Risk In Diabetic Patients Research Articles

Retrospective cohort study of androgen deprivation therapy and the risk of diabetes in men with prostate cancer in Lithuania

ObjectivesTo examine the risk of type 2 diabetes in patients with prostate cancer and its association with androgen deprivation therapy (ADT).Design and participantsWe performed a retrospective cohort study of patients...

Diabetes Caused by Statin Use: A Review

<p>Statins are generally recognised as being safe and well tolerated cholesterol-lowering drug and have been successfully used for prevention of primary and secondary cardiovascular disease. However, Some researchers have reported diabetes development in patients taking statins. A number of meta-analyses conducted in recent years have proved that the association is real even though its causality have not been fully elucidated. Various pathophysiological mechanisms that could explain the increased risk of diabetes in patients treated with statin have been described. These are mainly responsible for impairment of β -cell insulin secretion and alteration of intercellular signaling through depletion of important downstream products. This review aims to examine the relationship between statin treatment and the presence of diabetes. Previous clinical reviews of the evidence and pathophysiological mechanisms involved may also be explained. Furthermore, many studies have concluded that Pitavastatin and pravastatinom do not affect glycemic control and may be a beneficial treatment option in patients with, or at risk for, type 2 diabetes.</p>

Effect of Drinking on Diabetes Risk in Patients with Nonalcoholic Fatty Liver Disease

Data suggest that light-to-moderate alcohol consumption reduces the risk for developing type 2 diabetes mellitus (T2DM). To determine if this benefit

Continuous Positive Airway Pressure Treatment, Glycemia, and Diabetes Risk in Obstructive Sleep Apnea and Comorbid Cardiovascular Disease.

Despite evidence of a relationship among obstructive sleep apnea (OSA), metabolic dysregulation, and diabetes, it is uncertain whether OSA treatment can improve metabolic parameters. We sought to determine effects of long-term continuous positive airway pressure (CPAP) treatment on glycemic control and diabetes risk in patients with cardiovascular disease (CVD) and OSA. Blood, medical history, and personal data were collected in a substudy of 888 participants in the Sleep Apnea cardioVascular Endpoints (SAVE) trial in which patients with OSA and stable CVD were randomized to receive CPAP plus usual care, or usual care alone. Serum glucose and glycated hemoglobin A1c (HbA1c) were measured at baseline, 6 months, and 2 and 4 years and incident diabetes diagnoses recorded. Median follow-up was 4.3 years. In those with preexisting diabetes (n = 274), there was no significant difference between the CPAP and usual care groups in serum glucose, HbA1c, or antidiabetic medications during follow-up. There were also no significant between-group differences in participants with prediabetes (n = 452) or new diagnoses of diabetes. Interaction testing suggested that women with diabetes did poorly in the usual care group, while their counterparts on CPAP therapy remained stable. Among patients with established CVD and OSA, we found no evidence that CPAP therapy over several years affects glycemic control in those with diabetes or prediabetes or diabetes risk over standard-of-care treatment. The potential differential effect according to sex deserves further investigation.

Monocyte to HDL ratio as an indicator of subclinical atherosclerosis in diabetic retinopathy

ABSTRACTAim: Incidence of cardiovascular diseases is gradually increasing in patients with diabetic retinopathy (DR). MHR (Monocyte/HDL ratio), is a novel marker related with cardiovascular and cerebrovascular diseases. The aim of this study was to investigate the relationship between a subclinical atherosclerosis marker, carotid intima media thickness (CIMT), and MHR in diabetic retinopathy patients without an apparent cardiovascular disease. Material and Method: 106 diabetic patients without an apparent cardiovascular disease and 35 healthy controls matched for age, gender and body mass index (BMI) were included in this study. The patients were separeted into four groups which were proliferative diabetic retinopahy (PDR , n=30), nonproliferative diabetic retinopathy (NPDR, n=35), diabetic patients without retinopathy (n=41) and control group (n=35). Anthropometric, biochemical parameteres and CIMT were measured. Correlation and regression analysis were done to assess the relation between MHR and CIMT. Results: MHR was significantly different between groups and significantly higher in PDR group (p < .001). CIMT, a marker for atherosclerosis, significantly differed between groups (p < .001). CIMT levels were significantly higher in PDR while similar values were found in other than groups. In PDR group, a significant correlation was found between MHR and CIMT ( r=0.96; p < .001). According to binary logistic regression analysis, MHR had a significant effect on CIMT [ β=0.206, (%95 CI : 1.004-1.505), P=0.046 ]. Conclusion: This study showed that in patients with diabetic retinopathy, high levels of MHR which is a non-invasive, simple and inexpensive marker, might be useful for determination of subclinical cardiovascular risk. This study which is the first in literature that investigated the relation between MHR and CIMT in diabetic retinopathy might have a benefit on early detection of cardiac risk in diabetic patients without an apparent cardiovascular disease.

