Higher Fasting Glucose Levels Research Articles

Effects of Heavy Alcohol Use on Fasting Glucose and Insulin Resistance in Mid-Life Adults

Introduction: As our population ages, type 2 diabetes has become more prevalent in the United States and one in five mid-life adults (50-64 years) have type 2 diabetes. Unhealthy and heavy alcohol use (that exceeds recommended drinking limits) causes dysfunction of the liver and pancreas that can impact glucose control and thereby increase risks of type 2 diabetes. In young adults, we previously found that fasting glucose and insulin resistance were not associated with heavy alcohol use. However, it remains unclear if heavy alcohol use contributes to the development of type 2 diabetes in an aged population. Therefore, the purpose of this study is to determine the effect of heavy alcohol use on fasting glucose and insulin resistance in apparently healthy mid-life adults. Methods: Mid-life men (n=21) and postmenopausal women (n=28), non-smokers, free of obesity and major clinical diseases, were recruited from the community around the Dallas—Fort Worth metroplex. All participants underwent physical exam and fasting blood sampling. Alcohol use was assessed by the US Alcohol Use Disorders Identification Test (USAUDIT) and a dried blood spot phosphatidylethanol (PEth) test. A PEth cutoff of 20 ng/mL was used to define heavy drinkers. Insulin resistance was assessed by calculating HOMA-IR (Homeostatic model assessment for insulin resistance) as insulin (μU/L) x glucose (nmol/L)/22.5. Results: A total of 24 participants had PEth levels of <20 ng/mL (non-heavy drinkers; PEth ranged from <limit of quantification to 13 ng/mL; mean ± SEM for age: 58±1 years and body mass index: 25.2±0.6 kg/m2) and the other 25 participants had PEth levels ≥20 ng/mL (heavy drinkers; PEth ranged from 20 to 665 ng/mL; age: 57±1 years and body mass index: 25.7±0.5 kg/m2). Heavy drinkers had higher USAUDIT scores than non-heavy drinkers (11.3±1.4 vs. 3.3±0.5, p<0.001). No significant difference between these two groups were found in lipid values (P≥0.1) as well as renal (P≥0.3) and liver function values (P≥0.08). Compared to non-heavy drinkers, heavy drinkers had a higher level of fasting blood glucose (96±2 vs. 91±1 mg/dL, P=0.02), but similar blood insulin (9.2±2.5 vs. 5.5±0.5 μIU/L, P=0.2) and HOMA-IR (2.23±0.64 vs. 1.23±0.11, P=0.1). The results for stepwise linear regression model indicate that only USAUDIT score was an independent factor of fasting glucose (B=0.59, p<0.001). Conclusion: Our results indicate that compared to mid-life adult non-heavy drinkers, heavy drinkers had higher fasting blood glucose levels, despite similar renal and liver function. Our results also indicate that higher risks of alcohol use disorder were associated with higher levels of fasting glucose. These data suggest that heavy alcohol use may have negative effects on glucose regulation in aged populations and increase risks of type 2 diabetes. This work was supported by NIAAA AA028537 to CLH. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Blood glucose level affects iodine-123 labeled MIBG uptake in the lung

The aim of this study was to evaluate the correlation of blood glucose and the metaiodobenzylguanidine (MIBG) uptake in lung and compare the difference between the lung uptake of MIBG in diabetic and non-diabetic patients. Patients who underwent iodine-123 MIBG whole-body scan (WBS) in the Department of Nuclear Medicine Seoul National University Hospital between January 2014 and July 2022 were recruited and analyzed. Semi-quantitative analysis of the mean value of lung-to-mediastinum ratio (LMR) was performed. Correlation was analyzed with Pearson correlation test and mean difference was analyzed with independent t-test. There were 36 patients in diabetic group and 57 patients in non-diabetic group with mean age of 56 ± 14.1 and 52 ± 14.6 years, respectively. The mean 24-h LMRs in diabetic and non-diabetic groups were 1.38 ± 0.20 and 1.17 ± 0.14, respectively. Fasting glucose showed a mean value of 136 ± 37.7 and 96 ± 8.2 mg/dL, respectively. There was a significant positive correlation in diabetic (r = 0.397; P = 0.016) and non-diabetic groups (r = 0.579; P <0.001) with significant mean difference (0.21; P <0.001). In conclusion, lung uptake of MIBG is positively correlated with blood sugar level, with diabetic patients displaying higher lung uptake of MIBG compared with non-diabetic patients. In addition, higher lung uptake of MIBG is evident in patients with higher fasting glucose level and even in non-diabetic patients. Thus, in the situations where MIBG therapy is required, the radiation dose to the lungs must be carefully adjusted for patients with high blood sugar level.

