Prediabetes Research Articles

Protocol for the combined cardiometabolic deep phenotyping and registry-based 20-year follow-up study of the Inter99 cohort

IntroductionThe population-based Inter99 cohort has contributed extensively to our understanding of effects of a systematic screening and lifestyle intervention, as well as the multifactorial aetiology of type 2 diabetes (T2D)...

Characteristics and Clinical Outcomes of COVID-19 Patients with Hyperglycemia: Retrospective Cohort Study from a COVID-19 Referral Hospital, Bandung, Indonesia

Background: COVID-19 often causes severe complications in patients with metabolic disorders such as diabetes mellitus. On the other hand, inflammation caused by infection may also trigger insulin resistance resulting in hyperglycemia and related to disease severity. This study aimed to describe the characteristics and clinical outcomes of COVID-19 patients with hyperglycemia at one of the COVID-19 referral hospital in Bandung, Indonesia.Methods: This study was a retrospective cohort study using secondary data from medical records of COVID-19 patients admitted to Dr. Hasan Sadikin General Hospital from March 2020 to March 2021. This study included all patients with confirmed COVID-19, aged >18 years, and had at least one blood glucose test at admission. Patients were grouped based on three possible types of hyperglycemia namely diabetes mellitus, reactive hyperglycemia, and steroid-induced hyperglycemia, and then compared their characteristics and disease outcomes.Results: This study identified 1,114 patients’ medical records and included 1,013 data in the analysis. Hyperglycemia occurred in 45.1% of COVID-19 patients. The most common hyperglycemia types were diabetes mellitus (55.7%), reactive hyperglycemia (37.4%), and steroid-induced hyperglycemia (7%). The steroid-induced hyperglycemia group had similar characteristics as the diabetes group. The reactive hyperglycemia group exhibited a metabolic syndrome pattern resembling pre-diabetic conditions. The highest rates of severe disease and mortality were seen in the steroid-induced hyperglycemia group, followed by the diabetes group.Conclusion: There is an elevated prevalence of hyperglycemia in COVID-19 patients with diabetes. The steroid-induced hyperglycemia group has the most unfavorable outcomes. These observations emphasize the importance of identifying hyperglycemic conditions to improve management and outcomes.

Patterns of dyslipidemia and its associated factors among prediabetic subjects. A cross-sectional study at a primary care clinic.

Diabetes is closely linked to cardiovascular diseases, with diabetic dyslipidaemia serving as an established marker of the acceleration of complications, contributing to an increased cardiovascular risk among patients. Timely detection and early characterization of lipid abnormalities can help clinicians in implementing effective preventive measures. This study aimed to determine the patterns and associated factors of dyslipidaemia among Malaysian subjects with borderline diabetes. A retrospective study was conducted among subjects with borderline diabetes aged ≥18 years who visited a primary healthcare centre at Universiti Sains Malaysia from January 2017 to December 2018. Sociodemographic, clinical and laboratory data were obtained from electronic medical records. Data were analysed using SPSS version 25. A total of 250 participants with borderline diabetes were included in the analysis. Of them, 93.6% (n=234) had lipid abnormalities. Isolated dyslipidaemia characterised by a high low-density lipoprotein cholesterol (LDL-C) level (38.8%, n=97) was the most common pattern found, followed by combined dyslipidaemia of high LDL-C and triglyceride (TG) levels (22.8%, n=57). The male sex was found to be significantly associated with hypertriglyceridemia (adjusted odds ratio [AOR] = 1.86, 95% confidence interval [CI] =1.09-3.1)(P=0.02). Diastolic blood pressure ≥90mmHg was significantly associated with a low HDL-C level (A0R=2.09, 95% CI=1.0-4.1) (P=0.03). The majority of subjects with borderline diabetes have lipid abnormalities. Specifically, isolated dyslipidaemia characterised by a high LDL-C level is alarmingly prevalent. Further large-scale robust studies are needed to confirm the present findings.