Survey of knowledge for diagnosing and managing prediabetes in Latin-America: cross-sectional study

BackgroundPrediabetes has been proposed as a risk factor for the development of type 2 diabetes mellitus (DM2) and cardiovascular disease (CVD). Despite the clinical importance of prediabetes, little is known about the level of knowledge, beliefs and barriers to screening and treating prediabetes amongst care health providers in Latin America. The aim of the present survey was to evaluate the knowledge and beliefs about prediabetes amongst in Latin American health care providers.MethodologyIn a cross-sectional study, we adapted the written survey designed by the Johns Hopkins University group, and applied it to health care providers across Latin America during three meetings, in 2017, and with physicians from primary care centers in Bucaramanga, Colombia convened in 2017. The survey consisted of questions under four headings, diabetes screening, management of prediabetes, pharmacological treatment—metformin use, and demographic information. We perform a descriptive analysis to determine the differences in responses between different medical specialties.ResultsThe majority of the care providers that answered the survey were Colombian physicians, 54.5% of respondents had 10 years or more since completing their training and more women responded. Only 9.5% identified the 12 prediabetes risk factors described in the literature. The most common risk factor identified was a family history of diabetes, followed by overweight, a sedentary lifestyle and dyslipidemia, while ethnicity was the risk factor least commonly. 47.1% answered that laboratory tests to detect prediabetes are fasting glucose and HbA1C, 82.5% correctly identified fasting plasma glucose as the best test, 35.9% correctly responded that to the recommended weight loss goal is 5 to 7% and 49.1% that 150 min is considered the minimum level of physical activity per week. 78% agreed that the identification and treatment of prediabetes is important. 56% believed that patients with prediabetes progress more rapidly to diabetes and 40.6% considered that metformin could reduce the risk of diabetes in patients already diagnosed with prediabetes.ConclusionThese results demonstrate that there are important gaps in the knowledge of the diagnosis, clinical implications and management of prediabetes amongst Latin America health providers.

Metabolically Healthy Obesity And Risk Of Incident Diabetes In Patients Treated With Statins

Metabolically Healthy Obesity And Risk Of Incident Diabetes In Patients Treated With Statins

Prevalence and Major Risk Factors of Diabetes Mellitus Among Adult Mental Disorder Inpatients from 2005 to 2018 in Beijing, China: A Longitudinal Observational Study

Background: The prevalence of diabetes mellitus was often reported as higher in mental illness inpatients compared to the general population, but large study of the prevalence of diabetes among mental illness inpatients in China was scarce. We aim to investigate the prevalence, trends, and major risk factors of diabetes mellitus among adult mental disorder inpatients in Beijing, China. Methods: We did a longitudinal observational study using data from Beijing Municipal Commission of Health and Family Planning Information Center, including 188856 adult inpatients with mental disorders in 19 specialized psychiatric hospital from 2005 to 2018 in Beijing. Data of demographic characteristics was obtained from electronic health record (EHR) data. Schizophrenia, diabetes, and comorbidities were defined according to ICD-10 codes of discharge diagnosis. Overall prevalence of diabetes in adult mental disorder inpatients was calculated, and annual prevalence of diabetes was calculated and adjusted to the overall participant population. Univariate and multivariate logistic regression analysis was performed to obtain crude odds ratios (cORs) and adjusted odds ratios (aORs) for the risk of diabetes in patients with different demographic characteristics, with schizophrenia versus other mental disorders, and with different comorbidities. We also calculated the prevalence of diabetes in different age groups under a stratification of schizophrenia or other mental disorders. Findings: Out of 188856 adult inpatients, 23558 had diabetes mellitus, the prevalence was 12.47% (95% confidence interval (CI): 12.33-12.62%). The prevalence was 13.42% (95%CI: 13.18-13.66%) among patients with schizophrenia, and 11.81% (95%CI: 11.61-12.00%) among patients with other mental disorders. 87.48% patients with diabetes mellitus was coded as type 2 diabetes mellitus (T2DM), the prevalence of T2DM was 10.91% (95%CI: 10.77-11.05%). During 2005-2018, the prevalence of diabetes mellitus in adult patients were increasing with admitted year, from adjusted prevalence of 6.05% in 2005, to 12.41% in 2010, 14.48% in 2015, 14.08% in 2018. After adjusting for gender, ethnic origin, marriage status, payment, and hospital grade, results from the multivariate analysis showed that increasing age, diagnosed as schizophrenia (aOR=1.22, 95%CI: 1.18-1.26), comorbidity with hypertensive diseases (aOR=3.11, 95%CI: 3.01-3.22), lipoprotein metabolism disorders (aOR=2.03, 95%CI: 1.96-2.10), fatty liver (aOR=1.91, 95%CI: 1.84-1.98) were major risk factors of diabetes mellitus in adult mental disorder inpatients. Interpretation: The prevalence of diabetes mellitus was high among adult mental disorder inpatients in Beijing, China. Patients who were elderly, with schizophrenia, and those with hypertensive diseases, lipoprotein metabolism disorders, and fatty liver had higher risk for diabetes mellitus. Prevention and treatment of diabetes mellitus is of utmost relevance in hospitalized mental illness patients. Funding Statement: This study was supported by the grant from National Natural Science Foundation of China (No. 71874003 and No. 81703240). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study used information that is available in database of the Beijing Municipal Commission of Health and Family Planning Information Center, and all identifiable information was removed. Patients and the public were not involved in the design and conduct of the study.

