scholarly journals Do Antipsychotics Modify Age and Weight as Risk Factors for Diabetes Mellitus?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
D. Cohen ◽  
H. Burger ◽  
C. Gispen de Wied ◽  
R. Stolk ◽  
D. Grobbee

Aims:Study of risk factors of diabetes mellitus from the general population in a schizophrenic population.Method:Measurement of glucose and insuline levels, fasting and 120’ after oral glucose tolerance test (OGTT) and calculating of HOMA-IR and HOMA-B.Results:We studied 167 outpatients, mean age 40.2 years, 90.9% Caucasian, suffering from schizophrenia (83%) or schizoaffective disorder (17%).Age could not be confirmed as a risk factor on any of the glucose or insuline measurements or HOMA in patients with typical or atypical antipsychotics.With bodyweight, patients with typical differed from those with atypical antipsychotics. Weight was not a risk factor on any measurement or model in with typical antipsychotics. In patients with atypical, a significant correlation with levels of plasma glucose (p=0.017), insuline (p= 0.003 resp. p= 0.010) or glucose homeostasis models (p= 0.004 resp. p= 0.016). Fasting plasma glucose (FPG) was the notable exception (p=0.987).Conclusion:Diabetes risk factors age and weight behave differently in schizophrenia or schizoaffective disorder.The finding that age was not a risk factor, suggests that age is not a suitable criterion for the decision of glucose screening in this population.The different effect of weight (a risk factor only in patients treated with atypical, but not with typical antipsychotics) suggests in different pathophysiological pathway.As FPG was the only measurement with no correlation with either risk factors, this suggests that FPG is insufficiently sensitive for detection of disturbed glucosemetabolism in schizophrenia. Additional measurements (fasting insuline, HOMA-IR, HOMA-B, OGTT) seem to be necessary.

2020 ◽  
Author(s):  
Naohisa Masuko ◽  
Kenji Tanimura ◽  
Nobue Kojima ◽  
Hitomi Imafuku ◽  
Masashi Deguchi ◽  
...  

Abstract This prospective cohort study aimed to evaluate the risk factors for pregnancy complications and postpartum glucose intolerance (GI) in women with gestational diabetes mellitus (GDM). A total of 140 women with GDM were enrolled. Of these, 115 underwent a 75-g oral glucose tolerance test (OGTT) at 12 weeks after delivery. Clinical factors and parameters in the antepartum 75-g OGTT associated with pregnancy complications and postpartum GI were evaluated. Women with GDM experienced pregnancy complications, including hypertensive disorders of pregnancy (HDP, n=19), preterm delivery (PD, n=17), heavy-for-date (HFD, n=19), and light-for-date (LFD, n=12), and 22 of the 115 women with GDM developed postpartum GI. The univariate and multivariable logistic regression analyses revealed the following risk factors: histories of hypertension (odds ratio [OR], 23.8; 95% confidence interval [CI], 4.2–134.7; p<0.01) for HDP; histories of hypertension (OR, 9.8; 95% CI, 2.5–38.9; p<0.01) for PD; HbA1c levels (OR, 7.6; 95% CI, 1.5–37.9; p<0.05) for HFD; and oral deposition index (DI) (OR, 0.1; 95% CI, 0.02–0.7; p<0.01) for postpartum GI. Higher HbA1c levels and lower oral DI on the antepartum 75-g OGTT may be useful markers for identifying GDM women who are at high risk for HFD and postpartum GI, respectively.


Diagnosis ◽  
2019 ◽  
Vol 6 (4) ◽  
pp. 377-383 ◽  
Author(s):  
Graziella Bonetti ◽  
Davide Giavarina ◽  
Mariarosa Carta

Abstract Background Plasma glucose levels provide the cornerstone of diabetes evaluation, and so it is crucial that clinical laboratories provide accurate and reliable plasma glucose results. To prevent in vitro glycolysis, citrate is used. Here, we present the first study on the 75-g oral glucose tolerance test (OGTT) using the currently available new citrate-containing tubes in liquid and granular forms and the previous sodium fluoride (NaF) for the diagnosis of carbohydrate metabolism disorders and gestational diabetes mellitus (GDM) according to the American Diabetes Association (ADA) guidelines. Methods The 75-g OGTT was performed in 147 volunteers, 83 of whom were pregnant women. Blood was collected in NaF/K3 ethylenediaminetetraacetic acid (EDTA) and NaF/Na2EDTA/citrate in liquid form in tubes in Brescia and in NaF/K2Ox and NaF/Na2EDTA/citrate in granular form in Vicenza. Glucose was measured within 3–4 h from the OGTT. The mean biases were calculated and compared with the desirable bias (<± 2.1%). Results OGTT glucose concentrations were higher in citrate tubes when compared to NaF-containing tubes. When citrate tubes were used, GDM increased to 12.5 and 11.7% in Brescia and Vicenza, respectively. Impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and diabetes mellitus (DM) increased to 36.7, 6.7 and 3.4%, respectively, in Brescia. In Vicenza, an increase of 47 and 1.9% in IFG and IGT, respectively, was found. Conclusions OGTT glucose measurement in citrate-containing tubes was shown to be more effective than those containing only NaF in diagnosing carbohydrate disorders. This new glycolysis inhibitor seems to be a necessary preanalytical tool for accurate and reliable plasma glucose results.


