scholarly journals Prediabetes as a Therapeutic Target

2011 ◽  
Vol 57 (2) ◽  
pp. 215-220 ◽  
Author(s):  
Omid Rad Pour ◽  
Samuel Dagogo-Jack
Keyword(s):  
Cardiovascular Disease ◽  
Glucose Tolerance ◽  
Plasma Glucose ◽  
Glucose Concentration ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Plasma Glucose Concentration ◽  
Oral Glucose ◽  
Lifestyle Modifications ◽  
Increased Risk

BACKGROUND The term “prediabetes” is used to describe a condition that involves impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). IGT is defined by a 2-h oral glucose tolerance test plasma glucose concentration >140 mg/dL (7.8 mmol/L) but <200 mg/dL (11.1 mmol/L), and IFG is defined by a fasting plasma glucose concentration ≥100 mg/dL (5.6 mmol/L), but <126 mg/dL (7.0 mmol/L). Studies have shown that people with prediabetes tend to develop type 2 diabetes within 10 years and are at increased risk for cardiovascular disease and death even before the development of diabetes. CONTENT In this minireview we discusses the epidemiology, pathophysiology, and clinical implications of prediabetes. The rationale for therapeutic intervention in people with prediabetes, the goals of intervention, and the specific tools for intervention are presented. Emphasis is placed on data from randomized controlled clinical trials, whenever such data are available. SUMMARY Approximately 57 million Americans have prediabetes and are consequently at risk for cardiometabolic complications. Lifestyle modifications (dietary restriction and exercise) and certain medications can prevent the development of diabetes in persons with prediabetes. Lifestyle intervention also has been demonstrated to decrease cardiovascular disease risk markers, although data on clinical events are lacking.

scholarly journals Impact of low fasting plasma glucose on mortality in the general population

2020 ◽  
Vol 17 (3) ◽  
pp. 147916412093059
Author(s):  
Parag A Chevli ◽  
Muhammad Imtiaz Ahmad ◽  
Krupal Hari ◽  
Muhammad Ali Anees ◽  
Elsayed Z Soliman
Keyword(s):  
Cardiovascular Disease ◽  
Confidence Interval ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Hazard Ratio ◽  
Fasting Plasma ◽  
Increased Risk ◽  
All Cause Mortality

Background: While the association between hypoglycaemia and poor outcomes in diabetes is well established, it is unclear whether such an association is generalizable to those without diabetes. Methods: A total of 8497 participants free of cardiovascular disease and diabetes from the Third National Health and Nutrition Examination Survey were included. We examined the relationship between baseline low (<80 mg/dL) and high (⩾126 mg/dL) fasting plasma glucose compared to normal levels (80–99 mg/dL). Results: Over a median follow-up of 14 years, 2101 deaths occurred, of which 570 were due to cardiovascular disease. In a model adjusted for sociodemographic and cardiovascular disease risk factors, individuals with low fasting plasma glucose were at increased risk of cardiovascular disease and all-cause mortality [hazard ratio = 1.79 (95% confidence interval = 1.04–3.08) and hazard ratio = 1.35 (95% confidence interval = 1.02–1.78), respectively], compared to those with normal fasting plasma glucose. These associations were stronger among men than women for both cardiovascular disease mortality and all-cause mortality. Conclusion: Low fasting plasma glucose in individuals without diabetes is a risk factor for cardiovascular disease and all-cause mortality, especially in men.