Increased Risk of Diabetes in Inflammatory Bowel Disease Patients: A Nationwide Population-based Study in Korea.

The association of diabetes with inflammatory bowel disease (IBD) remains unclear. The risk of diabetes in patients with IBD compared with non-IBD controls was investigated. Using the National Health Insurance database of South Korea, 8070 patients with IBD based on the International Classification of Disease 10th revision (ICD-10) codes and rare intractable disease codes for Crohn’s disease (CD) and ulcerative colitis (UC) were compared with 40,350 non-IBD individuals (2010–2014). Newly diagnosed diabetes identified using ICD-10 codes and the prescription of anti-diabetic medication by the end of the follow-up period (2016) was investigated. During a mean follow-up of 5.1 years, the incidence of diabetes in patients with IBD was significantly higher compared with controls after adjusting for serum glucose levels and steroid use (23.19 vs. 22.02 per 1000 person-years; hazard ratio (HR), 1.135; 95% confidence interval (CI), 1.048–1.228). The risk of diabetes was significantly higher in patients with CD (HR, 1.677; 95% CI, 1.408–1.997), but not in UC (HR, 1.061; 95% CI, 0.973–1.156). The effect of IBD on the development of diabetes was significantly more prominent in younger patients (p < 0.001). Patients with CD are at a higher risk of diabetes. Regular monitoring for diabetes is recommended, even in younger CD patients who do not use steroid medication.

URINARY POTASSIUM LOSS INDUCED BY HYPERALDOSTERONE SECRETION ASSOCIATED WITH DIABETES MELLITUS PREVALENCE IN HYPERTENSIVE PATIENTS

Objective: Primary aldosteronism(PA) is characterized by hypersecretion of aldosterone with increased urinary potassium(K+) excretion and hypertension. Diabetes was more frequent in PA and the association between DM and PA involved in hypokalemia. The status of low serum K+ was related to chronic urinary K+ excretion. The aim of this study was to find out whether hyperaldosterone and urinary K+ excretion could increase the risk of diabetes in patients with PA. Design and method: 790 hypertensive in-patients were enrolled from Hypertension Center of People's Hospital Of Xinjiang. DM participants included patients with known or newly-diagnosed diabetes. All of them entered a protocol for screening PA. The positive initial screening group was defined on plasma aldosterone concentration (PAC) /renin activity (ARR) > 20 ng/dL per ng/mL/h. PA group was according on ARR > 20 plus PAC > 10 ng/dL after saline infusion test. Baseline characteristics were collected including blood pressure, lipids, plasma renin activity, PAC, serum K+ and 24 h-urine K+ levels. The relationship of hyperaldosterone or urinary K+ excretion with DM was evaluated during the screening process of PA. Results: In positive screening group, 24 h-urine K+ levels or PAC associated with DM prevalence, age tertile (OR 3.173, 95%CI 1.801–5.590, p < 0.01), urinary K+ tertile(OR 2.221, 95%CI 1.251–3.942, p < 0.01), PAC tertile(OR 1.728, 95%CI 1.091–2.737, p < 0.05) and the cumulative contribution(OR 1.262, 95%CI 1.073–1.483, p < 0.01), independent of systolic blood pressure and lipids. Compared with 86 age- and sex-matched patients without PA, patients with PA had significantly higher PAC (22.3+11.9 vs 12.6+5.7, p < 0.01), lower 24 h-urine K+ levels (46.2+29.9 vs 35.9+15.2, P < 0.01), and higher DM prevalence (29.1% vs 9.3%, P < 0.01). The level of urinary K+ (52.5+17.0 vs 46.7+21.3 vs 35.7+17.7, P < 0.05) and PAC (22.4+9.9 vs 22.9+17.2 vs 12.8+5.53, p < 0.05) were different significantly among three groups with PA&DM, single PA and no-(PA&DM) match for -age and -sex in a 1:1:1 fashion. And the correlation of 24 h-urine K+ levels or PAC with DM prevalence was clear among the groups, the coefficient of correlation were 0.323 and 0.300, respectively(P < 0.01). Conclusions: Urinary potassium loss induced by hypersecretion of aldosterone associated with DM prevalence in patients with hypertension.