Prediabetes-Associated Changes in Skeletal Muscle Function and Their Possible Links with Diabetes: A Literature Review.

The skeletal muscle plays a critical role in regulating systemic blood glucose homeostasis. Impaired skeletal muscle glucose homeostasis associated with type 2 diabetes mellitus (T2DM) has been observed to significantly affect the whole-body glucose homeostasis, thereby resulting in other diabetic complications. T2DM does not only affect skeletal muscle glucose homeostasis, but it also affects skeletal muscle structure and functional capacity. Given that T2DM is a global health burden, there is an urgent need to develop therapeutic medical therapies that will aid in the management of T2DM. Prediabetes (PreDM) is a prominent risk factor of T2DM that usually goes unnoticed in many individuals as it is an asymptomatic condition. Hence, research on PreDM is essential because establishing diabetic biomarkers during the prediabetic state would aid in preventing the development of T2DM, as PreDM is a reversible condition if it is detected in the early stages. The literature predominantly documents the changes in skeletal muscle during T2DM, but the changes in skeletal muscle during prediabetes are not well elucidated. In this review, we seek to review the existing literature on PreDM- and T2DM-associated changes in skeletal muscle function.

A novel marker for prediabetic conditions: Uric acid-to-HDL cholesterol ratio.

The objective of this study was to identify aparameter that can facilitate the diagnosis of prediabetes and predict the likelihood of its development in individuals at high risk. In this retrospective study, the study population was selected from Bolu Abant Izzet Baysal University Hospital's patients. Participants were divided into two groups, prediabetes and healthy group. We excluded individuals with certain conditions or taking certain medications. The study compared the ratios of uric acid to high-density lipoprotein (HDL) between the two groups and identified the optimal point of differentiation. The study analyzed data from 228 individuals, including 125 with prediabetes and 103 healthy controls. Those with prediabetes had asignificantly higher median UHR (0.13 (0.07-0.24)%) compared to healthy individuals (0.09 (0.05-0.16)%) (p < 0.001). Higher UHR values were associated with agreater risk of prediabetes. AUHR cut-off points greater than 0.11% had asensitivity of 74% and specificity of 69% in detecting prediabetes. The study provides evidence that UHR can serve as apractical and valuable diagnostic and screening tool for prediabetes (Tab. 2, Fig. 1, Ref. 23). Text in PDF www.elis.sk Keywords: serum uric acid, HDL cholesterol, UHR, prediabetes.

Short communication: Nutrient intake and total caloric intake are not entirely proportionate to metabolic disease prevalence

BackgroundDietary composition has been brought up as one of the main causes of the dramatic rise of metabolic disease over the past years. Intake of specific (macro)nutrients such as fat and sugar have been associated with higher risk of metabolic syndrome, as well as a general excessive energy intake. In a previous study, we investigated trends in (macro)nutrient intake and metabolic disease in the United States, but total caloric intake was not addressed. MethodsIn this follow-up study, data on total caloric intake per capita per day was collected for the United States from 1900 until now. Total caloric intake was also calculated based on previously collected data on nutrient intake per capita per day. Trends were visualized and statistically compared with data previously collected regarding metabolic syndrome, obesity, and diabetes. ResultsIt was found that total caloric intake has risen considerably, from approximately 3200 in the year 1900 to nearly 4000 from the year 2000 until now. The caloric intake did not correlate with the trends in metabolic disease prevalence, except for diagnosed (pre)diabetes. ConclusionsAs highlighted in our previous work, there is a discrepancy between nutrient and caloric intake and the steep rise in metabolic disease. This suggests that there are other factors that need to be addressed in future studies, in addition to excess nutrient and energy intake, as suspected causes of the metabolic disease epidemic.

Nonenzymatic Glucose Sensor Using Bimetallic Catalysts.

