Prevalence Of Carbohydrate Metabolism Disorders Research Articles

Association of Glutathione Peroxidase 3 (GPx3) and miR-196a with Carbohydrate Metabolism Disorders in the Elderly.

The escalating prevalence of carbohydrate metabolism disorders (CMDs) prompts the need for early diagnosis and effective markers for their prediction. Hyperglycemia, the primary indicator of CMDs including prediabetes and type 2 diabetes mellitus (T2DM), leads to overproduction of reactive oxygen species (ROS) and oxidative stress (OxS). This condition, resulting from chronic hyperglycemia and insufficient antioxidant defense, causes damage to biomolecules, triggering diabetes complications. Additionally, aging itself can serve as a source of OxS due to the weakening of antioxidant defense mechanisms. Notably, previous research indicates that miR-196a, by downregulating glutathione peroxidase 3 (GPx3), contributes to insulin resistance (IR). Additionally, a GPx3 decrease is observed in overweight/obese and insulin-resistant individuals and in the elderly population. This study investigates plasma GPx3 levels and miR-196a expression as potential CMD risk indicators. We used ELISA to measure GPx3 and qRT-PCR for miR-196a expression, supplemented by multivariate linear regression and receiver operating characteristic (ROC) analysis. Our findings included a significant GPx3 reduction in the CMD patients (n = 126), especially in the T2DM patients (n = 51), and a decreasing trend in the prediabetes group (n = 37). miR-196a expression, although higher in the CMD and T2DM groups than in the controls, was not statistically significant, potentially due to the small sample size. In the individuals with CMD, GPx3 levels exhibited a negative correlation with the mass of adipose tissue, muscle, and total body water, while miR-196a positively correlated with fat mass. In the CMD group, the analysis revealed a weak negative correlation between glucose and GPx3 levels. ROC analysis indicated a 5.2-fold increased CMD risk with GPx3 below 419.501 ng/mL. Logistic regression suggested that each 100 ng/mL GPx3 increase corresponded to a roughly 20% lower CMD risk (OR = 0.998; 95% CI: 0.996-0.999; p = 0.031). These results support the potential of GPx3 as a biomarker for CMD, particularly in T2DM, and the lack of a significant decline in GPx3 levels in prediabetic individuals suggests that it may not serve reliably as an early indicator of CMDs, warranting further large-scale validation.

Epidemiology of type 2 diabetes and prediabetes in the adult population of the Republic of Moldova (preliminary data)

Introduction. Type 2 DM accounts for over 95% of all diabetes cases worldwide and represents an important and independent cardio-metabolic risk factor. This is the first national study (Epidemiological study of widespread endocrine pathologies (diabetes, obesity) in the Republic of Moldova and its management strategy) that analyzes the prevalence of type 2 diabetes mellitus (DM), prediabetes, obesity, and dyslipidemia in the adult population of Moldova. Material and methods. This is an epidemiological cross-sectional study with cluster random sampling. A face-to-face interview was conducted with the participants using a pre-tested semi-structured questionnaire. All biochemical tests were performed in a certified laboratory. Statistical analysis used Spearman’s correlation test, chi-square, and Wilcoxon tests. The Research Ethics Committee of Nicolae Testemițanu State University of Medicine and Pharmacy (Minutes 3 from December 28 2020) approved this study. Results. 728 individuals were enrolled, of which 2.5% had unknown DM. Advanced age, obesity, and dyslipidemia were influencing factors for diabetes. 21.4% of participants had prediabetes, with a higher prevalence in men than in women (28.3 % versus 18.9 %). Only 23.2% of men and 30.4% of women had a BMI within the normal range. Abdominal circumference (AC) values greater than 102 cm and 88 cm in men and women, respectively, were determined in 39.4% of men and 53.8% of women. Conclusions. Our study showed an increased prevalence of carbohydrate metabolism disorders, including prediabetes, as well as a high prevalence of abdominal obesity. Persons with unknown diabetes mellitus have been identified.