Post-load glucose measurements in oral glucose tolerance tests correlate well with 1,5-anhydroglucitol, an indicator of overall glycaemic state, in subjects with impaired glucose tolerance

2001 ◽  
Vol 101 (3) ◽  
pp. 227-233 ◽  
Author(s):  
Toshikazu YAMANOUCHI ◽  
Tae INOUE ◽  
Eri OGATA ◽  
Akiko KASHIWABARA ◽  
Nobuyuki OGATA ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Plasma Glucose ◽  
Glucose Concentration ◽  
Inverse Correlation ◽  
Glycated Haemoglobin ◽  
Plasma Glucose Concentration ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Cross Sectional

Using both cross-sectional and longitudinal methods, we investigated the relationship between post-load serum glucose concentration in a 75 g oral glucose tolerance test (OGTT) and overall glycaemic state in subjects with impaired glucose tolerance (IGT). Glycaemic state was assessed by measuring glycated haemoglobin (HbA1c) and the serum concentration of 1,5-anhydroglucitol (1,5-AG). In the cross-sectional study, the concentration of 1,5-AG, while remaining within a normal range, was reduced to a degree proportional to the post-load glycaemic level. Although the correlation between HbA1c and post-load plasma glucose was relatively weak (r = 0.281, P < 0.001), a significant inverse correlation (r =-0.824, P < 0.0001) was found between 1,5-AG and mean post-load plasma glucose concentration in 211 subjects with IGT. Fasting plasma glucose (r =-0.539, P < 0.0001) and 2 h plasma glucose (r =-0.621, P < 0.0001) were correlated with 1,5-AG less strongly than was post-load glycaemia. Both 1,5-AG and HbA1c were correlated weakly but significantly with the fasting insulin concentration. In the longitudinal study we measured 1,5-AG and mean post-load plasma glucose with an OGTT once yearly for 10 years in 15 subjects with IGT. Strong inverse correlations were seen between 1,5-AG and mean post-load plasma glucose in each subject (range of r values among subjects of -0.584 to -0.978). These findings suggest a close relationship between post-load plasma glucose concentration measured by OGTT and overall glycaemic state in subjects with IGT.

Evaluation of the relationship between the one-hour plasma glucose concentration and beta-cell functions and cardiometabolic parameters during oral glucose tolerance test in obese children and adolescents

2020 ◽  
Vol 33 (6) ◽  
pp. 767-775
Author(s):  
Eda Mengen ◽  
Seyit Ahmet Uçaktürk
Keyword(s):  
Glucose Tolerance ◽  
Beta Cell ◽  
Plasma Glucose ◽  
Glucose Concentration ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Plasma Glucose Concentration ◽  
Oral Glucose ◽  
Cell Functions ◽  
The Relationship

AbstractBackgroundIn this study, we aimed to evaluate the relationship between the 1-h plasma glucose (PG) level in the oral glucose tolerance test (OGTT) and conventional glycemic parameters, indices evaluating beta-cell functions, and cardiometabolic risk factors.MethodsThe records of 532 obese patients who were followed up in the Pediatric Endocrinology Polyclinic and who underwent standard OGTT were evaluated retrospectively. All patients were divided into two groups according to OGTT data as the 1-h plasma glucose concentration <155 mg/dL (n=329) and ≥155 mg/dL (n=203). Patients with normal glucose tolerance (NGT) were divided into two groups according to the 1-h PG level, as 218 patients with NGT 1 h-low (<155 mg/dL) and 53 patients with high NGT 1 h-high (≥155 mg/dL).ResultsThere was a statistically significant difference between the lipid profiles of individuals with NGT 1 h-low (<155 mg/dL) and individuals with NGT 1 h-high (≥155 mg/dL) (p<0.001). Total cholesterol, LDL cholesterol, and triglyceride levels were higher, while HDL cholesterol levels were lower in individuals with NGT 1 h-high (≥155 mg/dL). The indices evaluating beta-cell functions were significantly higher in individuals with NGT 1 h-low (<155 mg/dL).ConclusionAs a result, a plasma glucose concentration above or equal to 155 mg/dL at 1 h during an OGTT is associated with a worse clinical phenotype characterized by changes in insulin sensitivity and β-cell function. Therefore, this threshold value can predict the progression of prediabetes in obese young people with NGT.

