conferring greater stroke risk is unsettled. Furthermore, it is not clear what impact recent lowering of the IFG threshold of pre-diabetes diagnosis (from 110 to 100 mg/dL) has had on this relationship. Objective: To conduct a systematic review and meta-analysis to - 1} investigate the magnitude and direction of the relation of pre-diabetes with stroke risk, 2} evaluate whether this relationship varies based on IFG threshold or inclusion of IGT criteria in the diagnosis. Methods: We searched PUBMED and EMBASE. We included studies that prospectively collected data within cohort studies or clinical trials, assessed stroke, had follow-up of at least one year, and reported estimates of the multivariate adjusted relative risk and 95% confidence interval for stroke associated with pre-diabetes. We combined data using the inverse variance approach. Results: The final primary analysis included 16 prospective cohort studies comprising 767,813 participants. In 9 publications with information about IFG (100 to 125 mg/dL), the summary estimate did not show increased risk of stroke (RR 1.08, 0.94 to 1.23, P=0.26) ( Fig 1). In 6 publications with information about IFG (110 to 125 mg/dl), the summary estimate showed increased risk of stroke (RR 1.21, 1.02 to 1.44, P=0.03). In 11 publications with information about IGT (140 to 199 mg/dL) or combination of IFG/IGT, the summary estimate showed increased risk of stroke (RR 1.24, 1.10 to 1.39, P=0.0003) ( fig 2). Conclusion: Baseline pre-diabetes, defined by fasting glucose 110-125 mg/dL or combination of IGT/IFG certainly raises future stroke risk. However, the current IFG definition (100-125 mg/dL) is not associated with increased stroke risk. Given the high prevalence of pre-diabetes, randomized trials to evaluate the efficacy of blood sugar lowering therapies in persons with this condition are warranted, but may need to focus on persons with IFG 110-125 mg/dL or a combination of IGT/IFG.

Toward the Minimal Volume of Exercise for the Prevention and Treatment of Type 2 Diabetes and Pre-Diabetes

Impaired glucose tolerance (IGT, 2h glucose 140-199 mg/dl), impaired fasting glucose (IFG, fasting glucose 100-125 mg/dl) and Type 2 diabetes (T2D) are conditions characterized by varying levels of insulin resistance causing hyperglycemia on the background of an insulin secretion defect. Patients with IGT and/or IFG are often regarded as having pre-diabetes. Rising levels of obesity and insufficient physical activity are independent risk factors for insulin resistance/diabetes [1]. In fact, these have resulted in a high prevalence of pre-diabetes (35% in American adults, 2008) and T2D (8.3% in Americans, 2011) [2]. Moreover, the prevalence of T2D is increasing rapidly in the US and throughout the world [2]. T2D is associated with substantial human costs in terms of reduced quality of life and life expectancy, and management of the symptoms and secondary complications of T2D accounts for a considerable proportion of total public health care expenditures. Exercise training is a recognized, although relatively underutilized strategy that is central to the prevention, care and management of T2D and pre-diabetes [3].

P-1198 - Prediabetes in a schizophrenia population

Introduction Diabetes has reached pandemic proportions. The prevalence of diabetes is higher in patients with schizophrenia when compared to the general population. Besides the traditionally recognized risk factors, this population also suffers from an increased BMI and a high use of second generation anti-psychotic drugs. Poor living conditions and unhealthy life styles may also play a role. The International Diabetes Federation estimates that 300 million people suffer from prediabetes worldwide. The presence of prediabetes in patients with schizophrenia has not been well studied. Objectives To evaluate HbA1c levels in non-diabetic schizophrenics. Aims To confirm the expected high prevalence of prediabetes in patients with schizophrenia. Methods We retrospectively reviewed the HbA1c results of 62 consecutive patients with schizophrenia seen in our office for medical reasons. Prediabetes was diagnosed if the A1c was 5.7% – 6.4% (39 – 46 mmol/mol). Results Of the 62 patients studied (ages 24 to 74 years), 46 were males (M) and 16 were females (F). 12 (8M; 4F) patients had HbA1c above 6.5 or were known diabetics. Of the remaining 50, 24(48%); (20M; 4F) had HbA1c in the prediabetic range, while 26 (52%); (18M; 8F) had HbA1c in the normal range. Conclusions Almost one half of our non-diabetic schizophrenia patients were found to suffer from prediabetes. Besides progressing to overt diabetes, these patients are at a high risk of experiencing adverse cardiovascular events later in life. Early intervention with life style changes and tailored therapeutics may favorably alter the medical course in these patients.

