Increase In Fasting Plasma Glucose Levels Research Articles

The Extent of Lifestyle-Induced Weight Loss Determines the Risk of Prediabetes and Metabolic Syndrome Recurrence during a 5-Year Follow-Up.

It is controversial whether lifestyle-induced weight loss (LIWL) intervention provides long-term benefit. Here, we investigated whether the degree of weight loss (WL) in a controlled LIWL intervention study determined the risk of prediabetes and recurrence of metabolic syndrome (MetS) during a 5-year follow-up. Following LIWL, 58 male participants (age 45–55 years) were divided into four quartiles based on initial WL: Q1 (WL 0–8.1%, n = 15), Q2 (WL 8.1–12.8%, n = 14), Q3 (WL 12.8–16.0%, n = 14), and Q4 (WL 16.0–27.5%, n = 15). We analyzed changes in BMI, HDL cholesterol, triglycerides (TGs), blood pressure, and fasting plasma glucose (FPG) at annual follow-up visits. With a weight gain after LIWL between 1.2 (Q2) and 2.5 kg/year (Q4), the reduction in BMI was maintained for 4 (Q2, p = 0.03) or 5 (Q3, p = 0.03; Q4, p < 0.01) years, respectively, and an increase in FPG levels above baseline values was prevented in Q2–Q4. Accordingly, there was no increase in prediabetes incidence after LIWL in participants in Q2 (up to 2 years), Q3 and Q4 (up to 5 years). A sustained reduction in MetS was maintained in Q4 during the 5-year follow-up. The present data indicate that a greater initial LIWL reduces the risk of prediabetes and recurrence of MetS for up to 5 years.

Associations of propylene oxide exposure with fasting plasma glucose and diabetes: Roles of oxidative DNA damage and lipid peroxidation

Whether propylene oxide (PO) exposure is associated with hyperglycemia were rarely explored. We aimed to determine the relationship between PO exposure and glucose metabolism, and potential role of oxidative stress. Among 3294 Chinese urban adults, urinary PO metabolite (N-Acetyl-S-(2-hydroxypropyl)-L-cysteine, 2HPMA), biomarkers of oxidative DNA damage (8-oxo-7,8-dihydro-20-deoxyguanosine, 8-OHdG) and lipid peroxidation (8-isoprostane, 8-iso-PGF2α) in urine were determined. The associations of 2HPMA with 8-OHdG, 8-iso-PGF2α, fasting plasma glucose (FPG), and risk of diabetes were explored. The roles of 8-OHdG and 8-iso-PGF2α on association of 2HPMA with FPG and risk of diabetes were detected. After adjusted for potential confounders, each 1-unit increase in log-transformed concentration of 2HPMA was associated with a 0.15-mmol/L increase in FPG level, and the adjusted OR (95% CI) of diabetes by the associations of log-transformed urinary 2HPMA concentrations was 1.47 (95% CI: 1.03–2.11). Combination effects of 2HPMA with 8-OHdG or 8-iso-PGF2α on risk of diabetes were detected, and elevated 8-iso-PGF2α significantly mediated 34.5% of the urinary 2HPMA-associated FPG elevation. PO exposure was positively associated with FPG levels and risk of diabetes. PO exposure combined with DNA oxidative damage or lipid peroxidation may increase the risk of diabetes, and lipid peroxidation may partially mediate the PO exposure-induced FPG elevation.

Observations of the Effects of Maternal Fasting Plasma Glucose Changes in Early Pregnancy on Fetal Growth Profiles and Birth Outcomes.

