Presence Of Impaired Fasting Glucose Research Articles

Diabetes risk and provision of diabetes prevention activities in 44 low-income and middle-income countries: a cross-sectional analysis of nationally representative, individual-level survey data

The global burden of diabetes is rising rapidly, yet there is little evidence on individual-level diabetes prevention activities undertaken by health systems in low-income and middle-income countries (LMICs). Here we describe the population at high risk of developing diabetes, estimate diabetes prevention activities, and explore sociodemographic variation in these activities across LMICs. We performed a pooled, cross-sectional analysis of individual-level data from nationally representative, population-based surveys conducted in 44 LMICs between October, 2009, and May, 2019. Our sample included all participants older than 25 years who did not have diabetes and were not pregnant. We defined the population at high risk of diabetes on the basis of either the presence of impaired fasting glucose (or prediabetes in countries with a haemoglobin A1c available) or overweight or obesity, consistent with the WHO Package of Essential Noncommunicable Disease Guidelines for type 2 diabetes management. We estimated the proportion of survey participants that were at high risk of developing diabetes based on this definition. We also estimated the proportion of the population at high risk that reported each of four fundamental diabetes prevention activities: physical activity counselling, weight loss counselling, dietary counselling, and blood glucose screening, overall and stratified by World Bank income group. Finally, we used multivariable Poisson regression models to evaluate associations between sociodemographic characteristics and these activities. The final pooled sample included 145 739 adults (86 269 [59·2%] of whom were female and 59 468 [40·4%] of whom were male) across 44 LMICs, of whom 59 308 (40·6% [95% CI 38·5-42·8]) were considered at high risk of diabetes (20·6% [19·8-21·5] in low-income countries, 38·0% [37·2-38·9] in lower-middle-income countries, and 57·5% [54·3-60·6] in upper-middle-income countries). Overall, the reach of diabetes prevention activities was low at 40·0% (38·6-41·4) for physical activity counselling, 37·1% (35·9-38·4) for weight loss counselling, 42·7% (41·6-43·7) for dietary counselling, and 37·1% (34·7-39·6) for blood glucose screening. Diabetes prevention varied widely by national-level wealth: 68·1% (64·6-71·4) of people at high risk of diabetes in low-income countries reported none of these activities, whereas 49·0% (47·4-50·7) at high risk in upper-middle-income countries reported at least three activities. Educational attainment was associated with diabetes prevention, with estimated increases in the predicted probability of receipt ranging between 6·5 (3·6-9·4) percentage points for dietary fruit and vegetable counselling and 21·3 (19·5-23·2) percentage points for blood glucose screening, among people with some secondary schooling compared with people with no formal education. A large proportion of individuals across LMICs are at high risk of diabetes but less than half reported receiving fundamental prevention activities overall, with the lowest receipt of these activities among people in low-income countries and with no formal education. These findings offer foundational evidence to inform future global targets for diabetes prevention and to strengthen policies and programmes to prevent continued increases in diabetes worldwide. Harvard T H Chan School of Public Health McLennan Fund: Dean's Challenge Grant Program and the EU's Research and Innovation programme Horizon 2020.