Prevalence of pre-diabetes and associated risk factors in an adult Omani population

The Sultanate of Oman has experienced an epidemiological transition over the last 4 decades with rising tide of non-communicable disease such as type-2 diabetes. This study aims to estimate the prevalence of pre-diabetes and explore the associated demographic, clinical and biochemical risk factors among a semi-urban Omani population. A semi-urban satellite town, Bidbid, located about 30 km west of the capital, Muscat, was selected as the study setting. The targeted participants were Omani adults (18 to 60 years old) who had resided in Bidbid municipality for at least 6 months prior to enrollment in the study. Using multistage random sampling, 1,600 Bidbid residents were invited to participate in the study. The study protocol gathered data on the socio-demographic and clinical backgrounds of the participants. Participants’ impaired glucose tolerance (IGT) impaired fasting glucose (IFG) and cholesterol and triglyceride levels were then measured. The study surveyed 1,313 individuals (490 men and 823 women) out of 1,600 who had been invited to participate. The participation rate was higher among women than men (91.5% compared to 54.3%). A total of 459 individuals (35% of participants) were diagnosed as pre-diabetic by either the IGT or IFG test; 121 (9%) were pre-diabetic by virtue of both measurements. Male gender, advanced age and obesity were each independently associated with higher prevalence of pre-diabetes. Increased prevalence of pre-diabetes also correlated with the indices of hypercholesterolemia and dyslipidaemia. Pre-diabetes is a substantial health problem in Oman that may present a significant challenge to the national healthcare system in the near future. Customized interventions targeting groups with high risk of pre-diabetes, especially men, the elderly and the obese, are urgently needed.

High prevalence of prediabetes and diabetes in a population exposed to high levels of an organochlorine cocktail

A heavily polluted area of Eastern Slovakia was targeted by the PCBRISK cross-sectional survey to search for possible links between environmental pollution and both prediabetes and diabetes. Associations of serum levels of five persistent organic pollutants (POPs), namely polychlorinated biphenyls (PCBs), 2,2'-bis(4-chlorophenyl)-1,1-dichloroethylene (p,p'-DDE), 2,2'-bis(4-chlorophenyl)-1,1,1-trichloro-ethane (p,p'-DDT), hexachlorobenzene (HCB) and beta-hexachlorocyclohexane (beta-HCH), with prediabetes and diabetes were investigated in 2,047 adults. Diabetes and prediabetes were diagnosed by fasting plasma glucose in all participants and by OGTT in 1,220 compliant participants. Our population was stratified in terms of individual POPs quintiles and associations between environmental pollution, prediabetes and diabetes were investigated. Prevalence of prediabetes and diabetes increased in a dose-dependent manner, with individuals in upper quintiles of individual POPs showing striking increases in prevalence of prediabetes as shown by OR and 95% CI for PCBs (2.74; 1.92-3.90), DDE (1.86; 1.17-2.95), DDT (2.48; 1.77-3.48), HCB (1.86; 1.7-2.95) and beta-HCH (1.97; 1.28-3.04). Interestingly, unlike PCBs, DDT and DDE, increased levels of HCB and beta-HCH seemed not to be associated with increased prevalence of diabetes. Nevertheless, individuals in the 5th quintile of the variable expressing the cumulative effect of all five POPs (sum of orders) had a more than tripled prevalence of prediabetes and more than six times higher prevalence of diabetes when compared with the 1st referent quintile. Increasing serum concentrations of individual POPs considerably increased prevalence of prediabetes and diabetes in a dose-dependent manner. Interaction of industrial and agricultural pollutants in increasing prevalence of prediabetes or diabetes is likely.

Association of central adiposity with prediabetes and decreased insulin sensitivity in rural Chinese normal-weight and overweight women

This study investigated whether high central adiposity was associated with prediabetes and decreased insulin sensitivity (IS) in both normal-weight (body mass index [BMI] <23 kg/m 2) and overweight (BMI ≥23 kg/m 2) rural Chinese women. Adipose variables measured by dual-energy x-ray absorptiometry (percentage body fat, percentage lower-body fat [%LF], and percentage trunk fat [%TF]) and general adipose variables (BMI and waist circumference) were used for examining the association of adiposity with prediabetes among 4071 rural Chinese women aged 20 to 60 years. Furthermore, the association of adiposity with IS was tested in both normal- and overweight women with normal glucose tolerance. BMI was highly correlated with percentage body fat and waist circumference, but was weakly correlated with %LF and %TF. Both high %TF (top quartile of %TF) and low %LF (lower 3 quartiles of %LF) were associated with higher prevalence of prediabetes in both normal- and overweight women. Compared with normal-weight women in low %TF, the odds of prediabetes were similarly increased for women with high %TF regardless of whether they were overweight (odds ratio [95% confidence interval] = 1.6 [1.3-2.0]) or not (odds ratio [95% confidence interval] = 1.5 [1.2-2.0]). Similarly, among 3280 women with normal glucose tolerance, high %TF was associated with increased fasting insulin, 2-hour oral glucose tolerance test insulin, and homeostasis model assessment of insulin resistance regardless of weight status (normal or overweight). Among relatively lean, rural Chinese women, high %TF was associated with increased odds of prediabetes and lower IS regardless of weight status (normal or overweight).