Diabetes mellitus in acromegaly: prevalence, pathophysiological particulars and treatment strategies

The prevalence of diabetes mellitus in acromegaly is significantly higher than that in the general population. Carbohydrate metabolism abnormalities often precede other phenotypic manifestations of acromegaly. The review presents data on the prevalence of carbohydrate metabolism disorders in acromegaly and describes their pathophysiological characteristics and approaches to treatment.
 Growth hormone (GH) excess is recognized as a key factor of glucose homeostasis abnormalities due to decreased insulin sensitivity (resulting from active lipolysis) and direct stimulation of insulin secretion. Insulin-like growth factor 1 (IGF1) improves insulin sensitivity; however, the GH diabetogenic effects prevail over the insulin-sensitizing impact of IGF1. Surgical and radiation treatment for somatotropinoma may indirectly improve carbohydrate metabolism, because they decrease the GH levels. Treatment with first generation somatostatin analogues can both improve glycemic control due to decreased GH levels and worsen it due to deterioration of postprandial insulin release, especially in patients with already manifest carbohydrate metabolism disorders. The GH receptor antagonist pegvisomant blocks the effects of excess GH on the target tissues without suppressing insulin secretion, which results in better glucose control; treatment with this agent can be preferred in patients with acromegaly and diabetes mellitus. Management of carbohydrate metabolism disorders in acromegaly is done in accordance with general treatment principles for type 2 diabetes mellitus.

The prevalence of carbohydrate metabolism disorders in patients after coronavirus infection

Introduction. A single-center observational cross-sectional comparative study was conducted among
 a random population sample of the adult population of the city of Moscow who applied to the pavilion
 "Healthy Moscow". The study included 796 patients who had a coronavirus infection from one to six months
 ago. Of the 796 surveyed, 112 participants had disorders of carbohydrate metabolism (hereinafter – DCM)
 (14.1%): 9.8% (78 people) were newly diagnosed with type 2 diabetes (D2t) of the total sample, prediabetes
 – 4.2% (33 people), type 1 diabetes – 0.1% (1 person). Previously diagnosed D2t was observed in 0.5% (4
 participants) of the total sample of patients. Viral pneumonia was significantly more common in patients
 with DCM, compared with the group without DCM (45.5% vs. 19.1%, p<0.001). In the group of lung injuries,
 DCM were observed with greater frequency, including D2t, the probability of which in the presence of lung
 damage increased by 3.7 times (95% CI: 2.04 – 6.67).
 Thus, the prevalence of newly detected DCM after COVID-19 was 14.1%, and the more severe the coronavirus
 infection, the more likely the DCM will develop in the future.
 The study was carried out as part of the project of the Department of Health of the city of Moscow
 "Scientific laboratory "Moscow polyclinic".
 For citation: Markova T.N., Anchutina A.A., Garib V.Yu., Yalochkina T.O., The prevalence of carbohydrate
 metabolism disorders in patients after coronavirus infection. City Healthсare. 2022;3(4):32-41 doi:10.47619/2713-2617.zm.2022.v.3i4;32-41

Ethnic differences in risk factors and prevalence of type 2 diabetes in the adult population of the Russian Federation

