Impaired Glucose Tolerance Research Papers (original) (raw)

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- Statistics, Epidemiology, Arsenic, Medicine

Endocrine dysfunction and parameters of metabolic syndrome were assessed in 91 patients aged 4.3-32.5 years who underwent allogeneic or autologous BMT in childhood. Final short stature, found in five of the 35 patients who attained final height, was associated with the underlying disease (specifically, Fanconi anemia) (P ¼ 0.0013), previous cranial irradiation (P ¼ 0.0007), type of conditioning irradiation (Po0.05) and allogeneic BMT (P ¼ 0.05). Growth hormone deficiency (n ¼ 10) was associated with previous cranial irradiation (Po0.005) and conditioning total body irradiation (Po0.001). Twelve patients had primary hypothyroidism, one had hyperthyroidism and one papillary thyroid carcinoma. Hypothyroidism was associated with neck/mediastinal (Po0.005) and conditioning irradiation (Po0.05). Primary gonadal failure was found in 24 of the mature patients (62.5% females). Hypogonadism was associated with the underlying disease (especially hematological malignancies) (Po0.05), pretransplant treatment (Po0.05), irradiation conditioning (Po0.001), older age (Po0.005) and advanced pubertal stage at BMT (Po0.05). Obesity (body mass index 42 s.d.) was found in 4.4% and type II diabetes and impaired glucose tolerance in 3.3% each. Dyslipidemia was found in 27.9% of the 43 patients tested. These findings emphasize the need for long-term follow-up of endocrine and metabolic parameters in young patients after BMT in order to offer proper treatment and improve quality of life.

- by Mafishe Philip
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- Stem Cells, Quality of life, Adolescent, Medicine

The prevalence and associated factors of diabetes mellitus (DM) and impaired glucose tolerance (IGT) were studied in a tribal community with an apparently high diabetes prevalence. A sample of 724 subjects aged Ն 25 years was selected using a multi-stage cluster method and underwent a 75 g oral glucose tolerance test. The crude prevalence of DM and IGT were 8.3 % (men 9.9 %; women 7.5 %) and 7.9 % (men 4.1 %; women 9.7 %), respectively. Age-adjusted prevalence rates, according to the standard population of Segi, were 10.4 % (95 % CI 7.7-13.2) and 9.8 % (95% CI 7.2-12.5) for DM and IGT, respectively. No urban/rural differences were found in the prevalence rates of DM and IGT. New cases (5.1%) were almost twice as common as previously known cases (3.2 %). Family history of diabetes, obesity, and advanced age were associated with higher rates of diabetes. The results confirmed that diabetes is common in the Danagla community compared to other communities of northern Sudan. Varying environmental, nutritional, and genetic factors may contribute to this high prevalence. These findings will have profound impact on the health services for this community and the Sudan as a whole.

- by Ashraf Soliman
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- Obesity, Sudan, Oman, Blood Glucose

Objective: To investigate the prevalence of type II Diabetes Mellitus (DM) and impaired glucose tolerance (IGT) and identify the metabolic abnormalities and risk factors associated with these conditions in an urban city of Yemen. Research design and methods: Cross-sectional, population-based study investigating 498 adults (245 males and 253 females) aged 25-65 years. The 1999 modified World Health Organization criteria were adopted for the diagnosis of Diabetes Mellitus and IGT. A standard questionnaire was applied and blood lipids, blood pressure, body mass index (BMI) and waist/hip ratio (WHR) were determined. Results: The overall prevalence of type II Diabetes Mellitus was 4.6% (7.4% in males and 2% in females). Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) were found in 2% and 2.2% of the study population. Factors independently related to any abnormality in glucose tolerance, using logistic regression analysis, were sex, hyperlipidaemia, hypertriglyceridaemia, and hypertension; whereas sex and age related to DM. More than 80% of the type II diabetics were over the age of 40, 35% being hyperlipidaemic, 22% being hypertensive and 18% obese. Sixty percent of IGT subjects were hyperlipidaemic and 20% were obese. Approximately 78% of obese individuals (≥30 kg/m 2) had normal glucose tolerance. Conclusion: The prevalence of type II DM and its potential increase reflected by the high prevalence of obesity in normal glucose tolerance subjects in the Yemeni population constitutes a major public health problem.

