Abstract 008: Risk Factors for Type 2 Diabetes Mellitus Preceded by β-cell Dysfunction, Insulin Resistance, or Both: The Cardiovascular Health Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Fumiaki Imamura ◽  
Kenneth J Mukamal ◽  
James B Meigs ◽  
Jose A Luchsinger ◽  
Joachim H Ix ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Older Adults ◽  
Fasting Glucose ◽  
Β Cell ◽  
Cell Dysfunction

Background: Type 2 diabetes mellitus (DM) results from insulin resistance (IR), pancreatic β-cell dysfunction, or both. We hypothesized that risk factors could differ for DM preceded predominantly by IR, β-cell dysfunction, or both. This hypothesis is particularly important for older adults, in whom β-cell dysfunction may be relatively common. Methods: During 18 years of follow-up among 3,899 older adults free of DM (mean±sd age =73.0±5.8), we identified 274 incident DM cases by DM medication use, fasting glucose (≥126 mg/dL), or 2-hour post-challenge glucose (≥200 mg/dL), for whom homeostatic model assessments for IR (HOMA-IR) and β-cell function (HOMA-B) were assessed after baseline and before DM diagnosis. Using median cutoffs of the follow-up HOMA-IR and HOMA-B, we subclassified incident DM into DM preceded by IR only (n=112), β-cell dysfunction only (n=70), or both (n=77). Using multivariate competing-risk Cox models, we tested whether DM risk factors were differentially associated with risk of each DM subclass. Results: Elevated triglyceride levels (≥150 mg/dL) and impaired fasting glucose (100-125 mg/dL) were each positively associated with DM, irrespective of the DM subclass. Other DM risk factors of older age, overweight, obesity, low HDL cholesterol, and hypertension had substantially varying relationships with risk of different DM subclasses (p<0.001 for the variations). For example, overweight (BMI=25-29.9 kg/m2) and obesity (BMI≥30 kg/m2) were each positively associated with DM preceded by IR only (hazard ratio [95% CI]= 2.21 [1.25-3.92] and 5.02 [2.81-9.00], respectively), but with a significant inverse association with DM preceded by β-cell dysfunction only (0.61 [0.37-1.00] and 0.33 [0.14-0.80], respectively) (Figure). Conclusions: Among older adults, some DM risk factors differ substantially depending on HOMA-IR or HOMA-B subclassification. These findings support our hypothesis of heterogeneity in incident DM, especially among older adults.

scholarly journals Risk Factors for Type 2 Diabetes Mellitus Preceded by β-Cell Dysfunction, Insulin Resistance, or Both in Older Adults

2013 ◽  
Vol 177 (12) ◽  
pp. 1418-1429 ◽  
Author(s):  
Fumiaki Imamura ◽  
Kenneth J. Mukamal ◽  
James B. Meigs ◽  
José A. Luchsinger ◽  
Joachim H. Ix ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Older Adults ◽  
Type 2 Diabetes Mellitus ◽  
Β Cell ◽  
Cell Dysfunction

scholarly journals Perkembangan Diabetes Melitus Tipe 2 dari Prediabetes di Bogor, Jawa Barat

2018 ◽  
pp. 59-69 ◽  
Author(s):  
Eva Sulistiowati ◽  
Marice Sihombing
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Plasma Glucose ◽  
Central Obesity ◽  
Fasting Glucose ◽  
Diabetes Melitus