#2858 EXERCISE AND PREDIABETES AFTER RENAL TRANSPLANTATION: THE EXPRED I STUDY

Abstract Background and Aims Post-Transplant Diabetes Mellitus (PTDM) is a severe disease that may affect about 30% of renal transplant patients. PTDM beyond 12 months (late PTDM) mostly develops in subjects with prediabetes. Although exercise may have a potential role in preventing late PTDM, there is scarce evidence on the effect of exercise in renal transplantation. We designed a 12-month exploratory study to test the capacity of therapeutic exercise in reverting prediabetes to prevent the development of late-PTDM. Method This is a pilot study in which renal transplant patients with prediabetes were treated with exercise for 12 months. To detect prediabetes and to evaluate the reversibility, relapse, or persistence of prediabetes, the oral glucose tolerance test (OGTT) was performed at baseline and every 3 months to the end of the study. Prediabetes was defined by the presence of Impaired Fasting Glucose (IFG) in 100-125 mg/dl and/or Impaired Glucose Tolerance (IGT) between 140-199 mg/dL after the OGTT. The protocol included a stepped incremental plan of aerobic and/or strength training. The frequency, intensity, and duration of aerobic exercise, as well as the addition of strength training depended on the recovery, persistence, or recurrence of prediabetes. All patients started with moderate aerobic exercise (brisk walking), 30 min/day and 5 times per week and, based on that, changes in prescription were considered every 3 months. Additionally, we evaluated: (a) an active plan for promoting adherence to exercise (telephone calls, digital technology, and visits) and (b) improvements in metabolic risk factors: obesity, dyslipidaemia, and blood pressure. Since prediabetes may spontaneously revert to normal glucose metabolism in 25-30% [1], we assume that in 60 cases, the spontaneous reversibility could be of 30% (n = 18) and the reversibility induced by exercise may account for another 30% (n = 18), so the total reversibility will be 60%. Considering an expected drop out of 20%, the number of cases necessary to include was 72 patients. Results The study was early interrupted due to efficacy after the evaluation of 27 patients that reach 12 months of follow-up. Mean age was 54.2 ± 9.6 and 67% were men. Half of the patients were obese and most had overweight. At baseline IGT or IFG alone were found, respectively, in 13 (48%) and 5 (19%) patients, and the combination of both in 9 (33%). All patients were on prednisone and tacrolimus with the addition of mycophenolate on 20 subjects and 7 on everolimus. Of the group, 16 (60%) reverted to normal glucose levels (fasting and 120 min after an OGTT): this was two time higher than the 30% reversibility rate shown in a previous publication [1], p <0.05, assuming a potency of 85%. In parallel, 11 (40%) subjects had prediabetes (9) or developed PTDM (2). No significant changes were found in weight during follow-up in all groups whereas triglycerides diminished in patients on whom prediabetes reverted (154 mg/dL ± 61 to 96 ± 27; p = 0.016). At the end of follow up, adherence to exercise was good (≥70%) in 13 patients (∼50%), moderate (40-70%) in 9 (∼30%) and bad (≤40%) in 5 (∼20%). Finally, all patients with good adherence reverted to normoglycaemia, 3 out of 9 (33%) cases with moderate reverted to normal glucose metabolism and no cases with bad adherence improved on follow-up. No relevant injuries attributed to exercise were observed during the study. Conclusion Therapeutic exercise is safe and effective to improve glucose metabolism in renal transplant patients with prediabetes. Adherence is a crucial aspect to consider in the planification of exercise treatment.

The Risk of Type 2 Diabetes Mellitus according to Changes in Obesity Status in Late Middle-Aged Adults: A Nationwide Cohort Study of Korea.

Although obesity is a well-known risk factor of type 2 diabetes mellitus (T2DM), there is scant data on discriminating the contribution of previous obesity and recent weight gain on developing T2DM. We analyzed the Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 where Korean residents underwent biennial health checkups. Participants were classified into four groups according to their obesity status (body mass index [BMI] ≥25 kg/m2) before and after turning 50 years old: maintaining normal (MN), becoming obese (BO), becoming normal (BN), and maintaining obese (MO). Cox proportional hazards regression model was used to estimate the risk of T2DM factoring in the covariates age, sex, BMI, presence of impaired fasting glucose or hypertension, family history of diabetes, and smoking status. A total of 118,438 participants (mean age, 52.5±1.1 years; men, 45.2%) were prospectively evaluated for incident T2DM. A total of 7,339 (6.2%) participants were diagnosed with T2DM during a follow-up period of 4.8±2.6 years. Incidence rates of T2DM per 1,000 person-year were 9.20 in MN, 14.81 in BO, 14.42 in BN, 21.38 in MO. After factoring in covariates, participants in the groups BN (adjusted hazard ratio [aHR], 1.15; 95% confidence interval [CI], 1.04 to 1.27) and MO (aHR, 1.14; 95% CI, 1.06 to 1.24) were at increased risk of developing T2DM compared to MN, whereas BO (hazard ratio, 1.06; 95% CI, 0.96 to 1.17) was not. Having been obese before 50 years old increased the risk of developing T2DM in the future, but becoming obese after 50 did not. Therefore, it is important to maintain normal weight from early adulthood to prevent future metabolic perturbations.

PSUN228 Incidence and Predictors of New Onset Diabetes After Transplant (NODAT) in Liver Transplant recipients.