Bimetallic glucose oxidation electrocatalysts were synthesized by two electrochemical reduction reactions carried out in series onto a titanium electrode. Nickel was deposited in the first synthesis stage followed by either silver or copper in the second stage to form Ag@Ni and Cu@Ni bimetallic structures. The chemical composition, crystal structure, and morphology of the resulting metal coating of the titanium electrode were investigated by X-ray diffraction, energy-dispersive X-ray spectroscopy, X-ray photoelectron spectroscopy, and electron microscopy. The electrocatalytic performance of the coated titanium electrodes toward glucose oxidation was probed using cyclic voltammetry and amperometry. It was found that the unique high surface area bimetallic structures have superior electrocatalytic activity compared to nickel alone. The resulting catalyst-coated titanium electrode served as a nonenzymatic glucose sensor with high sensitivity and low limit of detection for glucose. The Cu@Ni catalyst enables accurate measurement of glucose over the concentration range of 0.2-12 mM, which includes the full normal human blood glucose range, with the maximum level extending high enough to encompass warning levels for prediabetic and diabetic conditions. The sensors were also found to perform well in the presence of several chemical compounds found in human blood known to interfere with nonenzymatic sensors.

The Emerging Role of Prediabetes and Its Management: Focus on L-Arginine and a Survey in Clinical Practice.

The worldwide impressive growth of metabolic disorders observed in the last decades, especially type 2 diabetes mellitus and obesity, has generated great interest in the potential benefits of early identification and management of patients at risk. In this view, prediabetes represents a high-risk condition for the development of type 2 diabetes mellitus and cardiovascular diseases, and an ideal target to intercept patients before they develop type 2 diabetes gaining a prominent role even in international guidelines. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention, with evidence of about 50% relative risk reduction. Accumulating data also show potential benefits from pharmacotherapy. In this context, the only available data pertain to metformin as a pharmaceutical drug and vitamin D and L-arginine as nutraceuticals. L-arginine appears to be a very interesting tool in the clinical management of patients with pre-diabetes. In this review we summarize the current knowledge on the role of L-arginine in prediabetes as a potentially useful preventive strategy against the progression to type 2 diabetes, with a particular focus on the underlying molecular mechanisms and the past and ongoing trials. In this article we also report the interesting data about the perception of the prediabetic condition and its therapeutic management in the clinical practice in Italy. An early identification and a prompt management of people with prediabetes appears to be of paramount importance to prevent the progression to diabetes and avoid its cardiovascular consequences.

Lower serum carotenoid levels are associated with incident cognitive decline independent of traditional risk factors in a prospective study of older men from Northern Ireland

AbstractBackgroundNutritional influences, and antioxidant status in particular, have been implicated in the aetiology of cognitive decline. This study investigated the neuroprotective effects of serum antioxidants in a prospective cohort of older men to identify associations with cognitive outcomes, independent of traditional risk factors.MethodThis cohort study included 873 Northern Irish men nested within PRIME (Prospective Epidemiological Study of Myocardial Infarction) who were followed‐up for at least 15 years. Mini Mental State Examination (MMSE) was carried out at baseline. The Addenbrooke’s Cognitive Examination‐R and MMSE were carried out at follow‐up. A consensus diagnosis of normal cognition for age, mild cognitive impairment (MCI) or dementia was made using accepted clinical criteria. Serum concentrations of retinol, two forms of vitamin E (α‐ and ϒ‐tocopherol) and six carotenoids measured from baseline samples were quantified by high‐performance liquid chromatography and assessed by multiple logistic regression analyses.ResultThe case definition included the 163 men characterised with MCI and 46 men with dementia; 664 participants were considered cognitively normal controls (Table 1). In unadjusted analyses, serum levels of the carotenoids α‐carotene, β‐carotene, lycopene and β‐cryptoxanthin were significantly lower in MCI/dementia cases than controls, in contrast to ϒ‐tocopherol, which was significantly higher (Table 2). Following adjustment for traditional risk factors including height, APOε4 genotype, diastolic blood pressure, smoking status and the presence of (pre)diabetes or depression, the effect size of those carotenoids significant in the unadjusted analysis was attenuated somewhat; only α‐carotene remained significantly associated with MCI/dementia (odds ratio = 0.55; confidence interval: 0.31‐0.99; Table 2).ConclusionOur data implicates lower levels of serum carotenoids as potential early biomarkers of MCI/ dementia before overt manifestation of symptoms, independent of traditional risk factors. These findings are consistent with hypotheses supportive of a neuroprotective role of dietary antioxidants and corroborate previous associations of higher serum carotenoid levels with better cognition in aging subjects. There is emerging evidence that carotenoids, through their potent antioxidant and anti‐inflammatory properties, may positively impact cognitive function. Limiting cognitive decline through lifestyle, exercise, and a higher carotenoid intake, may prove beneficial.