Diabetes Mellitus After Pediatric Kidney Transplant.

Kidney transplant is the best renal replacement therapy for pediatric patients with end-stage renal disease; however, this procedure is not without complications. A major complication is the development of new-onset diabetes mellitus, which affects the outcomes of transplant in terms of kidney and patient survival. In this study, our objective was to calculate the percentage of pediatric patients who developed new-onset diabetes mellitus or transient hyperglycemia after kidney transplant, compare our data with international data, and discuss the related factors that predispose to diabetes. A retrospective study was conducted by reviewing the medical records of pediatric patients who had transplant procedures or were followed at the Royal Medical Services (Amman, Jordan) from 2007 to 2017. Our study cohort included 104 patients. The average follow-up time was 4 years and 7 months, with a maximum follow-up of 9 years. Ten patients developed posttransplant hyperglycemia, with 8 developing early hyperglycemia (during the first 3 months posttransplant). In 40% of patients, this complication was transient, and patients stopped insulin after immunosuppressant medications were decreased. However, 60% of patients continued to have diabetes, with 20% having late-onset diabetes and treatment with oral hypoglycemic agent. Pretransplant awareness of risk factors of new-onset diabetes mellitus after transplant and close monitoring of hyperglycemia during the posttransplant period are mandatory. Transient hyperglycemia after kidney transplant is common, and kidney transplant does not alleviate the high risk of diabetes in patients with chronic kidney disease.

Cardiovascular safety and efficacy of the PCSK9 inhibitor evolocumab in patients with and without diabetes and the effect of evolocumab on glycaemia and risk of new-onset diabetes: a prespecified analysis of the FOURIER randomised controlled trial

The proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolocumab reduced LDL cholesterol and cardiovascular events in the FOURIER trial. In this prespecified analysis of FOURIER, we investigated the efficacy and safety of evolocumab by diabetes status and the effect of evolocumab on glycaemia and risk of developing diabetes. FOURIER was a randomised trial of evolocumab (140 mg every 2 weeks or 420 mg once per month) versus placebo in 27 564 patients with atherosclerotic disease who were on statin therapy, followed up for a median of 2·2 years. In this prespecified analysis, we investigated the effect of evolocumab on cardiovascular events by diabetes status at baseline, defined on the basis of patient history, clinical events committee review of medical records, or baseline HbA1c of 6·5% (48 mmol/mol) or greater or fasting plasma glucose (FPG) of 7·0 mmol/L or greater. The primary endpoint was a composite of cardiovascular death, myocardial infarction, stroke, hospital admission for unstable angina, or coronary revascularisation. The key secondary endpoint was a composite of cardiovascular death, myocardial infarction, or stroke. We also assessed the effect of evolocumab on glycaemia, and on the risk of new-onset diabetes among patients without diabetes at baseline. HbA1c was measured at baseline then every 24 weeks and FPG was measured at baseline, week 12, week 24, and every 24 weeks thereafter, and potential cases of new-onset diabetes were adjudicated centrally. In a post-hoc analysis, we also investigated the effects on glycaemia and diabetes risk in patients with prediabetes (HbA1c 5·7-6·4% [39-46 mmol/mol] or FPG 5·6-6·9 mmol/L) at baseline. FOURIER is registered with ClinicalTrials.gov, number NCT01764633. At study baseline, 11 031 patients (40%) had diabetes and 16 533 (60%) did not have diabetes (of whom 10 344 had prediabetes and 6189 had normoglycaemia). Evolocumab significantly reduced cardiovascular outcomes consistently in patients with and without diabetes at baseline. For the primary composite endpoint, the hazard ratios (HRs) were 0·83 (95% CI 0·75-0·93; p=0·0008) for patients with diabetes and 0·87 (0·79-0·96; p=0·0052) for patients without diabetes (pinteraction=0·60). For the key secondary endpoint, the HRs were 0·82 (0·72-0·93; p=0·0021) for those with diabetes and 0·78 (0·69-0·89; p=0·0002) for those without diabetes (pinteraction=0·65). Evolocumab did not increase the risk of new-onset diabetes in patients without diabetes at baseline (HR 1·05, 0·94-1·17), including in those with prediabetes (HR 1·00, 0·89-1·13). Levels of HbA1c and FPG were similar between the evolocumab and placebo groups over time in patients with diabetes, prediabetes, or normoglycaemia. Among patients with diabetes at baseline, the proportions of patients with adverse events were 78·5% (4327 of 5513 patients) in the evolocumab group and 78·3% (4307 of 5502 patients) in the placebo group; among patients without diabetes at baseline, the proportions with adverse events were 76·8% (6337 of 8256 patients) in the evolocumab group and 76·8% (6337 of 8254 patients) in the placebo group. PCSK9 inhibition with evolocumab significantly reduced cardiovascular risk in patients with and without diabetes. Evolocumab did not increase the risk of new-onset diabetes, nor did it worsen glycaemia. These data suggest evolocumab use in patients with atherosclerotic disease is efficacious and safe in patients with and without diabetes. Amgen.