- by Mohammed Al-Mamary
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- Lipids, Diabetes mellitus, Blood Pressure, Body Mass Index

The term prediabetes refers to subjects with impaired fasting glucose and/or impaired glucose tolerance who are at increased risk for type 2 diabetes mellitus. Although both types of patients are at increased risk for developing type 2 diabetes mellitus and cardiovascular disease, they manifest distinct metabolic abnormalities. In this article, we summarize the metabolic abnormalities that characterize each state and the contribution of these metabolic abnormalities to the increased risk of diabetes and cardiovascular disease.

- by Muhamad Ghani
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- Cardiovascular disease, Insulin Resistance, Blood Glucose, Insulin

Overweight and obesity are important risk factors for type 2 diabetes. The marked increase in the prevalence of overweight and obesity is presumably responsible for the recent increase in the prevalence of type 2 diabetes. Lifestyle modification aimed at reducing energy intake and increasing physical activity is the principal therapy for overweight and obese patients with type 2 diabetes. Even moderate weight loss in combination with increased activity can improve insulin sensitivity and glycemic control in patients with type 2 diabetes and prevent the development of type 2 diabetes in high-risk persons (ie, those with impaired glucose tolerance).

- by Jasmine Thomas
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- Engineering, Obesity, Diabetes, Life Style

A total of 4428 adults (>18 years old) from 5 different selected regions in Peninsular and East Malaysia participated in this health survey. Using World Health Organization recommendations for body mass index (BMI), the prevalence of overweight and obesity were found to be 33.6% (95% CI= 32.2, 35.0) and 19.5% (95% CI= 18.3, 20.7) respectively. There were more females who were obese (22.5%, 95% CI=20.9, 24.0) compared to males (14.1%, 95% CI=12.3, 15.9). Highest prevalence of obesity were among the Indians (24.6%, 95% CI=20.3, 29.3), followed closely by the Malays (23.2%, 95% CI=21.6, 24.8%) and lowest prevalence was among the Chinese subjects (8.2%, 95% CI=6.2, 10.6). More than 43% of the 531 younger subjects (<30 years old) were either overweight (20%, 95% CI=16.6, 23.6) or obese (13.9%, 95% CI=11.1, 17.2%). All subjects who claimed to be non-diabetes were required to undergo 75 g glucose tolerance test. Compared to subjects with normal BMI (18.5-24.9 kg/m 2 ), there was a 3-and 2-folds increase in the prevalence of newly diagnosed diabetes and impaired glucose tolerance respectively, among obese subjects (BMI >30 kg/m 2 ) who initially claimed to have no diabetes. This study highlights a need for more active, inter-sectoral participation advocating a health-promoting environment in order to combat obesity in this country.

- by Ikram Ismail
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- Nutrition and Dietetics, Obesity, Malaysia, Food

William H. Herman, MD, MPH; Thomas J. Hoerger, PhD; Michael Brandle, MD, MS; Katherine Hicks, MS; Stephen Sorensen, PhD; Ping Zhang, PhD; Richard F. Hamman, MD, DrPH; Ronald T. Ackermann, MD, MPH; Michael M. Engelgau, MD, MS; and Robert... more

- by Stephen Sorensen
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- Life Style, Health Policy, Clinical Practice, Markov chains

