Rationale, Design, and Baseline Characteristics of Beijing Prediabetes Reversion Program: A Randomized Controlled Clinical Trial to Evaluate the Efficacy of Lifestyle Intervention and/or Pioglitazone in Reversion to Normal Glucose Tolerance in Prediabetes

Background. Patients with prediabetes are at high risk for diabetes and cardiovascular disease (CVD). No study has explored whether intervention could revert prediabetes to normal glycemic status as the primary outcome. Beijing Prediabetes Reversion Program (BPRP) would evaluate whether intensive lifestyle modification and/or pioglitazone could revert prediabetic state to normoglycemia and improve the risk factors of CVD as well.Methods. BPRP is a randomized, multicenter, 2 × 2 factorial design study. Participants diagnosed as prediabetes were randomized into four groups (conventional/intensive lifestyle intervention and 30 mg pioglitazone/placebo) with a three-year follow-up. The primary endpoint was conversion into normal glucose tolerance. The trial would recruit 2000 participants (500 in each arm).Results. Between March 2007 and March 2011, 1945 participants were randomized. At baseline, the individuals were53±10years old, with median BMI 26.0 (23.9, 28.2) kg/m2and HbA1c 5.8 (5.6, 6.1)%. 85% of the participants had IGT and 15% had IFG. Parameters relevant to glucose, lipids, blood pressure, lifestyle, and other metabolic markers were similar between conventional and intensive lifestyle intervention group at baseline.Conclusion. BPRP was the first study to determine if lifestyle modification and/or pioglitazone could revert prediabetic state to normoglycemia in Chinese population. Major baseline parameters were balanced between two lifestyle intervention groups. This trial is registered with www.chictr.org.cn:ChiCTR-PRC-06000005.

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A Randomized Controlled Clinical Trial of Lifestyle Intervention and Pioglitazone for Normalization of Glucose Status in Chinese with Prediabetes

Journal of Diabetes Research ◽

10.1155/2022/2971382 ◽

2022 ◽

Vol 2022 ◽

pp. 1-10

Author(s):

Yingying Luo ◽

Hongyuan Wang ◽

Xianghai Zhou ◽

Cuiqing Chang ◽

Wei Chen ◽

...

Keyword(s):

Glucose Tolerance ◽

Lifestyle Intervention ◽

Clinical Importance ◽

Normal Glucose Tolerance ◽

Controlled Clinical Trial ◽

Oral Glucose ◽

Intensive Lifestyle Intervention ◽

Normal Glucose ◽

Glucose Status

Aims. Prediabetes has been proved as an important risk factor of both diabetes and cardiovascular disease (CVD). Previous studies have shown that both lifestyle intervention and pioglitazone may delay the development of diabetes in patients with prediabetes. However, no study has ever explored whether these interventions could revert prediabetes to normal glycemic status as the primary outcome. Interventions that may revert prediabetes back to normal glucose status would be of great clinical importance. Materials and Methods. We conducted a randomized, multicenter, 2 × 2 factorial designed study to examine whether intensive lifestyle intervention and/or pioglitazone could revert prediabetes to normal glucose tolerance. The participants were followed up for three years unless they reverted to normal glucose state or developed diabetes at the annual oral glucose tolerance test (OGTT). Reversion to normal glucose tolerance was confirmed on the basis of the results of OGTT. Results. In our study, 1945 eligible patients were ultimately randomized into four groups. In this three-year follow-up study, overall, 60.0%, 50.3%, 56.6% and 65.1% reverted back to normoglycemic state over 3 years of follow-up in the conventional lifestyle intervention plus placebo, intensive lifestyle intervention plus placebo, conventional lifestyle intervention plus pioglitazone, and intensive lifestyle intervention plus pioglitazone groups, respectively. Compared to the conventional lifestyle intervention plus placebo group, all the other three groups did not show any significant benefit in terms of reverting back to normoglycemic state. Conclusion. In our study, for patients with prediabetes, neither intensive lifestyle intervention nor pioglitazone had led to a higher reversion rate to normal glucose state. Trail registration.http://www.chictr.org.cn: ChiCTR-PRC-06000005.