BACKGROUND: Russia is one of the most multinational states in the world. Identification of ethnic groups with a higher risk of developing DM2, analysis of risk factors for the development of DM2 will allow developing personalized approaches to the prevention and treatment of DM2.AIMS: To reveal ethnic features of the prevalence of carbohydrate metabolism disorders and risk factors for the development of DM2 in the adult population of the Russian Federation.MATERIALS AND METHODS. A retrospective analysis of the database of the national epidemiological cross-sectional study NATION was carried out. Depending on the self-specified nationality, on the basis of anthropological characteristics, the following ethnic groups were identified: “Mongoloid population”, “Peoples of the Volga region”, “Peoples of the North Caucasus”, “Peoples of Transcaucasia”, “Russians”. The analysis consisted of several stages and included: analysis of the anthropometric features of the selected groups, taking into account the presence of carbohydrate metabolism disorders (MO); study of the prevalence of violations of the MA in the selected ethnic groups; analysis of ethnic characteristics of risk factors for the development of type 2 diabetes; analysis of the frequency of violations of the MA in various ethnic groups, taking into account the territory of residence. MR disorders were defined as the presence of DM and/or prediabetes. In accordance with the WHO criteria, HbA1c≥6.5% corresponded to the diagnosis of DM, HbA1c values in the range of 5.7%≤HbA1c<6.5% to the diagnosis of prediabetes.RESULTS: The highest frequency of violations of the MA was observed in the group «Peoples of the Volga region» (31.2%), the lowest in the «Peoples of the North Caucasus» (15.6%). BMI in the group “Peoples of the Volga region” was significantly lower than in the group “Peoples of the North Caucasus. Violations of MR were more often observed in the abdominal nature of obesity, obesity of the 1st stage, age over 45 years in the groups «Mongoloid population» and «Peoples of the Volga region» than in the peoples of the «Northern Caucasus» and «Transcaucasia». The frequency of occurrence of SR violations among representatives of the Volga Peoples group living in their historical territories was higher than among Russians living in the same regions: 32.5% and 24.3% (p<0.001 χ2 criterion), and also higher than in the Russian CFD: 32.5% and 27.4%, respectively, p=0.001 (χ2 test). The prevalence of violations of the MA among the peoples of the North Caucasus was less than among the Russians of the Central Federal District — 13.9% and 27.36%, respectively (p<0.001 χ2 criterion). The prevalence of MR violations among representatives of the “Peoples of the North Caucasus” group living in their historical territories (n=598) was less than among those living in other regions of the Russian Federation (n=164) (13.9% and 21.95%, p= 0.012 criterion χ2).CONCLUSION: In the present work, for the first time, we analyzed the prevalence of MR disorders in various ethnic groups of the population of the Russian Federation, identified certain ethnic characteristics of DM2 risk factors and their contribution to the development of the disease. The obtained results should be used for planning preventive programs in various regions of the Russian Federation.

The Significance of Non-Drug Correction of Carbohydrate Metabolism Disorders

Today, one of the main tasks of the healthcare system in many countries of the world is the development and implementation of measures for primary and secondary prevention of the onset and progression of socially significant diseases. In recent decades, the prevalence of carbohydrate metabolism disorders and DM in particular has acquired the character of a pandemic, both in developed and developing countries of the world [1]. According to the latest data, the number of patients with DM in the world over the past 10 years has more than doubled, and by the end of 2015 reached 415 million people [2]. According to the forecasts of the International Diabetes Federation, 642 million people will suffer from diabetes in 2040 [2]. Such a rapid increase in the incidence of diabetes was the reason for the adoption of UN Resolution 61/225 of December 20, 2006 on diabetes mellitus, and in 2011 - the UN Political Declaration addressed to national health systems, calling for the creation of multidisciplinary strategies in the field of prevention and control of non communicable diseases, where special attention is drawn to the problem of diabetes, as one of the leading causes of disability and mortality in the population.