One hundred thirty-three patients with components of metabolic syndrome aged from 40 to 60 years were examined. To identify MS and its main components, the diagnostic criteria of MS recommended by the International Diabetes Federation (IDF,2005). Taking into account that the study provided for a comparative assessment of the relationship of disorders of the sympathoadrenal and vagoinsular phases of the glycemic curve with asymptomatic hyperuricemia, the level of glycemia was also determined one an hour after glucose loading (> 8.8 mmol/l). Uric acid (MC) was determined in serum. Blood uric acid levels >7 mg/DL were interpreted as hyperuricemia. Diagnosis of coronary heart disease was carried out based on a survey, ECG, and the results of previous examinations. The ECG was recorded at rest in 12 standard leads and analyzed according to the Minnesota code criteria.
The Association of uric acid with bodyweight and glycemic indices was established. To a greater extent, asymptomatic hyperuricemia is associated with glycemic levels 2 hours after glucose loading. It is assumed that the relationship of uric acid level with body weight may be due to the criteria for detection of both overweight and obesity, and the criteria of hyperuricemia. The risk group for asymptomatic hyperuricemia and CHD should include persons who are not informed about the presence or absence of CHD.

- by Ulugbek Kayumov
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- Obesity, Diabetes, Metabolic syndrome, Impaired Glucose Tolerance
- by Bronwen Martin
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- Metabolism, Energy Metabolism, Ghrelin, Glucose
- by Norikazu Harii
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- Glucose, Blood Glucose, Insulin sensitivity index, Insulin

Impaired fasting glucose (IFG) like impaired glucose tolerance (IGT) has increased risk of progressing to diabetes mellitus (DM). The aim of the study was to evaluate prevalance of IGT and type 2 DM with oral glucose tolerance test (OGTT) in Turkish patients who had fasting glucose of 110 and 125 mg/dl. Hundred and forty-eight (67.3%) women and 72 (32.7%) men (30-65 years old with mean age of 51.3 ± 8.7 year) who had fasting glucose range 110-125 mg/dl were evaluated with OGTT. Seventytwo patients had IGT (32.8%), 74 (33.6%) patients had type 2 diabetes and 74 (33.6%) patients had normal glucose tolerance (NGT). Mean fasting glucose and insulin levels were higher in the IGT group than in the NGT group. Mean level of total cholesterol was higher in DM than that in NGT and IGT groups. Mean triglyceride (TG) (P = 0.476), highdensity lipoprotein (HDL) (P = 0.594), low-density lipoprotein (LDL) (P = 0.612), Apoproteine A (P = 0.876), Apoproteine B (P = 0.518), uric acid (P = 0.948) and ferritin (P = 0.314) were found higher in diabetic patients. Lipoproteine a (P = 0.083), fibrinogen (P = 0.175) and hsCRP (P = 0.621) levels were higher in IGT. Mean HOMA S% levels of NGT, IGT and DM were found to be 65.0 ± 13.0%, 60.9 ± 16.0% and 50.1 ± 11.1%, respectively. HOMA B% levels were measured to be 80.4 ± 29.1% in NGT, 85.3 ± 14.59% in IGT and 60.1 ± 10.1% in DM. Significant difference was found between IFG and DM (P = 0.043) groups. The prevalences of diabetes and IGT were found to be 33.63 and 32.7% in IFG, respectively.

- by Candeğer Yılmaz
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- Insulin Resistance, Blood Glucose, Fasting, Diabetes mellitus

Diabetes mellitus is a frequent long-term complication of infantile nephropathic cystinosis. We studied 44 cystinotic patients, aged 22.1±5.4 years, transplanted at a mean age of 11.3±2.5 years; 25% were treated with insulin at 20 years of age or 10 years after transplantation, and over half required insulin at latest follow-up. In comparison, diabetes mellitus occurred in only 1% of non-cystinotic transplanted patients. Sequential oral glucose tolerance tests (OGTTs) in these patients showed the progressive deterioration of glucose metabolism. All but 2 patients had an abnormal response at latest followup. The high doses of corticosteroid given after transplantation or during rejection episodes were responsible for transient insulin dependency. However, the development of impaired glucose tolerance and diabetes mellitus depended mainly on the cystinotic process, which developed slowly with time. The deterioration of glucose tolerance was correlated with a decreased early phase of insulin secretion, estimated from the plasma insulin level at 30 min of the OGTT, while there was no evidence of insulin resistance. The occurrence of diabetes mellitus correlated with a worsening of the vital prognosis.