IntroductionAlthough the role of maternal hyperglycemia on birth outcomes is clear, literature regarding fetal growth is scarce. We examined the possible associations between maternal fasting plasma glucose (FPG) and fetal growth.Materials and MethodsA total of 35,981 singleton-pregnant women with FPG in the first trimester were included. Fetal growth parameters were measured during pregnancy by ultrasound at mid and late pregnancy. Information on birth characteristics was retrieved from medical records. We used multivariable linear and logistic regression to determine the associations between FPG and z-scores of fetal parameters and risks of birth outcomes and to assess effect modification by maternal characteristics.ResultsA per-unit increase in FPG levels was negatively associated with fetal parameters in mid pregnancy but positively correlated with those in late pregnancy and with birth characteristics. The effect estimates in late pregnancy were attenuated by maternal pre-pregnancy body mass index (BMI). A significant relationship between FPG and abdominal circumference (AC), an indicator of fetal adiposity, was sustained in subgroups of women with advanced age, positive family history of diabetes, and multiparity in fully adjusted models. After stratification by BMI, high FPG was associated with accelerated AC only in normal controls (0.044 SD; 95% CI: 0.010, 0.079) and overweight/obese women (0.069 SD; 95% CI: -0.002, 0.140) but not in underweight women. High FPG was an independent risk factor for large-for-gestational age in the whole group and stratified subgroups.ConclusionsIncreased FPG in early pregnancy is closely related to fetal growth. Maternal characteristics may modify the associations between FPG and fetal adiposity in late pregnancy.

Long-term exposure to PM2.5 and fasting plasma glucose in non-diabetic adolescents in Yogyakarta, Indonesia

BackgroundIndonesia is facing serious air pollution. However, very few studies have been conducted to examine the health risks of air pollution in Indonesia, particularly for adolescents. ObjectiveTo assess the association between long-term exposure to ambient particles with a diameter of <2.5 μm (PM2.5) and fasting plasma glucose (FPG) in adolescents. MethodsA cross-sectional study was conducted in 482 adolescents aged 14–18 years in Yogyakarta, Indonesia in 2016. We finally included 469 (97.30%) participants who had no missing data for data analysis. We collected individual data on socio-demographics, behavioral habits, and health information through standardized questionnaires. Satellite-based PM2.5 concentrations from 2013 to 2016 were assigned based on participants’ residential addresses. The association between PM2.5 and FPG was examined using a generalized linear regression model while FPG was modeled as a continuous variable. An ordered logistic regression model was used to assess the relationship between PM2.5 and FPG categories. ResultsEvery 1 μg/m³ increase in PM2.5 was associated with a 0.34 mg/dL [95 confidence interval (95% CI): 0.08 mg/dL, 0.59 mg/dL] increase in FPG levels. Comparing with the low FPG level (under 86 mg/dL), every 1 μg/m³ increase in PM2.5 was associated with a 10.20% (95% CI: 1.60%, 19.80%) increase in the odds of impaired fasting glucose (IFG) (100–125 mg/dL). Stratified analyses indicated greater effects on participants with hypertension [odds ratio (OR) = 1.30, 95% CI: 1.09, 1.57] and those had higher physical activities (OR = 1.36, 95% CI: 1.09, 1.57). Adolescents’ sex, obesity status and different cutoff points of FPG did not modify the association between the exposure to PM2.5 and FPG levels. ConclusionLong-term exposure to PM2.5 was associated with increased FPG levels in Indonesian non-diabetic adolescents.

Effectiveness and safety of selenium supplementation for type 2 diabetes mellitus in adults: a systematic review of randomised controlled trials.

The role of selenium (Se) in the management of type 2 diabetes mellitus (T2DM) remains unclear. We systematically assessed the effectiveness and safety of Se supplementation in adults with T2DM. MEDLINE, EMBASE and the Cochrane Library were searched up to April 2018 for randomised controlled trials (RCTs) evaluating the effectiveness of Se against a comparator on DM-related outcomes. Four RCTs (241 participants) were included. In individual RCTs, Se supplementation significantly reduced fasting insulin levels [mean difference (MD)=-3.6μIU mL-1 ; 95% confidence interval (CI)=-6.36 to -0.84; MD=-5.8μIU mL-1 ; 95% CI=-9.23 to -2.37], homeostasis model of assessment-estimated insulin resistance (HOMA-IR) (MD=-1; 95% CI=-1.79 to -0.21; MD=-1.6; 95% CI, -2.58 to -0.62) and homeostasis model of assessment-estimated B cell function (HOMA-B) (MD=-13.6; 95% CI=-23.4 to -3.8; MD=-22.6; 95% CI=-36.39 to -8.81). No effects of Se were noted on most of the other outcomes of interest. None of the RCTs assessed the mortality, diabetes-related complications, non-high-density lipoprotein (non-HDL), blood pressure and health-related quality of life. The impact on HDL and fasting plasma glucose (FPG) was ambiguous. Only one adverse event (nausea) was reported as a reason for discontinuing the intervention; however, among the studies, the reporting was not accurate. Furthermore, only one RCT reported increase in FPG level in the Se group (MD=36.38mg dL-1 ; 95% CI=15.39-57.37). Currently, there is no evidence to support the effectiveness of Se supplementation in the T2DM population.