Arterial hypertension and diabetes developed in pregnancy

BACKGROUND: Gestational diabetes mellitus is a significant medical and social problem in most countries. Despite the relatively high level of development of modern medicine, following the growth of obesity and type 2 diabetes, the prevalence of gestational diabetes mellitus is also increasing worldwide.
 AIM: To identify the frequency and structure of carbohydrate metabolism disorders and to compare the level of blood pressure in a random sample of pregnant women registered in the Perinatal center.
 MATHERIALS AND METHODS: The analysis of the data of examination of carbohydrate metabolism of pregnant women who are registered in the Perinatal Center (Leningrad region, Gatchina), has been carried out. The analysis of medical documentation, survey, endocrinological and gynecological examination, calculation of the body mass index and the study of carbohydrate metabolism have been carried out.
 RESULTS: There is an increase in the number of pregnant women with impaired carbohydrate metabolism over the years of observation. Gestational diabetes on diet therapy was 64.4% in 2019, 31.0% in 2020, 65.1% in 2021, on insulin therapy 32.2, 62.3, 28.9% respectively. There was an increase in the number of women with type 1 and type 2 diabetes diagnosed before pregnancy and newly diagnosed diabetes during pregnancy. Body mass index and blood pressure levels are higher and glycated hemoglobin levels are lower in diet-treated pregnant women with gestational diabetes compared with insulin therapy. An increase in glycated hemoglobin was found annually in a group of women with gestational diabetes mellitus on insulin therapy.
 CONCLUSIONS: The high prevalence of carbohydrate metabolism disorders and the associated increase in blood pressure in pregnant women in Saint Petersburg and the Leningrad Region justifies a targeted search for carbohydrate metabolism disorders in pregnant women.

Prevalence of carbohydrate metabolism disorders in patients with end-stage renal disease on hemodialysis therapy

There are quite a lot of scientific works today dedicated to the role of disorders carbohydrate metabolism (DCM) in the development of end-stage renal disease (ESRD), at the same time, the influence of chronic kidney disease (CKD) on the development of carbohydrate disorders remains insufficiently studied, especially in patients on renal replacement therapy (RRT). The annual steady increase in the number of patients with ESRD without diabetes mellitus (DM) requiring dialysis therapy leads to increased interest and the need to study carbohydrate status in these patients. It is known that hyperglycemia in patients without DM on hemodialysis (HD) is a predisposing factor to the development of cardiovascular accidents that worsen the quality of life and also increase mortality. The peculiarities of glucose metabolism in patients receiving RRT do not always allow adequate assessment of carbohydrate status using glycated hemoglobin (HbA1c). The review provides up-to-date information on the prevalence of DCM in patients with ESRD without DM receiving HD RRT, touches upon the peculiarities of glucose metabolism, interpretation of HbA1c and glycated albumin values, and mortality risk in hemodialysis patients with various DCM.

Prevalence of carbohydrate metabolism disorders and association with cardiovascular diseases in a large Siberian region

Aim. To study the prevalence of carbohydrate metabolism disorders in a repre - sentative sample of the working-age population of the Krasnoyarsk Krai aged 25-64 years and to identify the association of these disorders with cardiovascular pathology.Material and methods. A random representative sample within the all-Russian epidemiological study ESSE-RF included 1603 residents of the Krasnoyarsk Krai aged 25 to 64 years. The gradation of carbohydrate metabolism disorders was carried out on the basis of fasting plasma glucose level in accordance with the criteria of the American Diabetes Association (ADA). Hypertension (HTN) was defined as office BP ≥140/90 mm Hg or an indication of previous use of antihypertensive drugs. The presence of myocardial infarction (MI), stroke, coronary artery disease (CAD) was detected by anamnesis collection. Statistical processing was carried out using IBM SPSS v 22 and Microsoft Excel 2021 programs. When comparing differences by sex, age, level of education, and type of residence, differences was assessed by chi-squared test and considered significant at p≤0,05.Results. In total representative sample of Krasnoyarsk Krai population, 3,6% of participants indicated prior diabetes, while its prevalence naturally increased with age. The detection rate of fasting glucose of 5,6-6,9 mmol/l among individuals without prior diabetes (impaired fasting glycemia (IFG), as one of the criteria for prediabetes, according to ADA guidelines) was 22,5% of the general population. Fasting hyperglycemia (HG) ≥7,0 mmol/l without prior diabetes was registered in 3,8%. This figure can be roughly considered as the proportion of people with newly diagnosed diabetes. IFG and HG were significantly more common among men, as well as among those with primary and secondary education compared with higher education. In rural residents, all types of carbohydrate metabolism disorders were more common than in urban ones. Compared with the normoglycemic group, the presence of prior diabetes, IFG and GH was associated with a significantly higher prevalence of hypertension, CAD and stroke.Conclusion. The prevalence of IFG, fasting HG ≥7,0 mmol/l and diagnosed diabetes in a representative sample of the Krasnoyarsk Krai aged 25-64 years exceeds the national average, although it is consistent with the data of a number of other Siberian regions. The prevalence of both carbohydrate metabolism disorders in general and the percentage of possible undiagnosed diabetes increases with age. At the same time, there are more such individuals among those with primary and secondary education, as well as among rural residents. The approximate proportion of undiagnosed diabetes in the study population reaches 50%. Timely detection of carbohydrate metabolism disorders can contribute to the earlier implementation of active preventive measures and reduce the risk of cardiovascular events.