Abstract Background NODAT (New onset Diabetes after Transplant) is associated with multiple complications in liver transplant recipients which has to be diagnosed and treated early to prevent graft failure, cardiovascular morbidity and mortality. With improvement in the care of liver transplant recipients, post-transplant survival has significantly increased. With improved survival, incidence of chronic rejection, Diabetes, Hypertension, Dyslipidemia, etc. complications incidence also increasing. Aims and Objectives To know the incidence and predictors of NODAT. Methodology This was a prospective study of non-Diabetic recipients who underwent Liver Transplantation at Yashoda Hospital, Secunderabad from January 2020 to May 2021. The follow-up duration was 6 months. Total 65 patients were enrolled after excluding recipients who were <18 years of age, were already having diabetes, whose survival was less than 6 months of transplantation and who were not of an Indian origin. All the relevant clinical and biochemical data were collected. Appropriate statistical tests were applied to compare NODAT and Non-diabetes groups (recipients who did not develop diabetes after liver transplantation) to know the predictors of NODAT. Diagnosis of NODAT was be established by the standard ADA guidelines using Fasting blood sugar (FBS), Post prandial blood sugar(PPBS) or HbA1C. Diagnosis of NODAT required the presence of one of the four parameters: (i) fasting blood glucose levels ≥ 126 mg/dL on two occasions OR (ii) Insulin therapy requirement for >= 30 days OR (iii) oral hypoglycemic agent use for ≥ 30 consecutive days OR (iv) HbA1c ≥ 6.5. Transient NODAT was defined as the resolution of hyperglycemia within 6 months of transplantation. Results Total incidence of NODAT in our study was 29.2%. Among them 47.36% were transient NODAT and 52.67% were persistent NODAT. Factors significantly associated with occurrence of NODAT were: Type of Transplant (Living donor liver transplant v/s Deceased donor liver transplant), Presence of Impaired fasting glucose (IFG), presence of post-operative hyperglycemia, lower pre-transplant Magnesium & Immediate post-operative Magnesium level, lower post-operative Albumin, higher trough Tacrolimus level at 3 Months, higher Tacrolimus and steroid dose at 3 months. Factors for which association with NODAT could not be found were: Age, Hepatitis C cirrhosis, alcoholic cirrhosis, pre-transplant BMI, baseline MELD score, pre-transplant FBS, donor age, donor gender, donor BMI, donor FBS & Hba1c, donor CT LAI (Liver Attenuation Index, L-S) value, Steroid dose at discharge, immediate post-op trough Tacrolimus level and use of Everolimus. CONCLUSION: NODAT is the significant entity to be addressed. A robust strategy should be in place for the screening of NODAT. Lower Magnesium levels, presence of pre-transplant IFG and post-operative hyperglycemia give an early opportunity for detection of NODAT. Minimizing Tacrolimus level and steroid dose could be an effective strategy for the prevention of NODAT. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

Increased values in total cholesterol and LDL cholesterol in “prediabetic” middle-aged and elderly adults with A1C between 5.7 and 6.4%

Background and Aims : Patients with “prediabetes” are defined by the presence of Impaired Fasting Glucose and/or Impaired Glucose Tolerance and/or HbA1c 5.7-6.4%. Although prediabetes should not be seen as a clinical entity per se, the risk of diabetes and cardiovascular disease (CVD) may be increased in this condition. The aim of this study was to evaluate whether slight changes in glycated hemoglobin may interfere with the cholesterol profile

CYP3A and CYP2B6 Genotype Predicts Glucose Metabolism Disorder among HIV Patients on Long-Term Efavirenz-Based ART: A Case-Control Study.

Long-term antiretroviral treatment (cART) increases the risk of glucose metabolism disorders (GMDs). Genetic variation in drug-metabolizing enzymes and transporters may influence susceptibility to cART-associated GMDs. We conducted a case-control study to investigate the association of pharmacogenetic variations with cART-induced GMDs. A total of 240 HIV patients on long-term efavirenz-based cART (75 GMD cases and 165 controls without GMDs) were genotyped for CYP3A4*1B, CYP3A5 (*3,*6), CYP2B6*6, UGT2B7*2, ABCB1 (c.3435C>T, c.4036A>G), and SLCO1B1 (*1b, *5). GMD cases were defined as the presence of impaired fasting glucose, insulin resistance, or diabetes mellitus (DM). Case-control genotype/haplotype association and logistic regression analysis were performed by adjusting for age, sex, and BMI. The major CYP3A haplotype were CYP3A5*3 (53.8%), CYP3A4*1B (17.3%), combinations of CYP3A4*1B, and CYP3A5*6 (10.9%), and CYP3A wild type (7%). CYP3A5*6 allele (p = 0.005) and CYP3A5*6 genotype (p = 0.01) were significantly associated with GMD cases. Multivariate analysis indicated CYP3A haplotype as a significant predictor of GMD (p = 0.02) and IFG (p = 0.004). CYP2B6*6 significantly predicted DM (p = 0.03). CYP3A haplotype and CYP2B6*6 genotype are independent significant predictors of GMD and DM, respectively, among HIV patients on long-term EFV-based cART.