Exposure to Bisphenol a Substitutes and Gestational Diabetes Mellitus: A Prospective Cohort Study in China.

Background: The association of bisphenol A (BPA) and gestational diabetes mellitus (GDM) has been investigated in only a small number of studies, and research on the associations between BPA substitutes and GDM is scarce.Objective: We aimed to investigate the associations of four bisphenols [bisphenol A (BPA), bisphenol S (BPS), bisphenol F (BPF), and bisphenol AF (BPAF)] levels in urine sample with the risk of gestational diabetes mellitus (GDM) and plasma glucose levels.Methods: A total of 1,841 pregnant women from a cohort study were recruited at their first prenatal examination between 2013 and 2015 in Wuhan, China. Concentrations of four bisphenols (BPA, BPS, BPF, BPAF) were measured in first-trimester urine samples using Ultra-high performance liquid chromatography system coupled to a Triple Quadrupole mass spectrometer (UHPLC-TQMS). An oral glucose tolerance test (OGTT) was performed at 24–28 gestational weeks and GDM was diagnosed post hoc using International Association of Diabetes and Pregnancy Study Groups criteria. We used multivariable logistic regression models to examine the associations of urinary bisphenols with the risk of GDM, and multiple linear regression models to determine the associations between bisphenols exposure and plasma glucose levels.Results: Urinary BPAF was associated with increased odds of GDM among women with normal pre-pregnancy BMI [adjusted odds ratio (aOR) = 1.70 (95% CI: 1.08, 2.67) for the highest group compared to the lowest group], and the association remained significant after additional adjustment for other bisphenols [aOR = 1.68 (95% CI: 1.03, 2.72)]. No significant associations were observed for other bisphenols and GDM. Consistent with the result of GDM, women in the highest BPAF category had a mean of 0.05 mmol/L (95% CI: 0.01, 0.09) higher fasting plasma glucose (FPG) levels than women in the lowest category. For BPA and plasma glucose, non-linear associations were observed between urinary BPA and FPG and the sum of the PG z-score among women who were overweight (p for non-linear association < 0.05). We also found that the per-unit increase in natural log transformed specific gravity adjusted BPS [ln (SG-adj BPS)] was associated with a 0.03 mmol/L (95% CI: 0.01, 0.04) increase in FPG levels and the associations might be modified by fetal sex (p for interaction < 0.05). Among women with female fetus, a per-unit increase in ln (SG-adj BPS) was associated with a 0.04 mmol/L (95% CI: 0.02, 0.06) increase in FPG, a 0.11 mmol/L (95% CI: 0.04, 0.17) increase in 1 h-PG and a 0.19 mmol/L (95% CI: 0.08, 0.30) increase in the sum of PG z-score.Conclusions: Our results provide evidence that BPAF and BPS might be potential risk factors of GDM, which require to be studied further.

Glycemic Control in Patients Treated with Tyrosine Kinase Inhibitors for Chronic Myeloid Leukemia: A Systematic Review