The relationship between blood groups, ABO, and Rh and the risk of diabetes in patients with acute myocardial infarction referring to Amiralmomenin Hospital in Zabol in 2016

The relationship between blood groups, ABO, and Rh and the risk of diabetes in patients with acute myocardial infarction referring to Amiralmomenin Hospital in Zabol in 2016

Research Roundup

Lithium, sertraline therapies show similar results for bipolar II depression Antipsychotics increase diabetes risk in patients with schizophrenia Lithium for bipolar disorder shows strong effect in reducing hospitalization Psychiatric medication may reduce risk of alcohol use in periods of distress Glycopyrrolate at 2‐mg dose reduces night salivation in clozapine patients Intranasal oxytocin shows potential in preventing PTSD symptoms

Prevalence of Impaired Glucose Tolerance and Diabetes Mellitus in Women with Polycystic Ovarian Syndrome

ABSTRACTIn women of reproductive age polycystic ovary syndrome (PCOS) is the common endocrine disorder. It is one of the common causes of infertility due to anovulation. There is no single criterion for the diagnosis of this syndrome. It is crucial to diagnose PCOS early in its course since it has lifelong implications with increased risk for metabolic syndrome, type II Diabetes mellitus (DM), cardiovascular disease, endometrial hyperplasia, infertility and depression. Screening for the impaired glucose (IGT), allows for proper and timely prevention and management of complications. In this cross sectional study, we planned to detect the prevalence of impaired glucose tolerance and diabetes in women with PCOS which will facilitate prevention of long term sequelae. We also studied the extent of the risk for diabetes in patients with PCOS in relation to age, socioeconomic status, rural and urban areas, BMI, waist/hip circumference ratio, family history of PCOS and diabetes mellitusHow to cite this articleSmitha CHC, Sailakshmi MOPA, Nagaratnamma R. Prevalence of Impaired Glucose Tolerance and Diabetes Mellitus in Women with Polycystic Ovarian Syndrome. J Med Sci 2017;3(4):116-118.

Stress Induced Hyperglycemia and the Subsequent Risk of Type 2 Diabetes in Survivors of Critical Illness.