Adults' perceived health promotion needs in the prediabetes stage: a meta-synthesis study.

One of the methods to promote pre-diabetic patients' adherence to preventive behaviors and improving their lifestyle is to pay attention to their needs in the designed educational programs. Therefore, this study was conducted with the aim of identifying the needs of individuals with prediabetes. Three databases, including ISI/Web of Sciences, PubMed, Scopus were searched without time limitation until August 2022. The quality of the included studies was assessed using the Critical Appraisal Skills Programme tool. This study was reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines and to achieve the research goal, Sandelowski and Barroso's seven-step meta-synthesis method (2007) was used. Thematic synthesis was used to analyses the data. Out of the 1934 studies obtained, 34 studies were finally examined and 805 codes were recorded based on the extracted data. Through synthesizing and analyzing the primary studies, 8 main themes were extracted regarding individuals' needs in the prediabetes stage: Information needs, Cultural needs, psychological needs, Social support needs, Education needs, Financial needs, Service needs and Skill needs. The perceived needs and their types in each of the dimensions in detail can be a proper guide for designing educational programs and various interventions to control the prediabetes condition, leading to a reduction in the prevalence of type 2 diabetes in the society.

Cognitive deficits among people with schizophrenia and prediabetes or diabetes.

Both type 2 diabetes mellitus (T2DM) and schizophrenia are known to be associated with cognitive deficits. The impact of the comorbidities of T2DM or prediabetes (PD) on cognition among people with schizophrenia has been poorly researched. We evaluated the cognitive functioning of patients with schizophrenia and PD or T2DM and compared them to patients with schizophrenia with normal blood sugar. We retrospectively collated data on cognition, fasting blood glucose (FBG), lipids and other selected demographic and clinical variables of 171 patients with schizophrenia and 16 patients with schizoaffective disorder who were admitted to an inpatient rehabilitation facility in Western Australia from 2011 to 2018. The Brief Assessment of Cognition in Schizophrenia (BACS) was used to evaluate cognitive functioning. Parametric and non-parametric analyses were used to examine the study's aims. Sixty-six percent of the patients had normal blood sugar, 25% had PD and 9% had T2DM. The BACS composite score revealed an increasing gradient of cognitive deficits, ranging from mild to severe, between the normal, PD and T2DM groups, respectively. The T2DM group had a significantly lower composite score compared with the PD (p = 0.026) and normal groups (p < 0.001). On the BACS subtests, the scores of T2DM and PD patients were similar except for the token motor task, in which the T2DM group had significantly lower scores (p < 0.001). The T2DM group also had lower scores on the subtests of BACS, except memory tests, compared with those with normal blood sugar. There was no significant difference in the composite and subtest cognitive scores between the PD and normal groups. Our study revealed more pronounced cognitive deficits among patients with schizophrenia and dysglycaemia, particularly those with T2DM, compared with those with schizophrenia with normal blood sugar.