Plasma glucose concentration 60 min post oral glucose load and risk of type 2 diabetes and cardiovascular disease: Pathophysiological implications

2019 ◽  
Vol 16 (4) ◽  
pp. 337-343
Author(s):  
Fahim Abbasi ◽  
Paul JW Tern ◽  
Gerald M Reaven
Keyword(s):  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Impaired Fasting Glucose ◽  
Plasma Glucose ◽  
Glucose Concentration ◽  
Fasting Glucose ◽  
Normal Glucose Tolerance ◽  
Plasma Glucose Concentration ◽  
Oral Glucose ◽  
Normal Glucose

Aim: The aim of this study was to gain insight into the pathophysiological significance of elevated plasma glucose concentrations (mmol/L) 60 min post oral glucose load in apparently healthy individuals. Methods: Comparison of resistance to insulin action and associated cardio-metabolic risk factors in 490 apparently healthy persons, subdivided into those with a plasma glucose concentration 60 min following a 75-g oral glucose challenge of <8.6 versus ⩾8.6. Results: Insulin resistance was significantly greater in persons with normal glucose tolerance whose 60-min glucose concentration was ⩾8.6, associated with higher blood pressure, plasma concentrations of glucose, insulin, triglyceride and lower high-density lipoprotein cholesterol concentrations. Similar differences were seen in persons with impaired fasting glucose, but not in those with impaired glucose tolerance or both impaired fasting glucose and impaired glucose tolerance. The group whose 60-min glucose was <8.6 ( n = 318) contained primarily persons with normal glucose tolerance (88%), whereas the majority of those whose 60-min value was ⩾8.6 ( n = 172) had prediabetes (59%) and in particular combined impaired fasting glucose and impaired glucose tolerance. Conclusion: Plasma glucose concentration of ⩾8.6 mmol/L 60 min post oral glucose identifies higher proportions of combined impaired fasting glucose and impaired glucose tolerance individuals as well as normal glucose tolerance and impaired fasting glucose individuals with a more adverse cardio-metabolic profile, contributing to observed increased overall risk of type 2 diabetes and other metabolic diseases.

scholarly journals Assessment of Cardiovascular Disease Risk in Prediabetes

2020 ◽  
pp. 1-8
Author(s):  
Ashish Agarwal ◽  
Anupama Hegde ◽  
Afzal Ahmad ◽  
Charu Yadav ◽  
Poornima A. Manjrekar ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Interleukin 6 ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Anthropometric Measurements ◽  
Waist To Hip Ratio ◽  
Fasting Plasma ◽  
Increased Risk

Introduction: Prediabetes is associated with dysglycemia, endothelial dysfunction, obesity and inflammation, placing them at an increased risk of cardiovascular events. Aims: The present study aimed to investigate the risk of cardiovascular disease associated with prediabetes by estimation of serum interleukin-6, myeloperoxidase and urine microalbumin and their correlation with fasting plasma glucose and anthropometric measurements. Study Design: Cross sectional study. Place and Duration of Study: Study was conducted at Department of Biochemistry, Kasturba Medical College Hospitals, Mangaluru between 2014 and 2015. Methodology: Eighty subjects were categorised into prediabetes and healthy controls based on their fasting plasma glucose values. Anthropometric data (weight, body mass index, waist circumference, hip circumference and waist-to-hip ratio from all subjects were recorded. Interleukin-6 & myeloperoxidase were estimated in serum sample whereas microalbumin was estimated in random urine sample. Results: The mean anthropometric measurements and cardiovascular disease risk markers (interleukin-6, myeloperoxidase and urine microalbumin) were found to be significantly higher (p < 0.05) in prediabetes group. Myeloperoxidase had significant correlation with fasting plasma glucose (r-0.388) in the prediabetes group. Interleukin-6 and myeloperoxidase also showed a positive correlation with body mass index (r - 0.339, r - 0.327), waist circumference (r - 484, r - 0.493) and waist-to-hip ratio (r - 0.430, r - 0.493) while urine microalbumin did not correlate with fasting plasma glucose and anthropometric measurements in prediabetes group. Conclusion: This study suggests that prediabetes is associated with central adiposity and have an increased risk for cardiovascular disease.