IntroductionTyrosine kinase inhibitors (TKIs) have revolutionized the treatment of chronic myeloid leukemia (CML). Many endocrine receptors, such as insulin receptors, are tyrosine kinase receptors. Hence, TKIs may have effects that impact endocrine function. However, it is not clear to what extent glycemic outcomes are affected by TKI use in this patient population, including children (<18 years of age). A better understanding of these health outcomes and identification of populations at high risk for these effects is critical for choice of TKI and instituting appropriate long-term monitoring. Thus, the aim of this systematic review is to summarize the glycemic outcomes in patients with CML on TKI therapy.MethodsA systematic review of the literature up until January 2018 was conducted, utilizing databases including Cochrane Central, EMBASE, and MEDLINE. We included randomized controlled trials (RCT), quasi-RCT, cohort studies, cross-sectional studies and case-series. Eligible studies included male and female CML patients of all ages receiving treatment with TKIs including imatinib, dasatinib, nilotinib, ponatinib, or bosutinib. We included studies that reported glycemic outcomes as a primary or secondary outcome. Markers of glycemia reported include fasting plasma glucose (FPG), random blood glucose, HbA1c, and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) if reported. Additionally, a meta-analysis was planned if two or more studies with similar designs comparing the similar population and measuring the same outcome were identified. Titles, abstracts, and full text papers were reviewed by two independent reviewers and a third reviewer was consulted to resolve disputes.ResultsOut of 607 full-text studies retrieved, six studies met the inclusion criteria. These studies included 10 to 267 patients. None of these studies included children. Elevations in FPG levels were demonstrated across all trials using nilotinib. The prevalence of hyperglycemia in these studies ranged from 2.7% to 35.3% within the study populations. One cohort study comparing nilotinib, imatinib, and dasatinib demonstrated that increase in FPG levels with nilotinib treatment was more significant that with imatinib (p = 0.015), and dasatinib (p = 0.009), but no significant differences between dasatinib and imatinib (p = 0.95). A second cohort study comparing nilotinib and imatinib also revealed an increased prevalence of hyperglycemia with Nilotinib use (35.3%) compared to Imatinib use (27.3%). No studies were identified that evaluated glycemic control in bosutinib or ponatinib treated patients. Two studies reported an increase in HOMA-IR with nilotinib use, however, this was not associated with an increase in HbA1c levels, a diagnostic marker of pre-diabetes and diabetes.ConclusionsNilotinib use appears to be associated with dysglycemia to a greater extent than other TKIs in adult CML patients. However, the clinical significance of hyperglycemia while on TKI treatment and future diabetes risk remains unclear. There were no data outlining the glycemic effects of TKI in the pediatric age group. Glycemic and metabolic outcomes in CML patients should be closely monitored, and further research is needed to elucidate the glycemic control in pediatric patients with CML since they are likely to use lifelong TKI therapy. DisclosuresHillis:Bristol-Myers Squibb: Honoraria; Novartis: Honoraria.

Is there sufficient evidence for a causal association between antiretroviral therapy and diabetes in HIV-infected patients? A meta-analysis.

The association of antiretroviral therapy (ART) with diabetes is inconsistent and varies widely across primary epidemiological studies. A comprehensive and more precise estimate of this association is fundamental to establishing a plausible causal link between ART and diabetes. We identified epidemiological studies that compared mean fasting plasma glucose (FPG) concentrations and proportions of diabetes and metabolic syndrome between HIV-infected patients naïve and exposed to ART. Mean difference in FPG concentrations and odds ratios of diabetes and metabolic syndrome were pooled using random-effects meta-analyses. Data on 20178 participants from 41 observational studies were included in the meta-analyses. Mean FPG concentrations (Pooled mean difference: 4.66mg/dL; 95% confidence interval [CI], 2.52 to 6.80; 24 studies) and the odds of diabetes (Pooled odds ratios: 3.85; 95% CI, 2.93 to 5.07; 10 studies) and metabolic syndrome (Pooled odds ratios: 1.45; 95% CI, 1.03 to 2.03; 18 studies) were significantly higher among ART-exposed patients, compared to their naïve counterparts. ART was also associated with significant increases in FPG levels in studies with mean ART duration ≥18months (Pooled mean difference: 4.97mg/dL; 95% CI, 3.10 to 6.84; 14 studies), but not in studies with mean ART duration <18months (Pooled mean difference: 4.40mg/dL, 95% CI, -0.59 to 9.38; 7 studies). ART may potentially be the single most consistent determinant of diabetes in people living with HIV worldwide. However, given the preponderance of cross-sectional studies in the meta-analysis, the association between ART and diabetes cannot be interpreted as cause and effect.