The risk of severe coronary artery disease in prediabetes among the hypertensions --UPPDATE STUDY

Abstract Backgrounds and Objectives Hypertension and type 2 diabetes (DM) have become the major public health problems around the world and the concurrence of both diseases leads to more than triple risks developing ASCVD. However, in addition to type 2 diabetes, the diagnosis and treatment of prediabetes (preDM) status acquires more attention in these years. Among these issues, the risks of severe coronary artery disease in prediabetes concurrent with hypertension remains unknown. We sought to evaluate the association of prediabetes and severe coronary artery disease in hypertensions and to propose treatment suggestions using UPPDATE study data. Methods The national cross-sectional study-UPPDATE comprised of 8548 eligible hypertension subjects from 36 cities in China during 2017 to 2019. After consent form assigned, all enrolled hypertensives would undergo a clinical survey and clinical assessment, patients were also required to provide biomedical reports within one-year from his/her visit to outpatient department. Patients with severe coronary stenosis was defined as more than 70% stenosis in more than one coronary artery and underwent percutaneous coronary intervention (PCI). Diagnosis of preDM was based on patients’ HA1bc level ranging from 5.7% to 6.4%. Stata 13.0 was used for statistical analysis. Results Among 8548 hypertensives, 20.38% were diagnosed with diabetes and treated on hypoglycemic therapy,19.2% with HA1bc recorded (1658) can be classified into preDM according to previous definition. 1.76% of 4268 patients who reported ASCVD history had PCI before and 1123 of them provide HA1bc data within one-year from visit. Compared with patients without diabetes, preDM(Odds ratio 6.27, p=0.09 (95%CI 0.81-52.82)) and DM(Odds ratio 5.72, p=0.12 (95%CI 0.62-51.14)) showed significant association with severe coronary artery disease with PCI treatment. 63% preDM and 73% DM patients were undergoing anti-lipid therapy (p&amp;lt;0.05) and LDL-C level was 2.81±0.69mmol/L and 2.79±0.51mmol/L respectively (p=0.82). In multivariate regression analysis, systolic and diastolic blood pressure greater than 140mmHg and 80mmHg had higher risks of PCI treatment in preDM patients compared with the hypertensives without DM. Conclusion Compared with patients without diabetes, hypertension patients with preDM were associated with higher risks of severe coronary artery disease. Systolic and diastolic blood pressure should be controlled more strictly in preDM patients with hypertension to prevent severe coronary artery disease.

Improving pharmaceutical practice in diabetes care using point-of-care glycated haemoglobin testing in the community pharmacy.

To evaluate the use of point-of-care testing to detect new cases of diabetes mellitus at a Brazilian public community pharmacy. This cross-sectional study included individuals without a previous diagnosis of diabetes mellitus who met the criteria for screening according to the Brazilian Diabetes Society, which were identified during their presence at a Brazilian public community pharmacy. The measurements of HbA1c were performed using a Cobas b101 device (Roche Diagnostics) and were categorized according to the following classification established by the Brazilian Society of Diabetes: HbA1c <5.7%, normal; HbA1c between 5.7% and 6.4%, pre-diabetes; and HbA1c >6.4%, new diagnosis of T2DM. One hundred and eight users met the inclusion criteria. The patients' mean age was 54.4 (± 15.4) years old, ranging from 22 to 80 years old. Eighty (74.1%) participants presented with glycated haemoglobin levels over the standard threshold, of which 58 (72.5%) were in the pre-diabetes range (glycated haemoglobin levels between 5.7% and 6.4%), and 22 (27.5%) had glycated haemoglobin levels >6.4%, which corresponds to a new diagnosis of type 2 diabetes mellitus. The use of point-of-care glycated haemoglobin testing allowed community pharmacists at a Brazilian public community pharmacy to identify health system users with glycated haemoglobin alterations that corresponded to the pre-diabetes state or a new diagnosis of type 2 diabetes mellitus. This presented a good opportunity to refer these users to diabetes diagnosis and treatment services.