Managing Cardiovascular Risk in Patients with Type 2 Diabetes – Challenges and Opportunities

2010 ◽  
Vol 6 (4) ◽  
pp. 31
Author(s):  
Lars Rydén ◽  
Linda Mellbin ◽  
Klas Malmberg ◽  
◽  
◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Clinical Trial Data ◽  
Oral Glucose ◽  
Lifestyle Modifications ◽  
Oral Glucose Tolerance Testing ◽  
Coronary Death ◽  
Increased Risk ◽  
Challenges And Opportunities ◽  
Patients With Diabetes ◽  
Multifactorial Approach

The prevalence of diabetes and its associated complications, such as cardiovascular disease (CVD), has increased over recent years and is expected to continue to rise dramatically. People with diabetes have a poor prognosis, with a substantially increased risk of coronary heart disease, coronary death, non-fatal myocardial infarction, stroke, and other vascular deaths compared with non-diabetic subjects. Conversely, studies have also shown that many patients with CVD have undiagnosed dysglycaemia and that already impaired glucose tolerance and newly detected diabetes are associated with an impaired prognosis. Thus, screening for such conditions, preferably with oral glucose tolerance testing, should be performed in all patients with CVD. Guidelines advocate a multifactorial approach to the management of prediabetes, diabetes and CVD. This includes lifestyle modifications as well as targets for glycaemic control, blood pressure, lipids, and other cardiometabolic risk factors. Although clinical trial data have demonstrated that target-driven strategies can improve outcomes in patients with diabetes, the implementation and execution of these regimens in clinical practice needs to improve.

scholarly journals Plasma Dehydroepiandrosterone Sulfate and Cardiovascular Disease Risk in Older Men and Women

2020 ◽  
Vol 105 (12) ◽  
pp. e4304-e4327 ◽  
Author(s):  
Xiaoming Jia ◽  
Caroline Sun ◽  
Olive Tang ◽  
Ivan Gorlov ◽  
Vijay Nambi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Dehydroepiandrosterone Sulfate ◽  
Mortality Data ◽  
Atherosclerosis Risk In Communities ◽  
Percentage Decrease ◽  
Increased Risk ◽  
Study Population

Abstract Context Lower dehydroepiandrosterone-sulfate (DHEA-S) levels have been inconsistently associated with coronary heart disease (CHD) and mortality. Data are limited for heart failure (HF) and association between DHEA-S change and events. Objective Assess associations between low DHEA-S/DHEA-S change and incident HF hospitalization, CHD, and mortality in older adults. Design DHEA-S was measured in stored plasma from visits 4 (1996-1998) and 5 (2011-2013) of the Atherosclerosis Risk in Communities study. Follow-up for incident events: 18 years for DHEA-S level; 5.5 years for DHEA-S change. Setting General community. Participants Individuals without prevalent cardiovascular disease (n = 8143, mean age 63 years). Main Outcome Measure Associations between DHEA-S and incident HF hospitalization, CHD, or mortality; associations between 15-year change in DHEA-S (n = 3706) and cardiovascular events. Results DHEA-S below the 15th sex-specific percentile of the study population (men: 55.4 µg/dL; women: 27.4 µg/dL) was associated with increased HF hospitalization (men: hazard ratio [HR] 1.30, 95% confidence interval [CI], 1.07-1.58; women: HR 1.42, 95% CI, 1.13-1.79); DHEA-S below the 25th sex-specific percentile (men: 70.0 µg/dL; women: 37.1 µg/dL) was associated with increased death (men: HR 1.12, 95% CI, 1.01-1.25; women: HR 1.19, 95% CI, 1.03-1.37). In men, but not women, greater percentage decrease in DHEA-S was associated with increased HF hospitalization (HR 1.94, 95% CI, 1.11-3.39). Low DHEA-S and change in DHEA-S were not associated with incident CHD. Conclusions Low DHEA-S is associated with increased risk for HF and mortality but not CHD. Further investigation is warranted to evaluate mechanisms underlying these associations.