Fasting Plasma Glucose Levels Predict Steroid-Induced Abnormal Glucose Metabolism in Patients with Non-Diabetic Chronic Kidney Disease: A Prospective Cohort Study

Background/Aims: Glucocorticoids-induced abnormal glucose metabolism (AGM) is a common medical problem in patients with non-diabetic chronic kidney disease (CKD). However, little information is available regarding the prediction of steroid-induced AGM in this patient population. Methods: In this prospective cohort study, we consecutively enrolled 303 non-diabetic CKD patients with fasting plasma glucose (FPG) levels <5.6 mmol/l and normal oral glucose tolerance test (OGTT). OGTT was performed every 3 months during glucocorticoid treatment to identify new-onset AGM, and patients were followed for 12 months post steroid withdrawal. Results: During 593 person-years, there were 107 incident cases of steroid-induced AGM (18/100 person-year), including 55 (51.4%) diabetes and 52 (48.6%) pre-diabetes. In a multivariate model, each millimole increase per liter in FPG enhanced the risk of AGM by 4.6-fold (hazard ratio 4.58, 95% confidence interval, 2.67-7.83). After adjusting other risk factors, a progressively increased risk of AGM or DM was observed in patients with FPG levels ≥4.8 mmol/l, as compared with those whose levels were ≤4.3 mmol/l (p for trend <0.001). Furthermore, a greater increase in FPG level (≥0.3 mmol/l) during the first 3 months of glucocorticoid treatment was associated with an increased risk for future diabetes. For predicting steroid-induced diabetes, the area under the receiver-operating characteristic curve was 0.90 for the combination of FPG and changes in FPG levels at month 3. Conclusion: Higher-normal FPG and a greater increase in FPG levels during glucocorticoid treatment may help to identify non-diabetic CKD patients at increased risk of steroid-induced AGM or diabetes.

Fasting Plasma Glucose and Incident Heart Failure Risk: A Population-Based Cohort Study and New Meta-analysis

BackgroundThere remains uncertainty regarding the association between fasting plasma glucose (FPG) and risk of heart failure (HF) in individuals without a history of diabetes. Methods and ResultsWe assessed the association between FPG and HF risk in a population-based cohort of 1,740 men aged 42-61 years who were free from HF or diabetes at baseline. During a mean follow-up of 20.4 years, 146 participants developed HF. In age-adjusted analysis, the hazard ratio (HR) for HF per 1 mmol/L increase in FPG was 1.34 (95% confidence interval 1.22–1.48). This association persisted after adjusting for established HF risk factors: HR 1.27, 95% confidence interval 1.14–1.42. The findings remained consistent across several clinical subgroups and in analyses excluding incident coronary heart disease or diabetes during follow-up. In a meta-analysis of 10 prospective studies involving 4,213 incident HF cases, the HR for HF per 1 mmol/L increase in FPG level was 1.11 (95% confidence interval 1.04–1.17), with evidence of heterogeneity between studies (I2 = 79%; 95% confidence interval 63%–89%; P < .001). The corresponding HR was 1.12 (95% confidence interval 1.08–1.18) on exclusion of the single study that accounted for the heterogeneity. ConclusionsThere exists a positive, continuous, and independent association between FPG and risk for HF. Studies are warranted to evaluate the causal relevance of these findings.

Effects of levonorgestrel-releasing intrauterine system on glucose and lipid metabolism: a 1-year follow-up study

Purpose This prospective study aimed to assess the possible effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) on serum lipids and fasting blood glucose levels over a period of 1 year. Methods Forty-eight premenopausal women, attending our gynecology clinic with the complaint of menorrhagia, were enrolled in the study. Systolic and diastolic blood pressures were recorded. Serum concentrations of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and fasting plasma glucose (FPG) levels were tested before (pretreatment group) and 1 year later following insertion (on-treatment group). Baseline mean parameters were compared with mean parameters at 1 year for statistical significance using paired samples t-test. Results Thirty-three (68.75%) women were eligible for control in the on-treatment group. Mean age of the patients was 44.34±7.59 years. The study results showed that mean FPG level was significantly increased, whereas mean diastolic blood pressure was significantly decreased. Although mean systolic blood pressure tended to decrease and HDL-C concentrations to increase, these changes from baseline levels were insignificant. There were no significant changes in mean TG, TC, VLDL, LDL, AST and ALT. Discussion The only significant unfavorable effect observed was an increase in FPG level. Since it did not rise to risky values, but alerted us for the high risk patients for glucose intolerance before insertion. The LNG-IUS can be regarded as being safe in their effects on lipid metabolism, blood pressure and liver function tests.