Food insecurity, poor diet, and metabolic measures: The roles of stress and cortisol

Food insecurity is highly prevalent and linked to poorer diet and worse metabolic outcomes. Food insecurity can be stressful, and could elicit chronic psychological and physiological stress. In this study, we tested whether stress could be used to identify those at highest risk for worse diet and metabolic measures from food insecurity. Specifically, we hypothesized that cortisol (a physiological marker of stress) and perceived psychological stress would amplify the link between food insecurity and hyperpalatable food intake as well as metabolic measures. In a sample of 624 Black and White women aged 36–43 who participated in the NHLBI Growth and Health Study's midlife assessment, we assessed associations between food insecurity with hyperpalatable food intake (high fat + high sodium foods; high fat + high sugar foods; and high carbohydrate + high sodium foods), and metabolic measures (fasting glucose, insulin resistance, and waist circumference). We found that food insecurity was associated with higher levels of perceived stress (R2 = 0.09), and greater intake of high fat + high sugar (hyperpalatable) foods (R2 = 0.03). In those with higher cumulative cortisol (as indexed by hair cortisol), food insecurity was associated with higher levels of fasting glucose. Neither cortisol nor perceived stress moderated any other relationships, and neither variable functioned as a mediator in sensitivity analyses. Given these largely null findings, further research is needed to understand the role stress plays in the chronic health burdens of food insecurity.

Glucose Metabolism and Sex Hormones in Male Patients with Medication-naïve First-episode Schizophrenia: A Large-scale Cross-sectional Study.

Schizophrenia (SCZ) usually begins in early adult life. The underlying molecular mechanisms of SCZ remain unclear. There is evidence for the involvement of abnormalities in metabolic and endocrine systems in SCZ, even in drug-naïve first-episode schizophrenia patients (DNFES). However, the association between impaired regulation of glucose metabolism and sex hormones was not studied in SCZ. This study aimed to evaluate the interrelationship between sex hormones and high fasting glucose levels in male DNFES patients. A total of 99 patients with SCZ were recruited, and fasting glucose, fasting insulin, the insulin resistance index (HOMA-IR), and sex hormones were measured. We found that some male patients with SCZ had abnormal levels in glucose metabolism parameters and gonadal hormones that were not within the normal range. Linear regression analysis adjusted for age, waist circumference, and body mass index showed that testosterone levels were negatively associated with fasting insulin in male patients (β = -0.21, t = -2.2, p = 0.03). Our findings confirm the abnormalities in glucose metabolism parameters and gonadal hormones at the onset of the illness in male DNFES patients with SCZ. In addition, there was an interaction effect between abnormal glucose metabolism and sex hormones in male patients.

A high fat diet potentiates neonatal iron overload-induced memory impairments in rats.

The present study aimed at evaluating possible synergistic effects between two risk factors for cognitive decline and neurodegenerative disorders, i.e. iron overload and exposure to a hypercaloric/hyperlipidic diet, on cognition, insulin resistance, and hippocampal GLUT1, GLUT3, Insr mRNA expression, and AKT phosporylation. Male Wistar rats were treated with iron (30mg/kg carbonyl iron) or vehicle (5% sorbitol in water) from 12 to 14th post-natal days. Iron-treated rats received a standard laboratory diet or a high fat diet from weaning to adulthood (9months of age). Recognition and emotional memory, peripheral blood glucose and insulin levels were evaluated. Glucose transporters (GLUT 1 and GLUT3) and insulin signaling were analyzed in the hippocampus of rats. Both iron overload and exposure to a high fat diet induced memory deficits. Remarkably, the association of iron with the high fat diet induced more severe cognitive deficits. Iron overload in the neonatal period induced higher insulin levels associated with significantly higher HOMA-IR, an index of insulin resistance. Long-term exposure to a high fat diet resulted in higher fasting glucose levels. Iron treatment induced changes in Insr and GLUT1 expression in the hippocampus. At the level of intracellular signaling, both iron treatment and the high fat diet decreased AKT phosphorylation. The combination of iron overload with exposure to a high fat diet only led to synergistic deleterious effect on emotional memory, while the effects induced by iron and by the high fat diet on AKT phosphorylation were comparable. These findings indicate that there is, at least to some extent, an additive effect of iron combined with the diet. Further studies investigating the mechanisms associated to deleterious effects on cognition and susceptibility for the development of age-associated neurodegenerative disorders are warranted.

TG/HDL-c ratio as a predictor of progressive infarction in patients with anterior circulation single subcortical infarction.