- by Michel Broyer
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- Kidney transplantation, Survival Analysis, Adolescent, Renal transplantation

Objectives: Preliminary trials reflected the low prevalence of diabetes in Raica community consuming camel milk habitually. Our objective was to describe the prevalence and clinical factors associated with impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and diabetes (DM) among adults (!20 years) in large population group. Design: Population based, cross sectional study Methods: 2099 participants from different villages of north-west Rajasthan were selected using stratified sampling of a representative Raica and non-Raica Community, consuming or not consuming camel milk. Demographic, clinical, anthropometric parameters were obtained and oral glucose tolerance tests were performed in all individuals to diagnose IFG, IGT and DM. Associations were investigated using multivariate logistic regression using SPSS Version 10.0. Results: In the present study, the prevalence of diabetes in Raica community consuming camel milk (RCCM, n = 501) was 0%; Raica community not consuming camel milk (RCNCM, n = 554) was 0.7%; non-Raica community consuming milk (NRCCM, n = 515) was 0.4% and non-Raica community not consuming camel milk (NRCNCM, n = 529) was 5.5%. Stepwise logistic regression analysis showed that consumption of camel milk was statistically highly significant as protective factor for diabetes. Multiple logistic regression analysis revealed that camel milk consumption and community factor were associated with decreased prevalence of diabetes. Conclusion: Camel milk consumption and lifestyle have definite influence on prevalence of diabetes. Hence, adopting such life pattern may play protective role in preventing diabetes to some extent. #

- by Dhanpat Kochar
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- Diabetes, Multivariate Analysis, India, Diabetes mellitus

Background: A carbohydrate adjusted liquid formula (Inslow) containing palatinose as the major (>50%) carbohydrate
ingredient was developed. Longterm (3-5 months) consumption of Inslow was reported to improve glycemic control by
reducing the postprandial plasma glucose levels of subjects with diabetes and impaired glucose tolerance (IGT). The present
study aimed to elucidate the mechanism of postprandial glycaemic responses.

The prevalence of diabetes mellitus and impaired glucose tolerance (IGT) and their relationship to age and obesity were estimated in Punjab, Pakistan by a population-based survey done in 1998. Methods: Oral glucose tolerance tests were performed in a stratified random sample of 1852 adults aged ≥25 years. The diagnosis of diabetes and IGT were made on the basis of WHO criteria. Results: The prevalence of diabetes was 12.14% in males and 9.83% in females. Overall total glucose intolerance (diabetes and IGT) was present in 16.68% males and 19.37% females. Central obesity, hypertension and positive family history were strongly associated with diabetes. Conclusions: These results indicate that the prevalence of glucose intolerance is high in the studied population and comparable with the published data from the other three provinces of Pakistan i.e. Sindh, Baluchistan and North West Frontier Province, studied by the same group.

- by Abdul BASIT
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- Family history, Blood Glucose, Hypertension, Diabetes mellitus

Evidence suggests that fructose and sweetened beverages may be a risk factor for obesity and type 2 diabetes, but the role of sweetened fruit juices in glucose disturbances has been minimally explored. The aim of this study was to examine the association of total fructose, fresh fruit and sweetened fruit juice intake with glucose tolerance homeostasis in Japanese-Brazilians. A total of 475 men and 579 women aged >or=30 years were evaluated in a cross-sectional population-based survey with a standardized protocol including a 2-h oral glucose tolerance test (WHO criteria). Habitual food consumption was obtained using a validated food frequency questionnaire for Japanese-Brazilians. After adjustments for potential confounding variables, the odds ratio (OR; 95%CI) for impaired glucose tolerance was 2.1 (1.0-4.5; P for trend=0.05) for the highest as compared to the lowest tertile intake of total fructose and 2.3 (1.1-5.1; P for trend=0.05) for the highest as compared to the lowest ter...