The role of fibrinolysis in the development of prediabetes-associated coronary heart disease: a focus on the plasminogen activator inhibitor -1 and its potential use as a predictive marker in diet-induced prediabetes.

Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiovascular diseases (CVD). However, the onset of T2DM is preceded by prediabetes, which is associated with sedentary lifestyles and consumption of high-calorie diets. Studies have shown that impaired glucose homeostasis creates an environment for developing T2DM-related complications. Using a high-fat-high-carbohydrate diet-induced prediabetes animal model, this study sought to assess the risk factors of coronary heart disease (CHD) in diet-induced prediabetes and identify biomarkers that can be used for early detection of prediabetes-associated CHD. Male Sprague Dawley rats were randomly grouped into two groups and were kept on different diets for 20 weeks (n = 6 in each group). One group was fed standard rat chow to serve as a non-prediabetes (NPD) control, while the other group consumed a high-fat-high-carbohydrate diet to induce prediabetes (PD). Post induction, the homeostasis model assessment- insulin resistance (HOMA-IR) and glycated haemoglobin (HbA1c) was used to test for insulin resistance. Body weight, mean arterial pressure (MAP), resting heart rate (HR), inflammatory cytokines (C-reactive protein (CRP), tumor necrosis factor (TNF-α), interleukin-6 (IL-6)), lipids (total cholesterol (TC), triglyceride (TG), lipoproteins (HDL, LDL, VLDL)), endothelial function (endothelial nitric oxide (eNOS), endothelin -1 (ET-1)), fibrinolysis (plasminogen activator inhibitor-1 (PAI-1)) were all measured to assess the risk of CHD. All data were expressed as means ± S.E.M. Statistical comparisons were performed with Graph Pad. Instat Software using Student's two-sided t-test. The Pearson correlation coefficient and linear regression were calculated to assess the association. The value of p < 0.05 was considered statistically significant. There was significant insulin resistance accompanied by significantly increased HbA1c and body weight in PD compared to NPD. Simultaneously, there was a significant increase in inflammatory cytokines in PD compared to NPD. This was accompanied by significantly increased TG and VLDL and endothelial dysfunction in PD. The association between HOMA-IR and PAI-1 was insignificantly positive in NPD, whereas a significantly strong positive association was observed in PD. There is a positive correlation between insulin resistance and PAI-1 during prediabetes; therefore, suggesting that prediabetes increases the risk of developing vascular thrombosis. The current therefore study warrants further investigation on PAI-1 and other markers of fibrinolysis for the early detection of thrombosis and risk of CHD in prediabetes.

Study of HbA1c levels in non-diabetic individuals recovered from Covid-19.

To study the glycemic control by estimating HbA1c levels among previously non-diabetic individuals aged above 40 years, who recovered from coronavirus disease 2019 (Covid-19) infection. This is an analytical cross-sectional study of people affected with Covid-19 infection, who were home-isolated, hospitalized, and discharged. The simple random sampling technique was used for the study group. Tirupati City, Andhra Pradesh State, India. We assessed socio-demographic profiles, hba1c levels, RBS, and severity of infection. The obtained laboratory reports were analyzed by using means and proportions after entering data in MS Excel and converted to SPSS software new version. The study participants comprised mostly middle age group males and females (mostly 40-60 years, with 60% of them being females). Most of the study subjects were healthy, and 58% of them have normal hba1c levels. 32% of them are in border line diabetic. The prevalence of diabetes post Covid-19 infection is 10%. The majority of participants have normal random blood sugar levels (around 92%), and very less individuals have abnormal random blood sugar levels (2% of the subjects). There is no significant association between hypertension and raised blood sugar levels post Covid-19 infection. Based on the study, Covid-19 infection has an impact on blood sugar levels and altered glycemic control, switching a few individuals into diabetic and a significant number of individuals into the pre-diabetic state, who are non-diabetic individuals before Covid-19 infection.