COVID-19 pneumonia in patients with impaired fasting glucose, newly diagnosed diabetes and pre-existing diabetes: a tertiary center experience

COVID-19 infection is known to increase mortality in patients with diabetes. We aim to demonstrate the differences in disease course and clinical outcomes of patients with COVID-19 regarding the presence...

High level of fatty liver index predicts new onset of diabetes mellitus during a 10-year period in healthy subjects

Fatty liver index (FLI), a predictor of nonalcoholic fatty liver disease, has been reported to be associated with several metabolic disorders. This study aimed to evaluate the relationship between FLI and new onset of diabetes mellitus (DM). We investigated the association of FLI with new onset of DM during a 10-year period in subjects who received annual health examinations (n = 28,990). After exclusion of subjects with DM at baseline and those with missing data, a total of 12,290 subjects (male/female: 7925/4365) who received health examinations were recruited. FLI was significantly higher in males than in females. During the 10-year period, DM was developed in 533 males (6.7%) and 128 females (2.9%). Multivariable Cox proportional hazard models with a restricted cubic spline showed that the risk of new onset of DM increased with a higher FLI at baseline in both sexes after adjustment of age, fasting plasma glucose, habits of alcohol drinking and current smoking, family history of DM and diagnosis of hypertension and dyslipidemia at baseline. When the subjects were divided into subgroups according to tertiles of FLI level at baseline (T1–T3) in the absence and presence of impaired fasting glucose (IFG), hazard ratios after adjustment of the confounders gradually increased from T1 to T3 and from the absence to presence of IFG in both male and female subjects. In conclusion, a high level of FLI predicts new onset of DM in a general population of both male and female individuals.

MAFLD in Obese Children: A Challenging Definition.

Background: Recently, the new definition of Metabolic (dysfunction) associated fatty liver disease (MAFLD) has gained remarkable scientific interest. We aimed to evaluate the effectiveness of MAFLD definition in selecting obese children at higher cardiovascular risk. Methods: A total of 954 obese children and adolescents was retrospectively enrolled. Clinical, biochemical, and metabolic evaluations were performed. Hepatic steatosis was assessed by liver ultrasound. According to the metabolic status, the population was divided in three groups. Group 1 included obese patients without both non-alcoholic fatty liver disease (NAFLD) and metabolic dysregulation; group 2 included patients with obesity and NAFLD (then encompassing one MAFLD criterion); group 3 included patients with obesity, NAFLD and evidence of metabolic dysregulation (then encompassing more than 1 MAFLD criteria). Results: Patients of Group 3 showed a worse cardiometabolic profile, as also proven by the higher percentage of prediabetes (defined as the presence of impaired fasting glucose or impaired glucose tolerance) compared to other groups (p = 0.001). Conclusions: MAFLD criteria in obese children seem to be less accurate in identifying patients having an intrinsic higher cardiometabolic risk. This suggests the need for a more accurate definition in the context of pediatric obesity.

Hypertension Is Associated with Increased Risk of Diabetic Lung.

Lung function is often impaired in diabetic patients, especially in a restrictive pattern, which has recently been described as the diabetic lung. Since hypertension (HTN) is common in diabetic patients, our study investigated whether HTN acts as an aggravating factor in diabetic lung. Within the cross-sectional study from the 6th Korean National Health and Nutrition Examination Survey (KNHANES), fasting plasma glucose (FPG), blood pressure (BP), pulmonary function, and laboratory data were examined in 4644 subjects aged between 40 and 79 years. A multivariate regression model was used to investigate the relationship between BP, FPG, and pulmonary function. Lung function was significantly reduced in the HTN (p = 0.001), impaired fasting glucose (IFG) (p < 0.001), and diabetes mellitus (DM) (p < 0.001) groups. Next, a multivariate logistic regression model was used to derive the odds ratio (OR) of reduced lung function based on the presence of IFG, DM, and HTN. The OR of reduced forced vital capacity (FVCp < 80%) was 3.30 (p < 0.001) in the HTN-DM group and 2.30 (p < 0.001) in the normal BP-DM group, when compared with the normal BP-normal FPG group. The combination of HTN and DM had the strongest negative effect on FVC. The results presented in this study indicate that diabetes and hypertension have a synergistic association with impaired lung function.