- by Laércio Franco
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- Brazil, Japan, Blood Glucose, Fruit

Data on the prevalence of diabetes in Ghana is scanty and unreliable. In the present study we have ascertained the prevalence of diabetes, impaired fasting glycaemia (IFG) and impaired glucose tolerance (IGT) in a random cluster sample of Ghanaians aged 25 years and above from the Greater Accra area of Ghana. Diabetes, IFG and IGT were defined by criteria of the American Diabetes Association and World Health Organization. The mean age of the 4733 subjects involved in the study was 44.3 9 14.7 years, and participation rate was 75%. The crude prevalence of diabetes was 6.3%. Out of 300 subjects with diabetes, 209 (69.7%) had no prior history of the disease. Diabetes, IGT and combined IFG and IGT increased with age. The oldest age group (64 + years) had the highest diabetes prevalence (13.6%). The age-adjusted prevalence of diabetes, IFG and IGT, were 6.4, 6.0 and 10.7%, respectively. Diabetes was more common in males than females (7.7 vs. 5.5%) [PB 0.05]. Worsening glycaemic status tended to be associated with increase in age, body mass index, systolic and diastolic blood pressures. Ascertainment of predictors for diabetes in Ghanaians and the significance of the relatively high rates of and IFG and IGT however, remain to be determined.

- by Samuel owusu
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- Epidemiology, Ghana, Age, Blood Glucose

Previous interventions to increase physical activity and reduce cardiovascular risk factors have been targeted at individuals with established disease; less attention has been given to intervention among individuals with high risk for disease nor has there been determination of the influence of setting in which the intervention is provided. In particular, family practice represents an ideal setting for the provision and long-term maintenance of lifestyle interventions for patients at risk (ie high-normal blood pressure or impaired glucose tolerance).

- by Tom Overend
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- Primary Care, Research Design, Clinical Trial, Physical Activity

To describe tobacco use, obesity and overweight, high blood pressure, high blood cholesterol and impaired glucose tolerance in Alaska Native and American Indian women living in the Anchorage area. Cross-sectional evaluation of women enrolled in the Traditions of the Heart program. Traditions of the Heart was a randomized controlled trial of an intervention to reduce risk factors for cardiovascular disease. Starting in October 2000, Southcentral Foundation provided a 12-week group lifestyle intervention to eligible Alaska Native and American Indian women aged 40 to 64 residing in the Anchorage area. The study included assessment of biochemical and behavioral risk factors for cardiovascular disease. Of the 1334 women who enrolled between October 2000 and July 2005, 33.5% were current smokers, 78.8% were overweight or obese, 10.9% were hypertensive, 21.4% had elevated total cholesterol, and 5.6% had fasting glucose concentrations > or = 126 mg/dL. The women in this study had many ri...

- by Vanessa Hiratsuka
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- Health Education, Native American, Risk assessment, Cardiovascular disease

The prevalence of metabolic syndrome (MetS) and its associated risks remain unappreciated in Bamboutos Division, west region of Cameroon. This study aimed to evaluate the prevalence of MetS, its individual components, and associated risk factors among Bamboutos Division's adults population using a Joint Interim Statement of the International Diabetes Federation (IDF) Task Force on Epidemiology and Prevention definitions parameters. A cross-sectional study was conducted from May 2016 to May 2018 in Mbouda ADLUCEM Hospital and Mbouda District Hospital, two reference hospitals in Bamboutos Division, west region of Cameroon. Interview, physical and clinical examinations, and lipid and fasting blood glucose measurements were conducted for 604 adults. The definition of MetS proposed by IDF was used. The prevalence of MetS was 32.45% with highly significant female predominance (46.11% for females and 14.01 % for males). In the entire participants, the most common abnormalities were low-HDL (82.78%) and hypertriglyceridemia (53.97%) [p<0.001]. Participants with obesity (OR: 16.34; 95% CI: 9.21-28.96), overweight (OR: 7.45; 95% CI: 4.17-13.30), and highest hs-CRP (hs-CRP >11 mg/l) had a higher risk of developing MetS. The most common MetS component was abdominal obesity (OR: 353.13; 95% CI: 136.16-915.81). MetS is prevalent among Bamboutos Division's adults in west region of Cameroon and abdominal obesity is the most common MetS component. This study highlights the need for evidence-based prevention, diagnosis, and management of MetS and its associated factors among Bamboutos Division's adults in Cameroon.