The contributors predicting progressive infarction (PI) in patients with anterior circulation single subcortical infarction (ACSSI) and pontine single infarction (PSI) may be unidentical. The role of triglyceride to high-density lipoprotein cholesterol (TG/HDL-c) ratio on PI is unclear. The purpose of our study is to evaluate the correlation between TG/HDL-c ratio and PI in patients with ACSSI or PSI. Between January 2020 and October 2022, we retrospectively enrolled 738 patients including 638 ACSSI patients and 100 PSI patients to analyze. Demographic characteristics, clinical information, and laboratory data were collected within 24h of admission. PI occurred in 143 (19.4%) patients. In univariate analysis, patients with PI had higher initial National Institutes of Health Stroke Scale (NIHSS) scores, higher discharge NIHSS scores, higher levels of fasting glucose, total cholesterol, TG, low-density lipoprotein cholesterol, and TG/HDL-c ratio, but lower levels of creatinine compared to patients with non-PI (p<.05). Furthermore, the results of the subgroup analyses revealed the independent association between TG/HDL-c ratio and PI in ACSSI patients (OR 1.079, 95% CI 1.009-1.153, p=.026) rather than in PSI patients. Additionally, a receiver operating characteristic curve indicated that the optimal predictive cutoff value of the TG/HDL-c ratio was 3.985, and a TG/HDL-c ratio ≥3.985 was more likely to experience PI in ACSSI patients. In conclusion, the TG/HDL-c ratio was independently associated with PI in patients with ACSSI.

Association of diabetes and glycemic control with left atrial function: The Atherosclerosis Risk in Communities (ARIC) study

Background and aimsAlthough glycemic status is associated with impaired cardiac structure and function, less is known on left atrial (LA) function across the glycemic spectrum. We evaluated the association of diabetes and glycemic control with LA function in a community-based cohort of older adults. Methods and resultsThis cross-sectional analysis included 5075 participants from the Atherosclerosis Risk in Communities Study (mean age 75.5 years, 58 % women, and 20 % Black adults) with echocardiographic strain data for LA reservoir, conduit, and contractile function. Multivariable linear regression was used to assess associations of diabetes status and glycemic control with LA function. In participants without diabetes, we used ordinal linear regression to evaluate associations of fasting glucose and HbA1c with LA function. Compared to individuals with a normal fasting glucose, prevalent diabetes was associated with 0.68 % lower LA conduit function (95 % confidence interval (CI): 1.11 to −0.25) and prediabetes a 0.47 % reduction (95 % CI: 0.85 to −0.09) in fully adjusted analyses. Persons with diabetes and high HbA1c (HgbA1c ≥ 7 % vs <7 %) had 1.05 % lower LA conduit function (95 % CI: 1.63, −0.48). Among individuals without diagnosed diabetes, higher fasting glucose, but not HbA1c, was significantly associated with worse LA conduit function. No significant associations were observed for LA reservoir and contractile function. ConclusionsA history of diabetes, prediabetes, and higher fasting glucose levels in persons without diabetes were associated with worse LA conduit function. Corroborative research is needed in prospective cohorts as well as studies that explore underlying mechanisms.

Causal relationships between type 2 diabetes, glycemic traits and keratoconus.

The relationship between diabetes mellitus and keratoconus remains controversial. This study aimed to assess the potential causal relationships among type 2 diabetes, glycemic traits, and the risk of keratoconus. We used a two-sample Mendelian randomization (MR) design based on genome-wide association summary statistics. Fasting glucose, proinsulin levels, adiponectin, hemoglobin A1c (HbA1c) and type 2 diabetes with and without body mass index (BMI) adjustment were used as exposures and keratoconus was used as the outcome. MR analysis was performed using the inverse-variance weighted method, MR-Egger regression method, weighted-mode method, weighted median method and the MR-pleiotropy residual sum and outlier test (PRESSO). Results showed that genetically predicted lower fasting glucose were significantly associated with a higher risk of keratoconus [IVW: odds ratio (OR) = 0.382; 95% confidence interval (CI) = 0.261-0.560; p = 8.162 × 10-7]. Genetically predicted lower proinsulin levels were potentially linked to a higher risk of keratoconus (IVW: OR = 0.739; 95% CI = 0.568-0.963; p = 0.025). In addition, genetically predicted type 2 diabetes negatively correlated with keratoconus (IVW: BMI-unadjusted: OR = 0.869; 95% CI = 0.775-0.974, p = 0.016; BMI-adjusted: OR = 0.880, 95% CI = 0.789-0.982, p = 0.022). These associations were further corroborated by the evidence from all sensitivity analyses. These findings provide genetic evidence that higher fasting glucose levels are associated with a lower risk of keratoconus. However, further studies are required to confirmed this hypothesis and to understand the mechanisms underlying this putative causative relationship.

Specific Learning Disorders in Children and Adolescents with Obesity.

Specific learning disorders (SLDs) are the most frequently diagnosed developmental disorders in childhood. Different neurocognitive patterns have been found in patients with overweight and obesity, but no data on childhood obesity and SLDs have been reported. To increase our understanding of the relationship between neuropsychological developmental and obesity, we assessed the prevalence of SLD in a pediatric population with obesity. We retrospectively included 380 children and adolescents with obesity. For all participants, auxological, metabolic, demographic features, relationship and social skills, anamnestic data on pregnancy and the perinatal period, stages of development and family medical history were reviewed. SLD was defined according to the DSM-5 criteria. A group of 101 controls of normal weight was included. The overall prevalence of SLD was 10.8%, and SLD was more prevalent in patients with obesity (p < 0.001), with male predominance (p = 0.01). SGA was associated with SLD (p = 0.02). Speech retardation (p < 0.001), limited relationships with peers (p < 0.001) and didactic support (p < 0.001) were noted in the SLD group compared to the group without SLD. A higher prevalence of family history of neuropsychiatric disorders was observed in the SLD group (p = 0.04). A higher fasting glucose level was detected in patients with obesity and SLD compared to subjects without SLD (p = 0.01). An association between obesity and SLD could not be excluded, and an overlap of pathogenic factors for both conditions should be considered.