A Clinical Study of Nisha Amalaki Churna in Prameha Purvarupa (Pre-Diabetic State)

The incidence of Prameha is increasing rapidly because of changes in dietetic habits and lifestyle. If the Prameha Purvarupa (Pre-diabetic) clinical features are treated by formulation Nisha-amalaki Churna is recommended in Ayurvedic Classics, Proven efficacious and widely practiced in the management of Prameha (Diabetes). Materials and methods- 30 patients from OPD and IPD of Govt. Ayurvedic College &amp; Hospital, Balangir, fulfilling the Subjective and Objective Parameters were registered for clinical trial. After diagnosis they were under trial with Ayurvedic formulation Nisha-amalaki Churna treated in a dose of 3gm twice daily empty stomach, for a period of 30 days with Ushna Jala. The assessment of subjective and objective parameters were evaluated in 10th, 20th and 30th day from the day of initiation of trial up to 30 days in order to find the efficacy of the trial by statistical paired ‘t’ test

Identification of MicroRNAs Associated with Prediabetic Status in Obese Women.

MicroRNAs (miRNAs) recently emerged as means of communication between insulin-sensitive tissues to mediate diabetes development and progression, and as such they present a valuable proxy for epigenetic alterations associated with type 2 diabetes. In order to identify miRNA markers for the precursor of diabetes called prediabetes, we applied a translational approach encompassing analysis of human plasma samples, mouse tissues and an in vitro validation system. MiR-652-3p, miR-877-5p, miR-93-5p, miR-130a-3p, miR-152-3p and let-7i-5p were increased in plasma of women with impaired fasting glucose levels (IFG) compared to those with normal fasting glucose and normal glucose tolerance (NGT). Among these, let-7i-5p and miR-93-5p correlated with fasting blood glucose levels. Human data were then compared to miRNome data obtained from islets of Langerhans and adipose tissue of 10-week-old female New Zealand Obese mice, which differ in their degree of hyperglycemia and liver fat content. Similar to human plasma, let-7i-5p was increased in adipose tissue and islets of Langerhans of diabetes-prone mice. As predicted by the in silico analysis, overexpression of let-7i-5p in the rat β-cell line INS-1 832/12 resulted in downregulation of insulin signaling pathway components (Insr, Rictor, Prkcb, Clock, Sos1 and Kcnma1). Taken together, our integrated approach highlighted let-7i-5p as a potential regulator of whole-body insulin sensitivity and a novel marker of prediabetes in women.

Prediabetes and lifestyle habits in Reunion Island: Need for targeted interventions

Abstract Background Prediabrun is a cohort study of prediabetic patients settled in primary care in Reunion Island, focusing on the transition to diabetes. This study aimed to analyze the lifestyle habits of the first 330 prediabetics included. Methods A dietary score was calculated from the food frequency questionnaire to assess the adherence of participants to the National Nutrition and Health Plan 4 (PNNS-4) recommendations (-14 to 13.25). Physical activity was classified according to the WHO recommendation of 30 minutes of moderate activity per day. Results The mean dietary score of the participants was 3.7 with an equal distribution of patients between ‘moderately close’ and ‘close’ adherence to PNNS-4 recommendations. Although the average perception of their dietary balance (6/10) seemed consistent with the mean dietary score, there was no correlation between the two variables. The main discrepancies concerned fruits and vegetables consumption: only 2.4% consumed at least five fruits or vegetables per day, and less than half at least one. About 9/10 prediabetic subjects declared 30 minutes of physical activity per day, mainly consisting of walking, and housework. Prior knowledge of prediabetes had no impact on the lifestyle habits. Discussion Effective management of prediabetes requires a balanced diet and regular physical activity to avoid evolution to diabetes. These study results highlight the necessity of lifestyle interventions to assist prediabetic patients in modifying their habits. While subjects perceived their dietary balance to be adequate, they did not comply with dietary recommendations, regardless of their knowledge of their prediabetic condition. This indicates the need for specific dietary and physical activity support, easily accessible that can be prescribed by physicians and reimbursed by the national healthcare system. Key messages • Prediabetics in Reunion Island need targeted lifestyle interventions to improve adherence to dietary recommendations. • Prediabetic patients in Reunion Island require specific dietary and physical activity support, easily accessible and reimbursed by the national healthcare system.