833-P: Relationship between Prediabetes and Depression in Korean Adults

Objective: Currently, emotional well-being is becoming an increasingly important aspect of diabetes care and self-management. Routine screening for depressive symptoms is indicated in high-risk populations, including people with prediabetes and diabetes. However, a limited number of studies about the relationship between prediabetes and depression have been conducted in Asians. The aim of this study was to investigate the potential synergistic relationship between prediabetes and depression. Methods: This was a cross-sectional survey derived from the 2014 Korea National Health and Nutrition Examination Survey. 9-item Patient Health Questionnaire (PHQ-9) depression-screening test was used. Depression was defined as a score ≥10 on PHQ-9. Prediabetes was defined by the presence of impaired fasting glucose or A1c between 5.7 and 6.4%. Results: In total, 3848 subjects (1570 Men and 2278 women) aged 16 to 80 years without diabetes were studies. Among them, 1809 (47%) were prediabetes. The prevalence of depression was higher in the participants with prediabetes (4.7%) than without prediabetes (3.4%) (P&amp;lt;0.003). On multivariate logistic analyse, depression was significantly related with prediabetic participant with obesity (odds ratio (OR)= 3.103; 95% confidence interval (CI), 1.295-7.439). However, depression was not related with prediabeteic participant wit underweight (OR =1.001; CI, 0.662-1.514). Conclusion: This study shows the risk of depression in prediabetes with obesity. Future research is required to examine the mechanisms underlying the associations between prediabetes, mental health, and the risk of diabetes. Disclosure E. Jeon: None. S. Kim: None. J. Lee: None. H. Shon: None.

Atherogenic dyslipidemia increases the risk of incident diabetes in statin-treated patients with impaired fasting glucose or obesity

AimTo investigate which metabolic factors increase the risk of incident diabetes (T2D) in statin-treated patients. MethodsA retrospective study conducted in Greece including 1241 consecutive individuals with dyslipidemia attending a lipid clinic for ≥3 years. After defining associations with incident T2D, we assessed the risk of new-onset T2D based on the presence of impaired fasting glucose (IFG), atherogenic dyslipidemia, and overweight/obesity. ResultsAfter excluding 166 patients with baseline T2D and 193 subjects taking lipid-lowering therapy at the baseline visit, 882 participants were included in the study. Eleven percent (n=94) developed T2D during their follow-up (median 6 years; IQR: 4–10). Baseline patients’ age (OR: 1.05; 95% CI: 1.02–1.08, p<0.01), family history of diabetes (OR: 3.58; 95% CI: 1.86–6.91, p<0.01), IFG (OR: 6.56; 95% CI: 3.53–12.12, p<0.01), overweight/obesity (OR: 2.65; 95% CI: 1.39–5.05, p<0.01), atherogenic dyslipidemia (OR: 3.27; 95% CI: 1.50–7.15, p<0.01), and treatment with high-intensity statins (OR: 3.51; 95% CI: 1.89–6.51, p<0.01) were independently associated with increased risk of T2D in statin-treated patients. Among the IFG subjects, atherogenic dyslipidemia (OR: 3.44; 95% CI: 1.31–9.04, p=0.01) and overweight/obesity (OR: 2.54; 95% CI: 1.14–5.66, p<0.05) independently increased the risk of T2D. Among the overweight/obese ones, atherogenic dyslipidemia independently increased the risk of T2D (adjusted OR: 5.60; 95% CI: 2.19–14.30, p<0.01). ConclusionAtherogenic dyslipidemia appears to be an independent risk factor for new-onset T2D in statin-treated patients, while IFG, overweight/obesity and family history of diabetes remain risk factors for new-onset T2D in this group.

Circulating Netrin-1 as a Novel Biomarker for Impaired Fasting Glucose and Newly Diagnosed Type 2 Diabetes Mellitus