Abstrak Prediabetes merupakan kondisi gula darah puasa 100-125mg/dL (Impaired Fasting Glucose/IFG) atau kadar gula darah 2 jam setelah pembebanan 75 g glukosa 140-199 mg/dL (Impaired Glucose Tolerance/IGT). Prediabetes meningkatkan risiko terjadinya Diabetes Mellitus tipe 2 (DM tipe 2). Tujuan analisis ini untuk mengetahui terjadinya DM Tipe 2 pada responden dengan prediabetes dalam follow-up 2 tahun. Prospektif studi dalam 2 tahun pada 3344 responden Studi Kohor Faktor Risiko PTM non-DM tipe 2. Data yang dikumpulkan meliputi wawancara, pemeriksaan fisik (BB, TB, lingkar perut, tekanan darah), dan laboratorium (GDP, GDPP, Kolesterol total, HDL, LDL, Trigliserida). Kadar glukosa darah untuk DM Tipe 2 dan prediabetes mengacu pada kriteria ADA 2011. Analisis deskriptif tentang karakteristik, life tabel perkembangan DM Tipe 2 dari prediabetes. Prediabetes yang terjadi sebesar 24,6% (IFG 2,3%; IGT 19,2% dan mix IFG/IGT 2,8%) dan 13,4% mengalami DM tipe 2 dalam kurun waktu 2 tahun. Progresivitas terjadinya DM dari IFG, IGT dan mix TGTmasing-masing 6,21; 6,12 dan 14,6 per 100 orang per tahun. Faktor risiko yang mempengaruhi terjadinya DM tipe 2 antara lain: umur (40-54 tahun RR=1,97; CI 95%:1,02-3,82), 55-65 tahun (RR=2,74; CI 95%: 1,34-5,58), obesitas sentral (RR=4,42; CI 95%: 2,36-8,29), hipertensi (RR= 1,99; CI 95%: 1,29-3,06) dan hipertrigliserida (RR=1,83; CI 95%: 1,18-2,83). Proporsi prediabetes dan terjadinya DM tipe 2 di Bogor Tengah dalam pengamatan 2 tahun, meningkat dengan bertambahnya umur dan dipengaruhi oleh obesitas sentral, hipertensi, hipertrigliserida. Pengendalian faktor risiko dan pemeriksaan gula darah secara rutin dapat mencegah terjadinya DM tipe 2. Perlu ditunjang dengan posbindu PTM aktif di masyarakat, lingkungan kerja maupun sekolah. Kata kunci: Prediabetes, Diabetes Melitus tipe 2 (DM tipe 2), Bogor Tengah Abstract Prediabetes is a condition that fasting plasma glucose 100-125 mg/dL (Impaired Fasting Glucose/IFG) or blood glucose 2 hours after loading 75 g glucose 140-199 mg/dL (Impaired Glucose Tolerance/IGT). Prediabetes increases the risk of type 2 Diabetes Mellitus (T2DM). This analysis is to determine the progression rate to T2DM in prediabetes respondents during 2 years follow up. This is an two years prospective study in 3344 respondents Cohort Study of Risk Factors NCD without T2DM. The data collected included interviews, physical examination (body weight, height, abdominal circumference, blood pressure), and laboratory (fasting plasma glucose/FPG, plasma glucose 2 hours after loading 75 g glucose, total cholesterol, HDL, LDL, triglycerides). Blood glucose levels for DM and prediabetes refers to ADA criteria 2011. Data analisized by descriptive about characteristics, life table of T2DM development from prediabetes. Prediabetes occurred at 24.6% (IFG 2.3%, IGT 19.2% and mix IFG / IGT 2.8%) and 13.4% experienced type 2 diabetes within 2 years. The progression of DM from IFG, IGT and mix TGT is 6.21; 6.12 and 14,6 per 100 person per year respectively. The risk factors of T2DM are age (40-54 years old (RR=1,97; CI 95%:1,02-3,82), 55-65 years old (RR=2,74; CI 95%:1,34-5,58), central obesity (RR=4,42; CI 95%:2,36-8,29), hypertension (RR=1,99; CI 95%:1,29-3,06) and hypertriglyceride (RR=1,83; CI 95%:1,18-2,83). The proportion of prediabetes and progression T2DM in Central Bogor at 2 years follow up is quite high, increasing with age and influenced by central obesity, hypertension and hypertriglyceride. Controlling risk factors and checking blood glucose regularly can prevent T2DM. Need to be supported by posbindu PTM active in the community, work environment and school. Keywords: Prediabetes, type 2 Diabetes Mellitus (T2DM), Central Bogor

Abstract P130: Risk Factors for Progression to Type 2 Diabetes Mellitus From Prediabetes

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Margareta Hellgren ◽  
Ulf Lindblad ◽  
Bledar Daka
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Family History ◽  
Glucose Tolerance