The Efficacy of Medical Check-up Programs in Screening Healthy, Asymptomatic Individuals: A Cross-Sectional Study

Aim: Healthy asymptomatic individuals can be screened for various diseases using medical check-up programs. On the other hand, the prevalence of diabetes mellitus (DM) and prediabetes (PD), which are common metabolic disorders, are increasing worldwide. In this context, this study aims to determine the prevalence of DM and PD among the asymptomatic participants of a medical check-up program.&#x0D; Material and Methods: The population of this cross-sectional study consisted of 440 healthy, asymptomatic volunteers aged 40 years or older who attended a medical check-up program conducted between January and August 2021. Patients with confirmed morbidities or regular medication use and pregnant women were excluded from the study. All study participants underwent physical examination, laboratory test, and sonographic assessment. The study participants were grouped according to their glycemic states, i.e., DM, PD, and normoglycemia (NG). The study's primary outcomes were the prevalence of DM and PD. &#x0D; Results: The prevalence of DM and PD among the study participants was 12.5% (n=55) and 58.9% (n=259), respectively. The number of males was significantly higher in Group DM than in Groups PD and NG (p=0.014). Additionally, Group DM was significantly older than Groups PD and NG (p0.05 for all cases).&#x0D; Conclusion: The prevalence of DM and PD in presumed healthy asymptomatic participants was 12.5% and 58.9%, respectively, indicating unusually high prevalence in this population. In conclusion, the results of this study demonstrate that it is imperative that presumed healthy individuals are screened within the scope of medical check-up programs and followed closely afterward.

A retrospective study of people with familial hypercholesterolaemia in a Belgian lipid clinic

Background Familial hypercholesterolaemia (FH) is a genetic disease characterised by hypercholesterolaemia and premature cardiovascular events. Early diagnosis and treatment can reduce the cardiovascular burden. We describe the characteristics of patients with heterozygous FH followed in a tertiary hospital in Belgium. Methods We retrospectively studied a population of 321 patients with definite heterozygous FH who visited the UZ Leuven lipid clinic at least once between 1 January 2016 and 31 December 2020. Data are represented as mean ± SD. Results The age at time of diagnosis of FH was 39 ± 18 years. Patients with atherosclerotic disease (secondary prevention) were older (p < .001), more often male (p < .001), had a higher body mass index (p < .001), prevalence of (pre)diabetes (p < .001) and hypertension (p < .001) and had lower levels of low-density lipoprotein-cholesterol (LDL-C) (p < .001) than individuals without atherosclerotic disease (primary prevention). The average LDL-C in both primary (109 ± 53 mg/dL) and secondary (81 ± 63 mg/dL) prevention did not meet the targets of LDL-C as proposed by the 2019 ESC/EAS guidelines for the management of dyslipidaemias. However, LDL-C levels in the subgroup of patients treated with PCSK9 inhibition therapy, and especially in the triple therapy group (combination of statin, ezetimibe and PCSK9 inhibitor), were markedly lower (p < .001). Conclusions In this Belgian population, people with heterozygous FH remain undertreated. Reaching treatment targets in FH seems possible, although this requires combination treatment (with PCSK9-targeted therapy) in most patients. Earlier diagnosis of FH, more extensive lipid-lowering treatment and reimbursement options and a more holistic approach are needed to lower LDL-C and cardiovascular risk in patients with FH.