Cluster analysis reveals a homogeneous subgroup of PCOS women with metabolic disturbance associated with adverse reproductive outcomes.

Polycystic ovarian syndrome (PCOS) is a heterogeneous and complex reproductive endocrinological disease that could lead to infertility. There were many attempts to classify PCOS but it remains unclear whether there is a specific subgroup of PCOS that is associated with the best or worst reproductive outcomes of assisted reproductive techniques (ART). Infertile PCOS patients who underwent their first cycle of in vitro fertilization (IVF) in West China Second University Hospital, Sichuan University from January 2019 to December 2021 were included. Basic clinical and laboratory information of each individual were extracted. Unsupervised cluster analysis was performed. Controlled ovarian stimulation parameters and reproductive outcomes were collected and compared between the different clusters of PCOS. Our analysis clustered women with PCOS into "reproductive", "metabolic", and "balanced" clusters based on nine traits. Reproductive group was characterized by high levels of testosterone (T), sex hormone-binding globulin (SHBG), follicular stimulation hormone (FSH), luteinizing hormone (LH), and anti-Müllerian hormone (AMH). Metabolic group was characterized by high levels of body mass index (BMI), fasting insulin, and fasting glucose. Balanced group was characterized by low levels of the aforementioned reproductive and metabolic parameters, except for SHBG. Compared with PCOS patients in reproductive and balanced clusters, those in metabolic cluster had lower rates of good quality day 3 embryo and blastocyst formation. Moreover, PCOS patients in the reproductive cluster had greater fresh embryo transfer (ET) cancelation rate and clinical pregnancy rate after fresh ET than metabolic cluster (odds ratio [OR] = 3.37, 95% confidence interval [CI]: 1.77-6.44, and OR = 6.19, 95% CI: 1.58-24.24, respectively). And compared with PCOS of metabolic cluster, PCOS of balanced cluster also had higher chance for fresh ET cancelation (OR = 2.83, 95% CI: 1.26-6.35). Our study suggested that PCOS patients in metabolic cluster may be associated with adverse reproductive outcomes and might need individualized treatment and careful monitoring before and during ART.

Nail Folds Capillaries Abnormalities Association with Type 2 Diabetes Progression and Correlation with Diabetic Retinopathy

Abstract Background Retinopathy is regarded one of the most important complications of diabetes that occurs after long duration of the disease with untight glycemic control, and it is regarded as one of the preventable causes of blindness so proper evaluation of diabetic patients and their complications can prevent blindness. Aim of the Work to assess the capillaroscopic changes in type 2 diabetes mellitus patients and correlate the findings to the microvascular complication of the retina (diabetic retinopathy). Patients and Methods Our study was conducted on 62 patients of type 2 diabetes mellitus (16 male, 46 female) their ages above 18 years lies between (36-66) years. All patients were subjected to full history taking and thorough clinical examination. Results Nailfold capillaroscopy imaging revealed that 31 patients with positive capillaroscopic findings had branched and tortuous capillaries, 34 patients had hemorrhage,5 patients with dilated apical capillary, 46 patients had elongated capillaries,16 with normal capillary length and 48 patients with dilated capillary width capillary. Fundus examination revealed 26 patients with DR and 36 patients nonDR. Our study reported that DR patients had higher duration of diabetes more than non-DR patients. Also, DR patients showed higher levels of HbA1c more than the non-DR patients. Patients with diabetic retinopathy show high percentages of tortuous, branched capillaries. 46.2% of the DR patients had precapillary edema verses 19.4% of the non-DR patients. The mean capillary width in the DR group of patients was 27.68 ± 5.7 verses 23.02 ± 3.29 in the non-DR patients which indicate that patients with DR had more wide capillaries than the non-DR patients. Higher fasting glucose levels were detected in the DR patients than the non-DR patients. Branched, tortuous capillaries, hemorrhage and dilated apical capillaries are documented in the patients with higher median diabetic years 15-20 years in the DR group of patients. Tortuosity, precapillary edema and dilated apical capillaries are positive in patients with higher median diabetic years. (24) patients documented to have DR with HbA1c ≥7% and only 2 DR patients with HbA1c &amp;lt;7. (29) patients had tortuous capillaries with HbA1c ≥7 verses 2 patients had tortuous capillaries with HbA1c &amp;lt;7. Also, (19) patients had precapillary edema in HbA1c ≥7 group while (0) patient had precapillary edema in the HbA1c &amp;lt;7 group. Capillary width and branched capillaries are found to be a predictor of diabetic retinopathy in multivariant analysis. Conclusion nailfold capillaroscopy is regarded a helpful noninvasive newly emerging tool to assess the capillaroscopic changes in diabetic patients as an indicator to diabetic complication development such as diabetic retinopathy.