Background and Aims: Individuals with prediabetes, impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), have approximately 50% risk to develop type 2 diabetes mellitus (T2DM) within ten years. This paper examines risk factors for development of T2DM in individuals with prediabetes. Materials and Methods: A total of 2816 individuals were randomly selected and completed a careful physical examination and an oral glucose tolerance test. IFG and IGT was defined according to WHO. A representative sample of 1327 individuals were re-examined in a follow-up study after ten years. This study focuses on the participants who were diagnosed with prediabetes, IFG (n=67) and/or IGT (n=89) at baseline and who were re-examined at follow-up. Insulin resistance was estimated by HOMA-ir (Homeostatic Model Assessment for Insulin Resistance). Differences between the participants with prediabetes who developed T2DM and those who did not, were analyzed with general linear models and adjusted for age, sex and BMI. The risk to progress to T2DM in ten years was explored using binary logistic regression, adding the risk-factors one after another. Results: Of the 156 individuals with prediabetes 28% progressed to T2DM. Individuals who developed T2DM had higher BMI (α=3.2kg/m 2 , P<0.001), higher HbA1c (α=0.2 mmol/mol, P=0.047), higher C-reactive protein (α=3.3 mmol/L, P=0.040) and also significantly higher HOMAir (α=2.8, P<0.001) at base-line. The risk to develop T2DM increased in a step-wise manner in individuals with prediabetes when successively adding the risk-factors. Having a BMI ≥30kg/m 2 , a known family history for T2DM, HbA1c ≥37mmol/mol, HOMAir ≥2.8 and a low level of physical activity increased the risk to develop T2DM 5.6 times. Table 1. Conclusion: In individuals with prediabetes, those with additional risk-factors like obesity, HbA1c and HOMAir above mean values, family history for T2DM and a low level of physical activity require extra attention and intensive lifestyle interventions should be initiated.

scholarly journals Incidence and risk factors of type 2 diabetes mellitus in individuals with different fasting plasma glucose levels

2020 ◽  
Vol 11 ◽  
pp. 204201882092884
Author(s):  
Yumei Han ◽  
Shan Zhang ◽  
Shuo Chen ◽  
Jingbo Zhang ◽  
Xiuhua Guo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Protective Factors ◽  
Fasting Glucose ◽  
Density Lipoprotein ◽  
Older Age ◽  
Obesity Hypertension

Objective: Our aim was to examine the incidence and risk factors of type 2 diabetes mellitus (T2DM) among individuals with different fasting plasma glucose (FPG) levels. Methods: According to the first FPG value recorded between January 2006 and December 2017, individuals without T2DM (FPG <7 mmol/L) were divided into three groups: normal fasting glucose (NFG, FPG < 5.6 mmol/L), slightly impaired fasting glucose (IFGlow, 5.6 mmol/L ⩽ FPG < 6.1 mmol/L), and severely impaired fasting glucose (IFGhigh, 6.1 mmol/L ⩽ FPG < 7.0 mmol/L). Physical examination results, blood biochemical indicators, and questionnaire survey data were collected and the T2DM incidence was examined during the follow-up period. A Cox regression model was used to analyze the T2DM risk factors in the three groups. Results: A total of 44,852 individuals (55.33% men) were included in our study. During the follow-up period (mean follow-up time: 3.73 ± 0.01 years), 2912 T2DM cases occurred. The T2DM incidence rate of the NFG, IFGlow, and IFGhigh groups were 1.5%, 22.2%, and 43.8%, respectively ( p < 0.05). In the NFG group, the risk factors for T2DM were older age, overweight, obesity, hypertension, hyperuricemia, and increased estimated glomerular filtration rate (eGFR); the protective factors were female sex and high high-density lipoprotein cholesterol (HDL-C). In the IFGlow group, the risk factors for T2DM were older age, overweight, obesity, hypertension, and high total cholesterol (TC); the protective factors were increased triglyceride, low-density lipoprotein cholesterol (LDL-C), and HDL-C. In the IFGhigh group, the risk factors for T2DM were older age, obesity, high eGFR, and high TC; the protective factors were female sex, hyperuricemia, high LDL-C, and high HDL-C (all, p < 0.05). Conclusions: The increased T2DM rates were associated with increased FPG. Risk factors for T2DM vary in the NFG, IFGlow, and IFGhigh groups.

scholarly journals Visceral Adiposity Index is associated with Insulin Resistance, impaired Insulin Secretion, and β-cell dysfunction in subjects at risk for Type 2 Diabetes

2021 ◽  
pp. 100013
Author(s):  
Froylan David Martínez-Sánchez ◽  
Valerie Paola Vargas-Abonce ◽  
Andrea Rocha-Haro ◽  
Romina Flores-Cardenas ◽  
Milagros Fernández-Barrio ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
At Risk ◽  
Insulin Secretion ◽  
Visceral Adiposity ◽  
Visceral Adiposity Index ◽  
Β Cell ◽  
Cell Dysfunction ◽  
Impaired Insulin
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