Prevalence of carbohydrate metabolism disorders in patients with new coronavirus infection

BACKGRAUND: There is evidence of a multifactorial effect of SARS-CoV2 on carbohydrate metabolism with the development of hyperglycemia and the weighting of COVID19 even in people without DM.AIMS: Assess the prevalence of disorders carbohydrate metabolism (DCM) in hospitalized patients with a new coronavirus infection without a history of DM.MATERIALS AND METHODS: Patients with PCR-confirmed diagnosis of COVID19 aged 18-75 years (n=72) without a history of diabetes were examined. Observation was carried out from the moment of hospitalization to discharge. Patients were collected anamnesis data, laboratory and instrumental studies, HbA1c, fasting plasma glucose (FPG), postprandial glycemia.RESULTS: The prevalence of DCM (HbA1c≥6%) in 72 patients with COVID19 without a history of diabetes admitted to the hospital was 41,7%, while HbA1c ≥6,5% had 8,3%. The median HbA1c in the moderate-flow group was 5,7% [5,3–6,0], and in the severe-flow group it was 6,0% [5,8–6,2] (p=0,008). Participants were divided into groups according to the level of HbA1c≥6% and < 6%. The examined patients showed a high prevalence of risk factors for developing DM: age over 45 years — 83,3%, cardiovascular diseases — 46,3%, obesity — 50%. The study groups didn’t differ statistically in terms of risk factors for DM. In the group with HbA1c≥6%, FPG≥6,1 mmol / l on the second day and postprandial glycemia ≥7,8 mmol/l were observed in more cases than in the group with HbA1c<6% (39,1% vs 12,9%, p=0,051 and 47,8% vs 3,2%, p=0,0001, respectively). The prevalence of DCM in HbA1c was higher than in FPG (41,7% vs 29,2%, p=0,006). On the seventh day, the number of patients with FPG ≥ 6,1 mmol / l in the first group decreased from 39,1% to 4,4% (p=0,01), and in the second group-from 12,9% to 9,7% (p=1,0). There was a direct correlation between the level of HbA1c and C-reactive protein (r=0,271; p=0,048), and an inverse correlation with the content of lymphocytes in the blood (r=-0,25; p=0,068).CONCLUSIONS: In patients with a new coronavirus infection without a history of DM, a high prevalence of DCM was detected — 41,7%. Against the background of comparability of the studied groups by risk factors for DM, an increase in HbA1c, FPG and postprandial glycemia is a manifestation of transient hyperglycemia. Given the high prevalence of DCM, it can be assumed that SARS-CoV2 has diabetogenic properties.