- by Juan Pedro López Siguero
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- Epidemiology, Biology, Public Health, Type 2 Diabetes

Palabras clave: síndrome de ovario poliquístico, resistencia insulínica, test de tolerancia a la glucosa Abstract Critical evaluation of the oral glucose tolerance test for the diagnosis of insulin resistance in patients with polycystic ovary syndrome. Oral glucose tolerance test (OGTT) is the most commonly used method to evaluate insulin resistance (IR) in the clinical practice. Our objective was to evaluate

- by Cecilia Calvar
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- Clinical Practice, Insulin sensitivity index, Medicina, Polycystic Ovary Syndrome

Subjects with impaired fasting glucose (IFG) are at increased risk for type 2 diabetes. We recently demonstrated that IFG subjects have increased hepatic insulin resistance with normal insulin sensitivity in skeletal muscle. In this study, we quantitated the insulin secretion rate from deconvolution analysis of the plasma C-peptide concentration during an oral glucose tolerance test (OGTT) and compared the results in IFG subjects with those in subjects with impaired glucose tolerance (IGT) and normal glucose tolerance (NGT). One hundred and one NGT subjects, 64 subjects with isolated IGT, 24 subjects with isolated IFG, and 48 subjects with combined (IFG ? IGT) glucose intolerance (CGI) received an OGTT. Plasma glucose, insulin, and C-peptide concentrations were measured before and every 15 min after glucose ingestion. Insulin secretion rate (ISR) was determined by deconvolution of plasma C-peptide concentration. Inverse of the Matsuda index of whole body insulin sensitivity was used as a measure of insulin resistance; 56 subjects also received a euglycemic hyperinsulinemic clamp. The insulin secretion/insulin resistance (disposition) index was calculated as the ratio between incremental area under the ISR curve (DISR[AUC]) to incremental area under the glucose curve (DG[AUC]) factored by the severity of insulin resistance (measured by Matsuda index during OGTT or glucose disposal during insulin clamp). Compared to NGT, the insulin secretion/insulin resistance index during first 30 min of OGTT was reduced by 47, 49, and 74% in IFG, IGT, and CGI, respectively (all \ 0.0001). The insulin secretion/insulin resistance index during the second hour (60-120 min) of the OGTT in subjects with IFG was similar to that in NGT (0.79 ± 0.6 vs. 0.72 ± 0.5, respectively, P = NS), but was profoundly reduced in subjects with IGT and CGI (0.31 ± 0.2 and 0.19 ± 0.11, respectively; P \ 0.0001 vs. both NGT and IFG). Earlyphase insulin secretion is impaired in both IFG and IGT, while the late-phase insulin secretion is impaired only in subjects with IGT.

- by Muhamad Ghani
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- Insulin Resistance, Blood Glucose, Insulin, Insulin Secretion

Given the extreme increase in prediabetes, type 2 diabetes, and the potential for metabolic syndrome in obese youth, identifying simplified indexes for assessing stimulated insulin sensitivity is critical. The purpose of this study was validation of two surrogate indexes of insulin sensitivity determined from the oral glucose tolerance test (OGTT): the composite whole body insulin sensitivity index (WBISI) and the insulin sensitivity index (ISI). An obese population (aged 8 -18 yr) of normal and impaired glucose tolerance individuals was studied. One group (n ‫؍‬ 38) performed both the euglycemic-hyperinsulinemic clamp and OGTT for comparison of insulin sensitivity measurements as well as 1 H-magnetic resonance spectroscopy estimates of intramyocellular lipid content. Another larger (n ‫؍‬ 368) cohort participated only in an OGTT. Both the WBISI and ISI represented good estimates (r ‫؍‬ 0.78 and 0.74; P < 0.0005) for clamp-derived insulin sensitivity (glucose disposed, M-value), respectively. In the large cohort, the surrogate indexes demonstrated the shift toward poorer function and increased risk profile as a function of insulin resistance. Additionally, the WBISI and ISI correlated with intramyocellular lipid content (r ‫؍‬ ؊0.74 and ؊0.71; P < 0.0001), a tissue marker for insulin resistance. Insulin sensitivity can be estimated using plasma glucose and insulin responses derived from the OGTT in obese youth with normal and impaired glucose tolerance. (J Clin Endocrinol Metab 89: 1096 -1101, 2004)