Aims/Hypothesis: Netrin-1 has been introduced as a neuronal guidance cue, acting as a chemoattractant and chemorepulsive force during axonal migration. In recent studies, netrin-1 was shown to play various roles including tissue regeneration and modulation of inflammatory action. Inflammation is one of the major contributing factors in the development of insulin resistance and type 2 diabetes (T2DM). However, little is known about the possible relationship between serum netrin-1 and the risk of T2DM. Therefore, we investigated the association between levels of netrin-1 and glycometabolic parameters. Methods: Serum samples were collected from a total of 218 individuals (41 normal controls, 85 subjects with impaired fasting glucose (IFG) and 92 subjects with newly diagnosed T2DM). Clinical and biochemical parameters were assessed after receiving consent. Netrin-1 levels were determined by commercial enzyme-linked immunosorbent assay. Spearman correlation analyses and multivariable-adjusted linear regression analyses were conducted to examine the relationship between serum netrin-1 levels and glycometabolic parameters. Results: Serum netrin-1 level in subjects with IFG or T2DM was significantly higher than in normal control subjects (mean netrin-1 level; normal, IFG and T2DM; 275.9, 436.6 and 441.0 pg/mL, respectively; p for trend &amp;lt;0.001). Serum netrin-1 levels had a significant positive correlation with fasting glucose, HbA1c, HOMA-IR, AST and ALT. Meanwhile, statistically inverse correlation was found between netrin-1 and HDL cholesterol and eGFR levels. In addition, Serum netrin-1 was independently associated with the presence of IFG or T2DM after adjusting covariates and potential confounders. In terms of the AUC, serum netrin-1 levels presented an AUC of 0.784 for the prediction of IFG or T2DM. Conclusions/Interpretation: Our results suggest that netrin-1 may be a new biomarker for early detection for IFG or T2DM (Clinical trial no. NCT02650830). Disclosure H. Jung: None. J. Bae: None. E. Han: None. G. Kim: None. J. Lee: None. S. Kim: None. B. Lee: None. E. Kang: None. C. Ahn: None. B. Cha: None. Y. Lee: None.

Association of Alcohol Drinking Patterns With Presence of Impaired Fasting Glucose and Diabetes Mellitus Among South Korean Adults.

BackgroundWe aimed to investigate the association between alcohol drinking patterns and the presence of impaired fasting glucose (IFG) and diabetes mellitus (DM).MethodsWe used data from the Korean National Health and Nutrition Examination Survey, 2010–2014. The participants were aged ≥30 years and had no previous diagnosis of DM. High-risk drinking was defined as alcohol consumption of ≥7 glasses at a sitting for men, and ≥5 glasses for women. After adjusting for confounding factors, a polychotomous logistic regression analysis was performed to assess the association of drinking patterns with IFG and DM.ResultsFor men, high-risk drinking was associated with higher odds ratios (ORs) of IFG (2–4/month, OR 1.51; 95% confidence interval [CI], 1.13–2.04; 2–3/week, OR 1.79; 95% CI, 1.38–2.33; and ≥4/week, OR 2.24; 95% CI, 1.65–3.03) and of DM (2–4/month, OR 2.12; 95% CI, 1.20–3.77; 2–3/week, OR 1.78; 95% CI, 1.05–3.03; and ≥4/week, OR 2.98; 95% CI, 1.72–5.17). For women, high-risk drinking was associated with higher risk of IFG (2–4/month, OR 1.51; 95% CI, 1.04–2.21; 2–3/week, OR 3.19; 95% CI, 2.20–4.64; and ≥4/week, OR 2.23; 95% CI, 1.23–4.06), but not of DM, compared with non-high-risk drinkers who consumed alcohol ≤1 day/month. Non-high-risk drinkers who consumed alcohol ≥4 days/week had higher ORs of DM in men, but lower ORs of DM in women compared with non-high risk drinkers who consumed alcohol ≤1 day/month.ConclusionsCompared with non-high-risk alcohol drinking, even occasional high-risk alcohol drinking was associated with a higher risk of IFG in men and women, and DM in men. Nearly daily non-high-risk alcohol drinking was associated with a higher risk of DM in men and lower risk of DM in women.

Prevalence of Pre-Diabetes across Ethnicities: A Review of Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT) for Classification of Dysglycaemia.

Prediabetes can be defined by the presence of impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), or glycated haemoglobin (HbA1c) to identify individuals at increased risk of developing type 2 diabetes (T2D). The World Health Organization (WHO, 1999) and the American Diabetes Association (ADA, 2003) utilise different cut-off values for IFG (WHO: 6.1–6.9 mmol/L; ADA: 5.6–6.9 mmol/L) but the same cut-off values for IGT (7.8–11.0 mmol/L). This review investigates whether there are differences in prevalence of IFG, IGT, and combined IFG&IGT between ethnicities, in particular Asian Chinese and European Caucasians. In total, we identified 19 studies using the WHO1999 classification, for which the average proportional prevalence for isolated (i)-IFG, i-IGT, and combined IFG&IGT were 43.9%, 41.0%, and 13.5%, respectively, for Caucasian and 29.2%, 49.4%, and 18.2%, respectively, for Asian. For the 14 studies using ADA2003 classification, the average proportional i-IFG, i-IGT, and combined IFG&IGT prevalences were 58.0%, 20.3%, and 19.8%, respectively, for Caucasian; 48.1%, 27.7%, and 20.5%, respectively, for Asian. Whilst not statistically different, there may be clinically relevant differences in the two populations, with our observations for both classifications indicating that prevalence of i-IFG is higher in Caucasian cohorts whilst i-IGT and combined IFG&IGT are both higher in Asian cohorts.