ObjectiveStress induced hyperglycemia occurs in critically ill patients who have normal glucose tolerance following resolution of their acute illness. The objective was to evaluate the association between stress induced hyperglycemia and incident diabetes in survivors of critical illness.DesignRetrospective cohort study.SettingAll adult patients surviving admission to a public hospital intensive care unit (ICU) in South Australia between 2004 and 2011.PatientsStress induced hyperglycemia was defined as a blood glucose ≥ 11.1 mmol/L (200 mg/dL) within 24 hours of ICU admission. Prevalent diabetes was identified through ICD-10 coding or prior registration with the Australian National Diabetes Service Scheme (NDSS). Incident diabetes was identified as NDSS registration beyond 30 days after hospital discharge until July 2015. The predicted risk of developing diabetes was described as sub-hazard ratios using competing risk regression. Survival was assessed using Cox proportional hazards regression.Main ResultsStress induced hyperglycemia was identified in 2,883 (17%) of 17,074 patients without diabetes. The incidence of type 2 diabetes following critical illness was 4.8% (821 of 17,074). The risk of diabetes in patients with stress induced hyperglycemia was approximately double that of those without (HR 1.91 (95% CI 1.62, 2.26), p<0.001) and was sustained regardless of age or severity of illness.ConclusionsStress induced hyperglycemia identifies patients at subsequent risk of incident diabetes.

GW27-e0511 Risk assessment of diabetes in men with different cardiovascular risk

Identification and assessment of the risk of diabetes in patients with different risk of cardiovascular complications in cardiology practice. The study included 300 men aged 40 to 69 years with low-to-moderate (<5% on the scale of SCORE, n = 100), high (5-10% on a scale of SCORE, n = 101) and

Assessing the Risk for Diabetes in Patients With Unexpectedly Identified Tumors in the Adrenal Glands.

Assessing the Risk for Diabetes in Patients With Unexpectedly Identified Tumors in the Adrenal Glands.

Increased risk of diabetes in patients with anxiety disorders: A population-based study

ObjectiveFew known studies have investigated the epidemiology of diabetes in patients with anxiety disorders. Therefore, the study aimed to determine the prevalence and incidence of diabetes in patients with anxiety disorders. MethodsThe National Health Research Institute provided a database of 1,000,000 random subjects for study. We obtained a random sample aged 18years and over 766,427 subjects in 2005. Those study subjects who had at least two primary or secondary diagnoses of anxiety disorders were identified. We compared the prevalence of diabetes in anxiety patients with the general population in 2005. Furthermore, we investigated this cohort from 2006 to 2010 to detect the incident cases of diabetes in anxiety patients compared with the general population. ResultsThe prevalence of diabetes in patients with anxiety disorders was higher than that in the general population (11.89% vs. 5.92%, odds ratio, 1.23; 95% confidence interval, 1.17–1.28) in 2005. The average annual incidence of diabetes in patients with anxiety disorders was also higher than that in the general population (2.25% vs. 1.11%, risk ratio 1.34; 95% confidence interval, 1.28–1.41) from 2006 to 2010. Compared with the general population, patients with anxiety disorders revealed a higher incidence of diabetes in all age groups among both females and males. ConclusionsPatients with anxiety disorders had a much higher prevalence and incidence of diabetes in the younger adult age group than in the general population. The higher incidence of diabetes among anxiety patients was related to increased age, antipsychotic use, hypertension, and hyperlipidemia.

A Comprehensive Lifestyle Intervention to Prevent Type 2 Diabetes and Cardiovascular Diseases: the German CHIP Trial.

The prevalence of type 2 diabetes is continuously increasing. This chronic metabolic disorder is difficult to treat and imposes a considerable economic burden on the healthcare system. In view of the fact that type 2 diabetes is primarily caused by behavioral factors, effective preventive strategies are urgently needed. We examined the effects of a holistic lifestyle intervention on clinical and laboratory parameters as well as on the long-term diabetes risk in patients at risk to develop diabetes. We conducted a randomized controlled trial in a primary care setting in Hannover, Germany, with 83 patients diagnosed as (pre)diabetic or at risk for diabetes. CHIP Germany is a 40-hour coaching lifestyle intervention program for the primary and secondary prevention of type 2 diabetes and cardiovascular diseases. The intervention included a comprehensive nutrition and health educational program based on the American CHIP approach. The primary outcome parameter was the body mass index (BMI). Secondary outcome parameters included body weight, blood pressure, fasting glucose, HbA1c, blood lipids, and the FINDRISK score, which assesses long-term diabetes risk. At the final measurement after 12months, in the intervention group the BMI was reduced by 1.4 versus 0.2kg/m(2) in controls (p = .119). The mean sustained weight loss after 12months was -4.1kg in the intervention group versus -0.8kg in controls. Furthermore, we found a trend toward a stronger reduction in blood pressure, fasting glucose, and HbA1c as well as an improved FINDRISK score in the intervention group, compared to controls. Although failing to reach statistical significance at the final assessment, this comprehensive lifestyle intervention showed a noticeable reduction in several cardiometabolic risk factors which may facilitate the prevention of diabetes.