Symptomatic endometriosis in women of fertile age through the prism of autoimmunization to food allergens

The article provides a systematic review of the scientific publications, manuals and recommendations over the past 10 years devoted to the problem of endometriosis. The systematization of information about the etiopathogenetic mechanisms of the development of pathology and the data of multidisciplinary analysis of the carbohydrate metabolism disorders and food intolerance in the course of symptomatic endometriosis was carried out.Endometriosis is one of the most common benign gynecological proliferative pathologies in women around the world. Studying the structure of the rate of symptomatic endometriosis, a higher incidence of carbohydrate metabolism disorders and food intolerance was found in this group of patients. The incidence of endometriosis, the prevalence of carbohydrate metabolism disorders and autoimmunization demonstrate a significant tendency towards growth and «rejuvenation», which is undoubtedly a consequence of poor nutrition and lifestyle, excessive consumption of carbohydrate products, as well as social characteristics of the life of a modern woman.According to the current scientific evidence, carbohydrate metabolism disorders are associated with autoimmunization and immune dysfunction. Based on the analysis of literature data and the results of our own retrospective observations, the role of carbohydrate metabolism disorders and autoimmunization with food allergens (gluten, fructose, lactose) in the manifestation and progression of symptomatic endometriosis was revealed. Due to the violation of the interaction between the endocrine and immune axes of regulation of the female reproductive system as a result of systematic autoimmunization with certain aggressive food components, which can act as endocrine disruptors and secondary neuroendocrine messengers, women with food intolerance and carbohydrate metabolism disorders have a worse course of endometriosis and a higher course of endometriosis risks.Normalization of carbohydrate metabolism by using an elimination diet with the exclusion of disinfectant products is the topic of this article and the direction of the search for an effective and acceptable algorithm for the treatment of endometriosis.

Carbohydrate metabolism disorders in patients with heart failure: data from the local registry

Aim. To study the prevalence of carbohydrate metabolism disorders in patients with heart failure (HF) hospitalized in the city HF center.Material and methods. According to the local registry, the study sequentially included 183 patients (99 men and 84 women) hospitalized in the Nizhny Novgorod city HF center from September 1, 2019. The examination and treatment were carried out in accordance with the current clinical guidelines. In the first 48 hours after hospitalization, the concentration of the N-terminal pro-brain natriuretic peptide, soluble stimulating growth factor 2 (sST2), neutrophil gelatinase-associated lipocalin, cystatin C, blood creatinine was determined. The glomerular filtration rate was calculated using the СKDEPI equation. To assess the carbohydrate metabolism disorders, all patients were studied for fasting plasma glucose, glycated hemoglobin (HbA1c) and fructosamine. Statistical data processing was carried out using the R statistics package (R Core Team (2019)).Results. The incidence of carbohydrate metabolism disorders among patients withdecompensated HF was 75,89%, including previously diagnosed type 2 diabetes in 31,25%, newly diagnosed dysglycemia in 44,64% of patients. Less than one fourth of patients had normal parameters of carbohydrate metabolism according to HbA1c, fructosamine and fasting plasma glucose. The severity of carbohydrate metabolism disorders was significantly correlated with the severity of HF according to the following criteria: 6-minute walk test, HF functional class, sST2 level, and some parameters of cardiac remodeling. Among the criteria used for carbohydrate metabolism disorders, the HbA1c level was most closely associated with the criteria for HF severity.Conclusion. Carbohydrate metabolism disorders in HF patients are widespread and underdiagnosed during routine examination. The interrelation of carbohydrate metabolism parameters and indicators of HF severity is rationale for active detection of dysglycemia in these patients in order to potentially influence the prognosis.

Risk factors for carbohydrate metabolism disorders from a chronobiological position