The risk of type 2 diabetes mellitus according to 2-h plasma glucose level: The Korean Genome and Epidemiology Study (KoGES)

BackgroundAlthough impaired glucose tolerance (IGT) is a definite risk factor for type 2 diabetes mellitus (T2DM), there is limited information about the risk stratification for incident T2DM within IGT group. Thus, we aimed to evaluate the incidental risk for T2DM according to 2-h plasma glucose (2-h PG) level of oral glucose tolerance test (OGTT) and phenotype of IGT. Methods7654 Korean participated in the Korean Genome and Epidemiology Study (KoGES) were stratified by 2-h PG levels of OGTT, and followed up for 63,665 person-years. Cox proportional hazards model was used to calculate the hazard ratios (HRs) and 95% confidential interval (CI) for T2DM according to 2-h PG levels of OGTT with adjustment for multiple covariates. Subgroup analysis was performed by gender and the presence of impaired fasting glucose (IFG) or not. ResultsWithin IGT, the adjusted HRs for T2DM significantly increased proportionally to 2-h PG level [<140mg/dL: reference, 140–159mg/dL: 3.07 (2.67–3.54), 160–179mg/dL: 5.44 (CI 4.66–6.34), 180–199mg/dL: 7.91 (CI 6.53–9.59)]. IGT combined with IFG had the profoundly increased HRs than isolated IFG. Even within normal glucose tolerance (NGT), 2-h PG level≥120mg/dL had the higher risk for T2DM than other NGT groups. These associations were more dominant in male than female. ConclusionThe highest level of 2h-PG (180–199mg/dL) in IGT and IGT with IFG were strong predictor for T2DM. 2-h PG of 120–139mg/dL was more significantly associated with T2DM within NGT, and male was more susceptible for T2DM than female.

Vitamin E Deficiency and Oxidative Status are Associated with Prediabetes in Apparently Healthy Subjects

Previous studies have indicated that vitamin E deficiency and oxidative stress affect the beta cell function. Hence, the aim of this study was to determine the association between vitamin E deficiency and oxidative status with prediabetes in apparently healthy subjects. Apparently healthy men and women aged 18-65years were enrolled in a case-control study. Individuals with new diagnosis of prediabetes were considered as cases and compared with a control group of individuals with normal glucose tolerance. Smoking, alcohol intake, pregnancy, diabetes, kidney disease, liver disease, cardiovascular disease, malignancy, glucocorticoid treatment and consumption of lipid-lowering drugs, antioxidants and vitamin supplements were exclusion criteria. Vitamin E deficiency was defined by serum levels of α-tocopherol <11.6μmol/L, oxidative status was assessed by total antioxidant capacity and lipid peroxidation, and prediabetes was considered by the presence of impaired fasting glucose and/or impaired glucose tolerance. A total of 148 subjects were allocated into the case (n=74) and control (n=74) groups. The frequency of vitamin E deficiency was higher in the case group (41.8%) compared with the control group (35.1%), p=0.03. The logistic regression analysis adjusted by age, waist circumference and body mass index, revealed a significant association between vitamin E deficiency (OR 3.23; 95% CI: 1.34-7.79, p=0.009), lipoperoxidation (OR 2.82; CI 95%: 1.42-5.59, p=0.003) and total antioxidant capacity (OR 0.93; CI 95%: 0.90-0.96, p <0.001) with prediabetes. Results of the present study suggest that both vitamin E deficiency and oxidative status are associated with prediabetes in apparently healthy subjects.