Сlinical features of asthma-COPD overlap syndrome with comorbid type 2 diabetes mellitus

Background. Comorbidity profiles are a common subject of research in patients with asthma-COPD (chronic obstructive pulmonary disease) overlap (ACO), but in case of concurrent type 2 diabetes mellitus (T2DM), there is a lack of targeted research on the quality of life, clinical course, and lung function. The aim of the study was to clarify the clinical features of asthma-COPD overlap in combination with T2DM. Materials and methods. Sixty-nine patients were examined: 24 with ACO and T2DM (group 1), 21 with asthma and T2DM (group 2), and 24 with COPD and T2DM (group 3). A diagnosis of ACO was made according to GINA and GOLD 2017 guidelines. Quality of life was assessed using the CAT, ACQ, and SGRQ, and the severity of dyspnea was assessed using the mMRC scale, disease severity and prognosis using the BODE index. Spirometry with bronchodilation test, 6-minute walk test, and bioimpedance analysis were performed. Results. Patients in the main group had a higher total SGRQ score than those in group 3 (by 33 %, p = 0.001). Higher ACQ and total SGRQ scores indicate a trend toward worse asthma control and lower quality of life in patients with ACO and T2DM compared to the asthma + T2DM group (p = 0.056 and p = 0.054, respectively). Body mass index was higher than in patients with COPD and T2DM (by 16.3 %, p = 0.001). Higher serum glucose levels were found in patients with ACO and T2DM than in those with COPD and T2DM (by 18.3 %, p = 0.028). The FEV1 in the ACO and T2DM group was lower than in the asthma + T2DM group (by 18.7 %, p = 0.027), and the SVC was lower by 33 % (p = 0.021). There was a tendency to a lower result in the 6-minute walk test in the main group compared to patients from group 3 (p = 0.0548), and a higher frequency of exacerbations per year compared to groups 2 (p = 0.08) and 3 (p = 0.06). Conclusions. Patients with asthma-COPD overlap and concurrent type 2 diabetes mellitus have worse quality of life, lower FEV1 and SVC, submaximal exercise tolerance, higher fasting glucose levels, and a tendency towards increased exacerbation frequency.

Applying WHO2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk

AimsTo estimate the prevalence of gestational diabetes mellitus (GDM) in a Danish cohort comparing the current Danish versus the WHO2013 diagnostic criteria, and to evaluate adverse pregnancy outcomes among currently untreated women in the gap between the diagnostic thresholds.MethodsDiagnostic testing was performed by a 75 g oral glucose tolerance test (OGTT) at 24–28 weeks’ gestation in a cohort of pregnant women. GDM diagnosis was based on the current Danish criterion (2-h glucose ≥ 9.0 mmol/L, GDMDK) and on the WHO2013 criteria (fasting ≥ 5.1, 1 h ≥ 10.0 or 2 h glucose ≥ 8.5 mmol/L, GDMWHO2013). Currently untreated women fulfilling the WHO2013 but not the Danish diagnostic criteria were defined as New-GDM-women (GDMWHO2013-positive and GDMDK-negative). Adverse outcomes risks were calculated using logistic regression.ResultsOGTT was completed by 465 women at a median of 25.7 weeks’ gestation. GDMDK prevalence was 2.2% (N = 10) and GDMWHO2013 21.5% (N = 100). New-GDM was present in 19.4% (N = 90), of whom 90.0% had elevated fasting glucose. Pregnancies complicated by New-GDM had higher frequencies of pregnancy-induced hypertension (13.3% vs 4.1%, p = 0.002), large-for-gestational-age infants (22.2% vs 9.9%, p = 0.004), neonatal hypoglycaemia (8.9% vs 1.9%, p = 0.004) and neonatal intensive care unit admission (16.7% vs 5.8%, p = 0.002) compared to pregnancies without GDM.ConclusionsGDM prevalence increased tenfold when applying WHO2013 criteria in a Danish population, mainly driven by higher fasting glucose levels. Untreated GDM in the gap between the current Danish and the WHO2013 diagnostic criteria resulted in higher risks of adverse pregnancy outcomes.