scholarly journals Effects of Bilberry Supplementation on Metabolic and Cardiovascular Disease Risk

Molecules ◽  
2020 ◽  
Vol 25 (7) ◽  
pp. 1653
Author(s):  
Sze Wa Chan ◽  
Brian Tomlinson
Keyword(s):  
Oxidative Stress ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Vision Loss ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cardiovascular Complications ◽  
Increased Risk ◽  
Potential Benefits

Metabolic syndrome is a cluster of interrelated conditions that is associated with an increased risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Oxidative stress may impair normal physiological functions, leading to various illnesses. T2DM is considered to be associated with increased oxidative stress, inflammation, and dyslipidemia, which may play a significant role in the development of cardiovascular complications, cancer and vision loss through cataracts and retinopathy. While conventional therapies are a cornerstone for the management of the major risk factors of metabolic syndrome, increasing antioxidant defense by increasing intake of antioxidant-rich foods may improve long term prospects in CVD, obesity and T2DM. Bilberry (Vaccinium myrtillus L.) is one of the richest natural sources of anthocyanins which give berries their red/purple/blue coloration. Anthocyanins are powerful antioxidants and are reported to play an important role in the prevention of metabolic disease and CVD as well as cancer and other conditions. This review focuses on the potential effects of bilberry supplementation on metabolic and cardiovascular risk factors. Although there is evidence to support the use of bilberry supplementation as part of a healthy diet, the potential benefits from the use of bilberry supplementation in patients with T2DM or CVD needs to be clarified in large clinical trials.

scholarly journals 1-Hour OGTT Plasma Glucose as a Marker of Progressive Deterioration of Insulin Secretion and Action in Pregnant Women

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Alessandra Ghio ◽  
Giuseppe Seghieri ◽  
Cristina Lencioni ◽  
Roberto Anichini ◽  
Alessandra Bertolotto ◽  
...  
Keyword(s):  
Insulin Secretion ◽  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Pregnant Women ◽  
Plasma Glucose ◽  
Glucose Concentration ◽  
Insulin Action ◽  
Progressive Increase ◽  
Plasma Glucose Concentration ◽  
Linear Manner

Considering old GDM diagnostic criteria, alterations in insulin secretion and action are present in women with GDM as well as in women with one abnormal value (OAV) during OGTT. Our aim is to assess if changes in insulin action and secretion during pregnancy are related to 1-hour plasma glucose concentration during OGTT. We evaluated 3 h/100 g OGTT in 4,053 pregnant women, dividing our population on the basis of 20 mg/dL increment of plasma glucose concentration at 1 h OGTT generating 5 groups (<120 mg/dL,n=661; 120–139 mg/dL,n=710; 140–159 mg/dL,n=912; 160–179 mg/dL,n=885; and ≥180 mg/dL,n=996). We calculated incremental area under glucose (AUCgluc) and insulin curves (AUCins), indexes of insulin secretion (HOMA-B), and insulin sensitivity (HOMA-R), AUCins/AUCgluc. AUCglucand AUCinsprogressively increased according to 1-hour plasma glucose concentrations (bothP<0.0001for trend). HOMA-B progressively declined (P<0.001), and HOMA-R progressively increased across the five groups. AUCins/AUCglucdecreased in a linear manner across the 5 groups (P<0.001). Analysing the groups with 1-hour value <180 mg/dL, defects in insulin secretion (HOMA-B: −29.7%) and sensitivity (HOMA-R: +15%) indexes were still apparent (allP<0.001). Progressive increase in 1-hour OGTT is associated with deterioration of glucose tolerance and alterations in indexes of insulin action and secretion.

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