The incidence of new onset diabetes after transplantation and related factors: Single center experience

AimNew-onset diabetes after transplantation (NODAT) is a frequent metabolic complication and is considered a risk factor for patients undergoing renal transplant. The aim of this study was to evaluate the incidence and developing duration of new-onset diabetes after transplant (NODAT) and influencing factors. MethodsAll patients’ data was investigated retrospectively. Diabetics, follow-up period<6 months, age<18years were excluded. Demographic, clinical and laboratory data was recorded. Patients were divided into two groups: with/without NODAT. NODAT group was divided into four subgroups according to the time of developing NODAT, which were 0–3, 3–6, 6–12 and 12 months later. Two groups were compared, to investigate the incidence of NODAT and risk factors associated with the occurrence of NODAT. ResultsWe retrospectively analyzed the records of 570 patients, of which 420 patients were included. Seventy (16.6%) patients had NODAT (36 female, mean age 51.7±8.2 years, mean follow-up 41.6±21.5 months), 52.8% of patients developed NODAT within the first three months of being diagnosed. 350 patients (116 female, mean age 43.2±12.5 years, mean follow-up 41.6±21.5 months) were without NODAT. The incidence of impaired fasting glucose (IFG) during the first week after transplant was found to be higher in the patients with NODAT (p<0.001). There was positive correlation between NODAT and older age, obesity, family history of diabetes, presence of IFG, fasting plasma glucose, total and LDL-cholesterol, triglycerides, parathormone. Old age, obesity, presence of IFG, pretransplant hypertriglyceridemia and hyperparathyroidism were predictors of development of NODAT. ConclusionIncidence of NODAT, especially the first six months, was high. All patients should be screened for IFG within the first week. Patients with dyslipidemia, elderly and obese patients should be closely monitored for the risk of development of NODAT.

The incidence of new onset diabetes after transplantation and related factors: Single center experience

AimNew-onset diabetes after transplantation (NODAT) is a frequent metabolic complication and is considered a risk factor for patients undergoing renal transplant. The aim of this study was to evaluate the incidence and developing duration of new-onset diabetes after transplant (NODAT) and influencing factors. MethodsAll patients’ data was investigated retrospectively. Diabetics, follow-up period<6 months, age<18years were excluded. Demographic, clinical and laboratory data was recorded. Patients were divided into two groups: with/without NODAT. NODAT group was divided into four subgroups according to the time of developing NODAT, which were 0–3, 3–6, 6–12 and 12 months later. Two groups were compared, to investigate the incidence of NODAT and risk factors associated with the occurrence of NODAT. ResultsWe retrospectively analyzed the records of 570 patients, of which 420 patients were included. Seventy (16.6%) patients had NODAT (36 female, mean age 51.7±8.2 years, mean follow-up 41.6±21.5 months), 52.8% of patients developed NODAT within the first three months of being diagnosed. 350 patients (116 female, mean age 43.2±12.5 years, mean follow-up 41.6±21.5 months) were without NODAT. The incidence of impaired fasting glucose (IFG) during the first week after transplant was found to be higher in the patients with NODAT (p<0.001). There was positive correlation between NODAT and older age, obesity, family history of diabetes, presence of IFG, fasting plasma glucose, total and LDL-cholesterol, triglycerides, parathormone. Old age, obesity, presence of IFG, pretransplant hypertriglyceridemia and hyperparathyroidism were predictors of development of NODAT. ConclusionIncidence of NODAT, especially the first six months, was high. All patients should be screened for IFG within the first week. Patients with dyslipidemia, elderly and obese patients should be closely monitored for the risk of development of NODAT.

Association of hearing impairment with insulin resistance, β-cell dysfunction and impaired fasting glucose before onset of diabetes.

Diabetes is a known risk factor for hearing impairment. No study regarding the association of insulin resistance (IR), β-cell dysfunction and impaired fasting glucose (IFG) with hearing impairment has been reported in the population without diabetes. We examined these associations using a representative sample of the Korean population. Participants included 1589 males and 2496 females, who were ≥ 20 years of age and without diabetes from the Korea National Health and Nutritional Examination Surveys of the Korean population (2010). Audiometric tests and laboratory examinations were performed. Homeostasis model assessments of IR and β-cell function (HOMA-IR and HOMA-β) were calculated. The prevalence of both high- and low-/mid-frequency hearing impairment among subjects with IFG was higher compared with those with normal glycaemia (42.2% vs. 24.5%, 14.7% vs. 7.8%, respectively). After adjustment for age, HOMA-IR and HOMA-β showed significant association with high-frequency hearing impairment in males. In the multiple logistic regression analyses adjusting for confounding variables, the presence of IFG, higher HOMA-IR and lower HOMA-β remained as independent risk factors for high-frequency mild hearing impairment in males < 70 years [odds ratio (OR) 1.441, 95% confidence interval (95% CI), 1.056 to 1.967; OR, 1.448, 95% CI, 1.039 to 2.101; and OR, 0.447, 95% CI, 0.274 to 0.729, P < 0.05, respectively). IR, β-cell dysfunction and IFG are associated with high-frequency mild hearing impairment in the male population < 70 years before the onset of diabetes.