Type 2 diabetes clusters in the Novosibirsk region

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a heterogeneous disease. Determination of different T2DM phenotypes will improve the prediction of metabolic disorders, the risk of complications and individual diabetes therapy.AIM: To identify clusters of T2DM in patients with different duration of diabetes with a study of the frequency of diabetic complications and drug therapy in the Novosibirsk region.MATERIALS AND METHODS: The study was carried out at Diamodul in the period 2013–2017 in the Novosibirsk region. K-means cluster analysis was performed in 2805 T2DM patients aged 44 to 75 years with a duration of diabetes of 7.84±6.53 years based on 5 variables — HbA1c, age at diagnosis, BMI, C-peptide, sex.RESULTS: Cluster analysis identified three clusters: cluster 1 in 1003 patients (35.7%) with preserved β-cell function, age of T2DM diagnosis 51.72±8.29 years and BMI 33.50±5.74 kg/m2, in men there was a 27% higher risk of developing diabetic nephropathy compared to women. Cluster 2 in 432 patients (15.4%) with increased function of β-cells, the age of diagnosis of T2DM was older — 52.91±7.75 years, patients had a higher BMI of 35.64±7.21 kg/m2 and more high diastolic blood pressure, earlier development of diabetic retinopathy, nephropathy and polyneuropathy, and better response to metformin therapy and combined therapy with metformin and sulfonylurea. Cluster 3 in 1370 patients (48.8%) with reduced function of β-cells, the age of diagnosing T2DM was younger — 49.63±8.32 years, patients had a lower BMI of 33.09±6.36 kg/m2 and had longer diabetes, high fasting glucose levels, males were associated with a higher risk of developing diabetic nephropathy (by 26%) compared with women, the first line of therapy was insulin therapy in 52.8% of patients.CONCLUSION: The conducted study in T2DM patients with different duration of diabetes confirmed the possibility of using cluster analysis to identify phenotypes of T2DM in the Russian population by five variables (HbA1c, age at the time of diagnosis, BMI, C-peptide, gender). A high incidence of early development of diabetic polyneuropathy, nephropathy and retinopathy was revealed in a cluster with increased function of β-cells, male gender was risk factor for diabetic nephropathy and polyneuropathy.

178-LB: Association of Pregnancy Oral Glucose Tolerance Test (OGTT) Glucose Response with Metabolic Profile in Mother and Child—Hyperglycemia and Adverse Pregnancy Outcomes Follow-up Study (HAPO-FUS)

The glucose response shape during an OGTT, monophasic or biphasic, can characterize physiologically distinct groups with differences in insulin secretion and sensitivity. Biphasic response (glucose rebound after nadir ≥ 0.025 mmol/L) has been associated with higher insulin sensitivity and β-cell function. We aimed to identify the association of the pregnancy OGTT response shape with follow-up maternal and offspring metabolic profiles. Method: Using HAPO-FUS study data from the NIH-NIDDK repository, monophasic glucose response was defined as 2-hr glucose - 1-hr glucose &amp;lt; 0. Multiple linear regression assessed the relationship of glucose response shape with maternal profile at 10-year follow-up and offspring metabolic profile at 10-12 years of age. Maternal covariates include age, gestational age, field center and BMI. Child covariates include age, sex, pubertal stage, and family history of diabetes. Results: 4,605 mothers (83.7% monophasic) and 3792 children were included. Mothers with monophasic shape were older (30.7 vs 29.8 years, p=.002), had higher BMI (26.7 vs 26.0 kg/m2, p=.003), HbA1c (4.80 vs 4.70 %, p &amp;lt;.001), 1-hour c-peptide level (9.60 vs 7.75 ug/dL, p &amp;lt;.001) and gestational diabetes (14 vs 9.5%, p &amp;lt;.001). At 10-year follow-up, pregnancy monophasic response was associated with higher fasting glucose level (0.06 [0.01, 0.11], p =.01) and log HOMA-IR (0.06 [0.02, 0.10], p=.007) in mothers at follow-up. Offspring had higher cord c-peptide (0.12 [0.04, 0.21], p=.005) and body fat percent (1.35 [0.50-2.21], p =.002). Offspring insulin sensitivity (-0.17 [-0.04, -0.3], p=.01) and Matsuda index (-0.46 [-0.15, -0.76], p=.003) were lower with monophasic response. Conclusion: Maternal glucose response profiles during pregnancy determined by both insulin secretion and whole-body insulin resistance are associated with long-term maternal and offspring metabolic profile. Disclosure V. V. Thaker: None. C. A. Leduc: None. R. Salem: Other Relationship; Travere Inc. Funding National Institutes of Health (K23DK110539)