2021 ◽  
Vol 29 ◽  
pp. 57-63
Author(s):  
Jiayu Lu ◽  
Song Zhang ◽  
Hongqing Jiang ◽  
Lin Yang ◽  
Dongmei Hao ◽  
...  

BACKGROUND: Oral glucose tolerance test (OGTT) is a standard for the diagnosis of gestational diabetes mellitus (GDM). However, clinically, some cases with normal results were diagnosed as GDM in the third trimester. OBJECTIVE: To establish a risk model based on energy metabolism, epidemiology, and biochemistry that could predict the GDM pregnant women with normal OGTT results in the second trimester. METHODS: Qualitative and quantitative data were analyzed to find out the risk factors, and the binary logistic backward LR regression was used to establish the prediction model of each factor and comprehensive factor, respectively. RESULTS: The risk factors including the rest energy expenditure per kilogram of body weight, oxygen consumption per kilogram of body weight, if more than the weight gain criteria of the Institute of Medicine, the increase of body mass index between the second trimester and pre-pregnancy, and fasting blood glucose. By comparison, the comprehensive model had the best prediction performance, indicating that 85% of high-risk individuals were correctly classified. CONCLUSION: Energy metabolism, epidemiology, and biochemistry had better recognition ability for the GDM pregnant women with normal OGTT results in the second trimester. The addition of metabolic factors in the second trimester also improved the overall prediction performance.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Silas Alegu Nwali ◽  
Robinson Chukwudi Onoh ◽  
Ikechukwu Bo Dimejesi ◽  
Vitus Okwuchukwu Obi ◽  
Sunday Emmanuel Jombo ◽  
...  

Abstract Aim To compare universal screening with selective risk factor based screening for GDM, using the one-step 75 g oral glucose tolerance test (OGTT). Materials and method A cross-sectional, comparison between universal and selective risk factor based screening for GDM, among 400 antenatal care clients at Alex-Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA). All the participants had 75 g OGTT at 24–28 weeks of gestation and risk factor screening for GDM. All 400 participants formed the universal group while participants with one or more of the considered risk factors formed the selective risk factor group. Data were analyzed using IBM SPSS version 20. Statistical comparison was done using t- test for continuous variables. Logistics regression was used to determine the level of associations of the independent predictors for hyperglycemia. Level of significance was set at P < 0.05. Results The point prevalence of GDM using universal and selective screening were 11.51 and 7.93% respectively, giving a selective screening miss rate of 31.11%. The sensitivity, specificity, positive predictive value and negative predictive value were 73.58, 48.82, 19.12 and 92.51% respectively for the selective risk factor based screening compared to universal screening. On multivariate analysis; age ≥ 35 years, weight ≥ 90 kg, history of previous GDM and hypertension were significantly related to the development of hyperglycemia. Conclusion Selective risk factor based screening missed 31.11% of patients with GDM when compare to Universal screening with one step 75 g OGTT. Universal screening for GDM using the one step 75 g OGTT is recommended for pregnant women and more studies are needed to compare pregnancy outcomes for pregnant women diagnosed with GDM with and without risk factors.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Inés Urrutia ◽  
◽  
Alicia Martín-Nieto ◽  
Rosa Martínez ◽  
J Oriol Casanovas-Marsal ◽  
...  

AbstractThe aim of this study was to estimate the incidence of diabetes mellitus in the Basque Country and the risk factors involved in the disease by reassessing an adult population after 7 years of follow-up. In the previous prevalence study, 847 people older than 18 years were randomly selected from all over the Basque Country and were invited to answer a medical questionnaire, followed by a physical examination and an oral glucose tolerance test. In the reassessment, the same variables were collected and the resulting cohort comprised 517 individuals of whom 43 had diabetes at baseline. The cumulative incidence of diabetes was 4.64% in 7 years and the raw incidence rate was 6.56 cases/1000 person-years (95%CI: 4.11–9.93). Among the incident cases, 59% were undiagnosed. The most strongly associated markers by univariate analyses were age > 60 years, dyslipidaemia, prediabetes and insulin resistance. We also found association with hypertension, obesity, family history of diabetes and low education level. Multivariate analysis adjusted for age and sex showed that a set of risk factors assessed together (dyslipidaemia, waist-to-hip-ratio and family history of diabetes) had great predictive value (AUC-ROC = 0.899, 95%CI: 0.846–0.953, p = 0.942), which suggests the need for early intervention before the onset of prediabetes.


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