steady increase in the prevalence of carbohydrate metabolism disorders is closely related to overweight and obesity. Obesity is associated with a sedentary lifestyle, poor diet, sleep disturbance, which can lead to dysfunction of circadian rhythms with a decrease in the production of the hormone melatonin. The aim of the study is to clarify the most significant risk factors for carbohydrate metabolism disorders in obese patients from the standpoint of chronobiology. Material and methods. The retrospective study involved 120 patients with obesity (body mass index 31.35±3.80 kg/m2) with early disorders of carbohydrate metabolism (EDCM), type 2 diabetes mellitus (T2DM) and without disorders of carbohydrate metabolism (n=40 in each group). The age of the patients was 40-69 years, of which 75% were women and 25% were men. The patients' food diaries (for 24 hours) and Horne-Ostberg tests were analyzed. Fasting glucose, glycated hemoglobin, leptin, insulin were determined in the venous blood plasma; the insulin resistance index (HOMA-IR) was calculated, anthropometric indicators, basal body temperature (BT) were measured. Results and discussion. Patients of all groups were comparable in age, sex, BMI. The patients had an irrational distribution of the amount of calories consumed during the day, frequent meals, and a tendency to late breakfast (9:30-10:00 h) and dinner (19:00-20:00). In all 3 groups, leptin and insulin resistance was determined. In patients with DM2 leptin and insulin deficiency was revealed, which was confirmed by the presence of negative correlations between insulin concentration and energy consumption (r=-0.817, p<0.001) and carbohydrates intake (r=-0.299, p<0.001), as well as between carbohydrate intake and leptin concentration (r=-0.221, p<0.01) and HOMA-IR (r=-0.257, p<0.005). The duration of sleep averaged 7±1 h per day, and bedtime using artificial illumination, on average, varied in the range of 22:00-23:30, which can lead to circadian mismatch, with the progression of insulin resistance. The decrease in the amplitude of the BT circadian rhythm in patients with EDCM and T2DM, as well as the presence of an inverse correlation between BT and energy consumption (r=-0.531, p<0.0001) and fat intake (r=-0.533, p<0.0001), and a positive correlation between BT and protein consumption (r=0.533, p<0.0001), may indicate the involvement of melatonin in the development and progression of disorders of carbohydrate metabolism. Conclusion. The most significant risk factors for the development of disorders of carbohydrate metabolism, accompanied by circadian dysfunction in the surveyed, include irrational distribution of the energy value of food during the day, frequent meals, late breakfast and dinner; shifting the time of going to bed, shortening the duration of sleep, exposure to artificial lighting in the evening.

Впервые выявленные сахарный диабет 2-го типа и предиабет у госпитализированных пациентов с сердечно-сосудистыми заболеваниями: частота, соответствие исходных уровней АД, липидов и HbA 1c целевым значениям

To estimate the prevalence of carbohydrate metabolism disorders and the conformity of baseline blood pressure (BP), low-density lipoproteins (LDL), and HbA 1c to the target levels in patients with established cardiovascular diseases.

Modern Aspects of the Clinic, Diagnosis and Treatment of Prediabetes

Prediabetes is a common violation of carbohydrate metabolism, the medical and social relevance of which is due to the negative impact on the incidence of type 2 diabetes mellitus (DM) and cardiovascular disease (CVD). The analyzed literature emphasizes the presence of a close pathogenetic relationship between type 2 DM/prediabetes and CVD. This relationship becomes even more relevant, taking into account, on the one hand, the persistent upward trend in the prevalence of carbohydrate metabolism disorders in the population, and on the other hand, the fact that in patients with dysglycemia it is cardiovascular complications that are the main cause of death. However, while the significance of type 2 DM as a risk factor for CVD is widely known and its presence immediately stratifies most patients to a group of high or very high cardiovascular risk, the contribution of prediabetes to the development of CVD remains underestimated among the therapeutic and cardiological communities. The high prevalence of prediabetes creates prerequisites for a further increase in the incidence of type 2 DM and CVD in the Russian Federation, which requires doctors of various specialties to be wary of early detection of prediabetes, since timely preventive measures can significantly reduce the risk of type 2 DM and its complications in the future. Currently, the effectiveness of both non-drug and drug strategies in preventing the development of type 2 DM in people with prediabetes has been confirmed, more and more data are accumulating about the possibility of effective prevention of CVD in prediabetes. According to modern research, the primary role of measures to actively change lifestyle in the treatment and prevention of prediabetes is emphasized, at the same time, the effectiveness of these measures can be reduced due to insufficient commitment of the patients themselves to their independent long-term implementation. Therefore, the strategy of prescribing metformin for the prevention of type 2 diabetes is absolutely justified if the doctor and patient recognize the inefficiency or inability to follow the recommendations for active lifestyle changes for a long time. The article presents the data on the etiology, epidemiology, diagnosis, and approaches to the management of patients with prediabetes from the standpoint of modern recommendations.