331-OR: Fasting Metabolic Flexibility in Prediabetes

Metabolic flexibility cannot be easily clinically assessed, but the respiratory exchange ratio (RER) measured via indirect calorimetry can indicate substrate utilization. When indirect calorimetry is performed to measure resting metabolic rate, a normal RER should reflect a lipolytic metabolism (close to 0.7). We aimed to describe fasting glucose metabolism in relation to RER in patients seeking a nutritional intervention. In 10175 patients (7,222 (71%) females, median (quartiles) age of 46 (36, 55) years, and BMI of 28.3 (25.0, 32.3) kg/m2) a greater RER was associated with higher fasting values of glucose, insulin and higher insulin resistance (HOMA-IR), controlling for sex, age, and BMI (differences going from a RER of 0.7 to 1 RER for glucose 1.7 (95% CI 0.66, 2.8; p=0.002), for insulin 1.9 (95% CI 1.3, 2.6; p=&amp;lt;0.001), and for HOMA-IR 0.49 (95% CI 0.32, 0.66; p=&amp;lt;0.001)). As an higher RER relates to an altered glucose metabolism, within the whole sample we selected patients with prediabetes with 1 year follow-up. We matched 86 patients having either a RER indicating a lipolytic metabolism (&amp;lt;0.775) or glycolytic metabolism (&amp;gt;0.925). Patients were matched for sex, age, BMI, waist circumference, and arm muscle area. The high RER group had a lower probability of normalizing fasting glucose level within 1 year (log(OR) -0.89 (95% CI -1.8, -0.03; p=0.046)), with higher fasting glucose levels at followup (5.4 (95% CI 0.98, 9.9; p=0.017)). Moreover, while losing similar weight than the low RER group (-0.55 (95% CI -3.7, 2.6; p=0.7)), they lost a lower amount of fat mass (1.2 (95% CI 0.02, 2.4; p=0.047)). Our results suggest than an higher RER relates to a dysfunctional glycolytic metabolism at rest. We also show that prediabetic patients with higher RER are more likely to not respond to a lifestyle intervention, warranting a more intensive treatment for this subgroup. This lower probability of success doesn’t seem related to a lower adherence to the proscription, as weight loss was similar across RER categories, but to a lower weight loss quality. Disclosure A.Foppiani: None. R.De amicis: None. A.Leone: None. S.Bertoli: None. A.Battezzati: None. Funding Italian National Recovery and Resilience Plan Mission 4 Component 2 Investment 1.3 - Call for Proposals (341) of 15 March 2022 of Italian Ministry of University and Research funded by the European Union - NextGenerationEU (PE00000003) Concession Decree (1550) of 11 October 2022 adopted by the Italian Ministry of University and Research (CUP D93C22000890001)

Dyslipidaemias in patients with diabetes mellitus type 2 - a cumulative impact on coronary artery disease occurence

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Introduction.&amp;lt;/strong&amp;gt; Cardiovascular complications are one of the leading causes of mortality releted to diabetes mellitus typ 2 (T2DM). Dyslipidemia is one of the associated risk factors for coronary artery disease (CAD) in patients with T2DM. The aims of our study were: to determine the characteristics of lipid disorders in persons with T2DM; to determine the cumulative impact of investigated risk factors (gender, age, genetic predisposition, smoking habits, diabetes mellitus, hypertension, obesity) for the occurence of the coronary artery disease; to determine the influence of lipid profile on coronary artery disease development. &amp;lt;strong&amp;gt;Methods.&amp;lt;/strong&amp;gt; A cross-sectional study was conducted in the Educative Center of the Primary Health Center Banja Luka in the period 01.11.2021&amp;amp;ndash;30.04.2022. Adult patients (&amp;amp;ge;18 years) with T2DM were recruited into the study. The data about socio-demographic characteristics, lifestyle and clinical factors were collected using structural questionnaire as a tool. For all subjects, anthropometric measurements, blood pressure readings, and laboratory findings (fasting blood glucose, HbA1c, lipid profile) were taken.&amp;lt;strong&amp;gt; Results.&amp;lt;/strong&amp;gt; A total of 221 patients with T2DM participated in the study, 52.03% were males. Hypertriglycerdidemia was found in 63.81% subjects, hypercholesterolemia in 56.60%, low HDL-cholesterol in 49.77% subjects and increased level of LDL-cholesterol in 39.37% subjects. Metabolic dyslipidemia (increased triglyceride levels and low HDL levels), representing the major predictor of CAD, was found in 35.29% subjects. Older age, physical inactivity, obesity, hypertension and high levels of fasting glucose in blood were significantly related to dyslipidaemia in patients with T2DM. &amp;lt;strong&amp;gt;Conclusion.&amp;lt;/strong&amp;gt; The representation of dyslipidemia in our subjects with T2DM is high, what increases the risk for coronary artery disease. Therefore, it is necessary not only to implement the therapy for glucoregulation, but also the secondary preventive measures for dyslipidemia, and that is the cardiovascular prevention.&amp;lt;/p&amp;gt;

Association between Obesity and Cardiovascular Disease Risk Factors in Different Age Groups of Adolescents: An Analysis of Data from the Korean National Health and Nutritional Examination Survey.