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Liraglutide Therapy in a Prediabetic State: Rethinking the Evidence

Current Diabetes Reviews ◽

10.2174/1573399816666191230113446 ◽

2020 ◽

Vol 16 (7) ◽

pp. 699-715 ◽

Cited By ~ 1

Author(s):

Georgios S. Papaetis

Keyword(s):

Type 2 Diabetes ◽

Glucose Tolerance ◽

Cell Function ◽

Normal Glucose Tolerance ◽

Current Evidence ◽

Β Cell ◽

Prediabetic State ◽

New Therapeutic Approaches ◽

Normal Glucose

Background: Prediabetes is defined as a state of glucose metabolism between normal glucose tolerance and type 2 diabetes. Continuous β-cell failure and death are the reasons for the evolution from normal glucose tolerance to prediabetes and finally type 2 diabetes. Introduction: The necessity of new therapeutic approaches in order to prevent or delay the development of type 2 diabetes is obligatory. Liraglutide, a long-acting GLP-1 receptor agonist, has 97% homology for native GLP-1. Identification of the trophic and antiapoptotic properties of liraglutide in preclinical studies, together with evidence of sustained β-cell function longevity during its administration in type 2 diabetes individuals, indicated its earliest possible administration during this disease, or even before its development, so as to postpone or delay its onset. Methods: Pubmed and Google databases have been thoroughly searched and relevant studies were selected. Results: This paper explores the current evidence of liraglutide administration both in humans and animal models with prediabetes. Also, it investigates the safety profile of liraglutide treatment and its future role to postpone or delay the evolution of type 2 diabetes. Conclusion: Liralgutide remains a valuable tool in our therapeutic armamentarium for individuals who are overweight or obese and have prediabetes. Future well designed studies will give valuable information that will help clinicians to stratify individuals who will derive the most benefit from this agent, achieving targeted therapeutic strategies.

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GDF-15 and Hepcidin Levels in Nonanemic Patients with Impaired Glucose Tolerance

Journal of Diabetes Research ◽

10.1155/2016/1240843 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Mehmet Muhittin Yalcin ◽

Alev Eroglu Altinova ◽

Mujde Akturk ◽

Ozlem Gulbahar ◽

Emre Arslan ◽

...

Keyword(s):

Uric Acid ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Area Under The Curve ◽

Normal Glucose Tolerance ◽

Current Data ◽

Prediabetic State ◽

Protein Levels ◽

Normal Glucose ◽

Positive Correlations

Aims. Growth Differentiation Factor-15 (GDF-15) has been suggested as one of the regulators of hepcidin, an important regulatory peptide for iron deposition. Current data is conflicting about the relationship between hepcidin and disorders of glucose metabolism. We aimed to investigate serum hepcidin and GDF-15 concentrations and their associations with each other, in nonanemic subjects with impaired glucose tolerance (IGT) in comparison with the nonanemic subjects with normal glucose tolerance (NGT).Methods. Thirty-seven subjects with IGT and 32 control subjects with NGT, who were age-, gender-, and body mass index- (BMI-) matched, were included in the study.Results. Serum GDF-15 levels were significantly higher in IGT compared to NGT. There were no differences in hepcidin, interleukin-6, and high sensitive C-reactive protein levels between the groups. We found a positive correlation between GDF-15 and hepcidin levels. There were also positive correlations between GDF-15 and age, uric acid, creatinine, and area under the curve for glucose (AUC-G). Hepcidin was correlated positively with ferritin levels. In the multiple regression analysis, GDF-15 concentrations were independently associated with age, uric acid, and AUC-G.Conclusions. Impaired glucose tolerance is associated with increased GDF-15 levels even in the absence of anemia, but the levels of hepcidin are not significantly altered in prediabetic state.

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Influence of improvement or worsening of glucose tolerance on risk of stroke in persons with impaired glucose tolerance

International Journal of Stroke ◽

10.1177/1747493018784432 ◽

2018 ◽

Vol 13 (9) ◽

pp. 941-948

Author(s):

Xiaoxia Shen ◽

Ping Zhang ◽

Jinping Wang ◽

Yali An ◽

Edward W Gregg ◽

...

Keyword(s):