Pre-diabetes and arterial stiffness in uraemic patients

In order to address factors of relevance for new onset diabetes mellitus and cardiovascular disease after kidney transplantation, we investigated the presence of pre-diabetes, arterial stiffness and endothelial dysfunction in patients with end-stage renal disease (ESRD) accepted for kidney transplantation. Pre-diabetes and an insulin sensitivity index were estimated by an oral glucose tolerance test in 66 consecutive uraemic patients, without diabetes, being on the waiting list for the first renal transplantation. Mean age was 43 +/- 13 years. Duration of ESRD was 32 +/- 27 months. A control group consisted of 14 healthy subjects. Arterial stiffness was measured by aorta pulse wave velocity (PWV) and aorta augmentation index (AIX). Endothelial function was evaluated by flow-mediated vasodilatation (FMD) and plasma concentrations of von Willebrand factor antigen (vWF). Mean arterial blood pressure (MAP) was measured in supine resting position. Twenty-seven uraemic patients (41%) had pre-diabetes (IFG+IGT), and 39 had normal glucose tolerance. The uraemic patients were more insulin resistant with lower insulin sensitivity index compared to healthy controls (6.1 +/- 3 vs. 15 +/- 7, P < 0.0001) but with no difference between patients with and without pre-diabetes. HbA1c and fasting plasma glucose was comparable in uraemic patients with and without pre-diabetes. PWV was higher in pre-diabetic compared to normoglycaemic uraemic patients (9.1 +/- 3 vs. 7.3 +/- 2 m/s, P = 0.03) and healthy controls (9.1 +/- 3 vs. 6.7 +/- 1, P = 0.01), while AIX did not differ (24.9 +/- 13 vs. 23.2 +/- 12 vs. 17 +/- 16, P = NS). Presence of pre-diabetes was positively associated to PWV in a univariate analysis. Multivariable analysis revealed age and MAP as independent predictors of PWV in uraemic patients. FMD and vWF were impaired in uraemic patients compared to healthy controls (3 +/- 4 vs. 7 +/- 3, P = 0.007 and 1.8 +/- 0.7 vs. 0.96 +/- 0.3 kIU/L, P = 0.0002, respectively) but with no difference between the two groups of uraemic patients. In conclusion, a high prevalence of pre-diabetes, impaired insulin resistance, increased arterial stiffness of aorta as well as impaired augmentation index and vasodilatation was demonstrated in uraemic patients prior to kidney transplantation. Increased arterial stiffness of aorta and augmentation index were independently associated with age and blood pressure.

HoMA does not identify insulin resistance in cohorts with a high prevalence of pre-diabetes: a study of Black africans african americans

HoMA does not identify insulin resistance in cohorts with a high prevalence of pre-diabetes: a study of Black africans african americans

Prevalence of Pre-Diabetes and Its Association With Clustering of Cardiometabolic Risk Factors and Hyperinsulinemia Among U.S. Adolescents

OBJECTIVE—Impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are considered to constitute “pre-diabetes.” We estimated the prevalence of IFG, IGT, and pre-diabetes among U.S. adolescents using data from a nationally representative sample.RESEARCH DESIGN AND METHODS—We analyzed data from participants aged 12–19 years in the National Health and Nutrition Examination Survey 2005–2006. We used fasting plasma glucose and 2-h glucose during an oral glucose tolerance test to assess the prevalence of IFG, IGT, and pre-diabetes and used the log-binomial model to estimate the prevalence ratios (PRs) and 95% CIs.RESULTS—The unadjusted prevalences of IFG, IGT, and pre-diabetes were 13.1, 3.4, and 16.1%, respectively. Boys had a 2.4-fold higher prevalence of pre-diabetes than girls (95% CI 1.3–4.3). Non-Hispanic blacks had a lower rate than non-Hispanic whites (PR 0.6, 95% CI 0.4–0.9). Adolescents aged 16–19 years had a lower rate than those aged 12–15 years (0.6, 0.4–0.9). Overweight adolescents had a 2.6-fold higher rate than those with normal weight (1.3–5.1). Adolescents with two or more cardiometabolic risk factors had a 2.7-fold higher rate than those with none (1.5–4.8). Adolescents with hyperinsulinemia had a fourfold higher prevalence (2.2–7.4) than those without. Neither overweight nor number of cardiometabolic risk factors was significantly associated with pre-diabetes after adjustment for hyperinsulinemia.CONCLUSIONS—Pre-diabetes was highly prevalent among adolescents. Hyperinsulinemia was independently associated with pre-diabetes and may account for the association of overweight and clustering of cardiometabolic risk factors with pre-diabetes.