We investigated the association between obesity and cardiovascular disease risk factors (CVDRFs) in adolescents. We performed a cross-sectional study using the data from 8149 adolescents, aged 10-18 years, included in the Korean National Health and Nutrition Examination Survey (2011-2020). Using the body mass index, we defined "overweight" (≥85th to <95th percentile) and "obese" (≥95th percentile). We analyzed the associations between obesity and CVDRFs (high blood pressure, abnormal lipid profiles, and high fasting glucose levels) by sex and age groups (early [10-12 years], middle [13-15 years], and late [16-18 years] adolescence). When analyzing all the subjects, being overweight was correlated with high blood pressure and abnormal all-lipid profiles in boys and high triglyceride and low high-density lipoprotein cholesterol levels in girls, while obesity was associated with all CVDRFs in both boys and girls. Analyzing separately in the age subgroups, the correlation between obesity and CVDRFs tended to be shown earlier in boys than in girls, and obesity tended to be associated with CVDRFs earlier than being overweight. The association between obesity and CVDRFs may begin to be shown at different periods of youth, depending on the degree of obesity, CVDRF variables, and sex.

Snacking Behavior and Association with Metabolic Risk Factors in Adults from North and South India

BackgroundSnacks are increasingly contributing to daily diets around the world. Studies from high-income countries have demonstrated the link between snack consumption and metabolic risk factors, but there are very few studies from low- and middle-income countries. ObjectivesThe objective of this study was to assess snack behavior and its associations with metabolic risk factors in Indian adults. MethodsAdults from the UDAY study (October 2018–February 2019, n = 8762) from rural and urban Sonipat (North) and Vizag (South) India were studied for snack consumption (food frequency questionnaire), demographic factors, including age, sex, etc. and metabolic risk factors, including BMI, waist circumference, fat percentage, plasma glucose, and blood pressure. We compared snack consumption by categories of sociodemographic factors (Mann–Whitney U test, Kruskal–Wallis test) and studied the likelihood for metabolic risk (logistic regression analysis). ResultsHalf of the study participants were women and resided in rural locations. Savory snacks were the most preferred; 50% of the participants consumed them 3–5 times/wk. Participants preferred to purchase out-of-home prepared snacks and eat them at home (86.6%) while watching television (69.4%) or with family/friends (49.3%). The reasons for snacking were hunger, craving, liking, and availability. Snack consumption was higher in Vizag (56.6%) than in Sonipat (43.4%), among women (55.5%) than men (44.5%), and the wealthiest; it was similar in rural–urban locations. Frequent consumers of snacks had 2 times higher likelihood for having obesity (OR: 2.22; 95% CI: 1.51, 3.27) central obesity (OR: 2.35; 95% CI: 1.60, 3.45), and higher fat percentage (OR: 1.92; 95% CI: 1.31, 2.82) and higher fasting glucose levels (r=0.12 (0.07–0.18) than consumers who consumed snacks rarely (all P ≤ 0.05). ConclusionsSnack (savory and sweet) consumption was high among adults from sexes in both urban and rural locations of north and south India. This was associated with higher risk of obesity. There is a need to improve the food environment by promoting policies for ensuring healthier food options to reduce snacking and associated metabolic risk.

261. COVID-19 and Diabetes Mellitus: Glycemic Control and Risk Factors for Mortality, experience from Pakistan.

Abstract Background Diabetes mellitus (DM) is a chronic disease characterized by glucose dysregulation by insulin deficiency or resistance. DM is one of the risk factors and found to be associated with high mortality in patients with corona virus disease-19 (Covid-19). There are challenges in managing poorly controlled DM among Covid-19 patients. Our aim is to highlight the effect of Covid-19 and DM on each other by studying glycemic control and risk factors for mortality. Methods This study is a single center retrospective observational review from Pakistan. Covid-19 diagnosed patients admitted during the months of March 2020 to March 2021were included. The patients were divided into DM and non-DM. Demographics, clinical variables and outcome were collected and compared between these groups. Glycemic control during hospitalization (blood sugar level fasting and pre-meal twice a day) was noted. Fasting glucose level &amp;gt;120 mg/dl, and random &amp;gt;200 mg/dl were considered as poor glycemic control. Survivors and non- survivors among DM patients were compared. Results A total of 366 patients were included in this study, 113(30.87%) were DM and 253(69.12%) were non-DM. Mean age was comparable in two groups, however, patients in DM group were older (age &amp;gt;45 years, p=value 0.039). Significantly more patients with hypertension (p value&amp;lt; 0.001) and ischemic heart disease (p value&amp;lt; 0.001) developed Covid-19 in DM group. There was no difference in mortality among both groups (p=0.29). (Table 1) .In DM patients, the significant risk factors for mortality were age &amp;gt;60years, hypertension and renal disease. High fasting and pre-dinner blood glucose levels (mean) obtained at admission and day 5 were significantly associated with mortality. (Table2). Conclusion Diabetic patients with advanced age and concomitant other comorbid conditions is associated with increased risk of death. In diabetic patients, more attention should be focus on dynamic monitoring and strict glycemic control as severe COVID 19 infection and its treatment with steroids can have a negative impact on outcome. Disclosures All Authors: No reported disclosures.