Распространенность нарушений углеводного обмена у пациентов, планирующихся на хирургию возрастной катаракты

Распространенность нарушений углеводного обмена у пациентов, планирующихся на хирургию возрастной катаракты

Влияние кардиоваскулярной и метаболической патологии на сроки развития профессиональной хронической фтористой интоксикации у работников алюминиевого производства

With the aim of studying the effect of disorders of carbohydrate and lipid - tion exchange and associated cardiovascular disease at the time of development of occupational fluorosis assessed the prevalence of this disease among workers in aluminum production. A significant dissociation of carbohydrate and lipid metabolism indices against the background of high prevalence of overweight, obesity, arterial hypertension in workers in contact with elevated concentrations of inorganic fluorine compounds was established in comparison with patients of the comparison group who are not exposed to toxic substances (р=0,003, t=3,159). The increase in fasting glycemia was revealed already with the work experience of up to 10 years, which can testify to the danger of early development of type 2 diabetes in workers of aluminum production and the need for timely preventive measures in this category of workers. At the same time, patients with occupational fluorosis had significantly higher prevalence of carbohydrate metabolism disorders compared to trained workers without occupational fluorosis (р=0,006). It was revealed that professional fluorosis develops significantly earlier in workers with concomitant cardiovascular disease and metabolic changes.

Early diagnostics of carbohydrate metabolism disorders in comparison with other metabolic disorders among employees of internal affairs bodies suffering from hypertension

This article reflects the results of screening patients with hypertension for early diagnosis of diabetes mellitus 2 type (DM 2 type) and associated potential complications. The results showed a high prevalence of carbohydrate metabolism disorders, including first-diagnosed type 2 diabetes. Also, all patients with impaired glucose metabolism had higher body mass index, hyperglycemia and even had signs of kidney damage, which clinically were not evident.

Prevalence of Diabetes, Prediabetes, and Stress Hyperglycemia: Insulin Therapy and Metabolic Control in Patients on Total Parenteral Nutrition (Prospective Multicenter Study)

The prevalence of carbohydrate metabolism disorders in patients who receive total parenteral nutrition (TPN) is not well known. These disorders can affect the treatment, metabolic control, and prognosis of affected patients. The aims of this study were to determine the prevalence in noncritically ill patients on TPN of diabetes, prediabetes, and stress hyperglycemia; the factors affecting hyperglycemia during TPN; and the insulin therapy provided and the metabolic control achieved. We undertook a prospective multicenter study involving 19 Spanish hospitals. Noncritically ill patients who were prescribed TPN were included, and data were collected on demographic, clinical, and laboratory variables (glycated hemoglobin, C-reactive protein [CRP], capillary blood glucose) as well as insulin treatment. The study included 605 patients. Before initiation of TPN, the prevalence of known diabetes was 17.4%, unknown diabetes 4.3%, stress hyperglycemia 7.1%, and prediabetes 27.8%. During TPN therapy, 50.9% of patients had at least one capillary blood glucose of >180 mg/dL. Predisposing factors were age, levels of CRP and glycated hemoglobin, the presence of diabetes, infectious complications, the number of grams of carbohydrates infused, and the administration of glucose-elevating drugs. Most (71.6%) patients were treated with insulin. The mean capillary blood glucose levels during TPN were: known diabetes (178.6 ± 46.5 mg/dL), unknown diabetes (173.9 ± 51.9), prediabetes (136.0 ± 25.4), stress hyperglycemia (146.0 ± 29.3), and normal (123.2 ± 19.9) (P<.001). The prevalence of carbohydrate metabolism disorders is very high in noncritically ill patients on TPN. These disorders affect insulin treatment and the degree of metabolic control achieved.