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Plasma Glucose ◽

Exercise Intervention ◽

Control Diet ◽

Intervention Group ◽

Normal Glucose Tolerance ◽

Early Years ◽

Normal Glucose

Background and aim We sought to determine the effect of regression to normal glucose tolerance (NGT) or progression to diabetes in early years of impaired glucose tolerance (IGT) on subsequent risk of stroke. Methods In 1986, 576 adults aged 25 years and older with impaired glucose tolerance in Da Qing, China, were randomly assigned by clinic to control, diet, exercise, or diet plus exercise intervention groups for a six-year period. Subsequently participants received medical care in their local clinics. We tracked participants for additional 17 years to ascertain stroke events and other outcomes. Results At the end of 6-year intervention trial follow-up, 272 (50.2%) had progressed to diabetes, 169 (31.2%) regressed to normal glucose tolerance, and 101 (18.6%) remained impaired glucose tolerance. During the subsequent 17-year follow-up, 173 (31.9%) developed a stroke, 26.7% of normal glucose tolerances, 30.7% of impaired glucose tolerances, and 36.1% of those with diabetes. After controlling for age, sex, baseline blood pressure, smoking, total cholesterol, previous cardiovascular disease and intervention group, those who developed diabetes in the first six years had a higher incidence of stroke than those who reverted to normal glucose tolerance (HR = 1.49, 95% CI 1.01–2.19, p = 0.04), whereas for those who remained impaired glucose tolerance compared to those who regressed to normal glucose tolerance the HR was 1.25 (95% CI 0.80–1.93; p = 0.30). A 1-mmol/L increase in both fasting and 2-h post-load plasma glucose from entry to end of the six-year trial was significantly associated with a higher risk of development of stroke in the subsequent 17 years, respectively (HR = 1.07, 95% CI 1.03–1.11, p < 0.0001 for fasting glucose, HR = 1.05, 95% CI 1.02–1.09, p = 0.007 for 2-h post-load plasma glucose). Conclusions Among Chinese adults with impaired glucose tolerance, early progression to diabetes predicted a higher risk of stroke, compared those who regressed to normal glucose tolerance.

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Predictors of deterioration of glucose tolerance and effects of lifestyle intervention aimed at reducing visceral fat in normal glucose tolerance subjects with abdominal obesity

Journal of Diabetes Investigation ◽

10.1111/j.2040-1124.2010.00080.x ◽

2010 ◽

Vol 2 (3) ◽

pp. 218-224 ◽

Cited By ~ 3

Author(s):

Etsuko F Akita ◽

Hiromi Iwahashi ◽

Yukiyoshi Okauchi ◽

Kohei Okita ◽

Midori Noguchi ◽

...

Keyword(s):

Glucose Tolerance ◽

Lifestyle Intervention ◽

Abdominal Obesity ◽

Visceral Fat ◽

Normal Glucose Tolerance ◽

Normal Glucose

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Return to Normal Glucose Tolerance Reaps CV Benefits

Internal Medicine News ◽

10.1016/s1097-8690(09)70170-2 ◽

2009 ◽

Vol 42 (5) ◽

pp. 17

Author(s):

MIRIAM E. TUCKER

Keyword(s):

Glucose Tolerance ◽

Normal Glucose Tolerance ◽

Normal Glucose

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STUDIES IN CONGENITAL GENERALIZED LIPODYSTROPHY (SEIP-BERARDINELLI SYNDROME)

Acta Endocrinologica ◽

10.1530/acta.0.0720475 ◽

1973 ◽

Vol 72 (3) ◽

pp. 475-494 ◽

Cited By ~ 21

Author(s):

Svein Oseid

Keyword(s):

Insulin Resistance ◽

Glucose Tolerance ◽

Normal Glucose Tolerance ◽

Juvenile Form ◽

Congenital Generalized Lipodystrophy ◽

Glucose Levels ◽

Normal Glucose ◽

Glucose Tolerance Tests ◽

The One ◽

Adipose Organ

ABSTRACT Six cases of congenital generalized lipodystrophy have been studied at different ages from infancy to adolescence with regard to glucose tolerance, insulin secretion, and insulin sensitivity. During the first few years of life there is normal glucose tolerance. The fasting immuno-reactive insulin (IRI) levels are either slightly elevated or normal. The IRI response to glucose is exaggerated and prolonged, at least from the third year of life. Some degree of insulin resistance is already present in infancy. From the age of 8–10 years glucose tolerance decreases rapidly. The fasting IRI levels are usually grossly elevated, while fasting plasma glucose levels are only moderately elevated or normal. The IRI responses to oral and iv administered glucose, and to tolbutamide are exaggerated; the insulinogenic indices are high. Cortisone primed glucose tolerance tests become abnormal. Insulin resistance is marked, and increases with age. After cessation of growth at approximately 12 years of age, frank diabetes with fasting hyperglycaemia and diabetic glucose tolerance curves developed in the one patient followed beyond this age. Her fasting IRI was increased, but there was a poor IRI response to glucose stimulation, suggesting a partial exhaustion of the β-cells. Her initial IRI response to tolbutamide was still good, but not as brisk as in the younger patients. This type of diabetes is quite different from the juvenile form, and also from the diabetes of older age. It may be causally related to the lack of an adequate adipose organ necessary for the disposal of excesses of glucose, or possibly related to another anti-insulin mechanism.

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