- by James Dziura
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- Endocrinology, Obesity, Adolescent, Metabolic syndrome
- by Ivan Presta
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- Genetics, Polymorphism, Insulin Resistance, Insulin

Aims/hypothesis The aim of this study was to determine the frequency of undiagnosed glucose abnormalities and the burden of cardiovascular disease (CVD) risk among south Asians and white Europeans attending a systematic screening programme for type 2 diabetes (ADDITION-Leicester) and to estimate the achievable risk reduction in individuals identified with glucose disorders. Methods Random samples of individuals (n=66,320) from 20 general practices were invited for a 75 g OGTT and CVD risk assessment. Ten-year CVD risk among screendetected people with diabetes or impaired glucose regulation (IGR) (impaired fasting glycaemia and/or impaired glucose tolerance [IGT]) was computed using the Framingham-based ETHRISK engine and achievable risk reduction was predicted using relative reductions for treatments extracted from published trials.

sleep duration and incidence of type 2 diabetes 2 Objective: Both short and long sleep duration have frequently been found to be associated with an increased risk for diabetes. The aim of the present exploratory analysis was to examine the association between sleep duration and type 2 diabetes after lifestyle intervention in overweight people with impaired glucose tolerance in a 7-year prospective follow-up. Methods: 522 individuals (aged 40-64 years) were randomly allocated either to intensive dietexercise counseling group or control group. Diabetes incidence during follow-up was calculated according to sleep duration at baseline. Sleep duration was obtained for 24 h period. Physical activity, dietary intakes, bodyweight and immune mediators (CRP, IL-6) were measured. Results: Interaction between sleep duration and treatment group was statistically significant (p=0.003). In the control group, the adjusted hazard ratios with 95% CI for diabetes were 2.29 (1.38-3.80) and 2.74 (1.67-4.50) in the sleep duration groups 9-9.5 h and ≥10h, respectively, compared with that of 7-8.5 hours. In contrast, sleep duration did not influence the incidence of diabetes in the intervention group; for sleep duration groups 9-9.5 h and ≥10 h, the adjusted hazard ratios with 95% CI were 1.10 (0.60-2.01) and 0.73 (0.34-1.56), respectively, compared with that in the reference group (7-8.5 h sleep). Lifestyle intervention resulted in similar improvement in body weight, insulin sensitivity and immune mediator levels regardless of sleep duration. Conclusion: Long sleep duration is associated with increased type 2 diabetes risk. Lifestyle intervention aiming at weight reduction, healthy diet and increased physical activity may ameliorate some of this excess risk.

- by Matti Uusitupa
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- Endocrinology, Epidemiology, Diabetes, Life Style

Context: Studies in older people have shown inconsistent agreement between homeostasis model assessment of insulin resistance (HOMA-IR) and dynamic measures of insulin action and have not evaluated HOMA β-cell. Objective: We compared measures of insulin sensitivity and β-cell function from the frequently sampled iv glucose tolerance test (FSIGT) to HOMA models. Design/Patients/Setting/Intervention: Two hundred fourteen young and old with normal glucose tolerance (NGT) and old with impaired glucose tolerance (IGT) participated in a retrospective analysis of FSIGT data in a university medical setting. Main Outcome Measure: Sensitivity to insulin (SI) and acute insulin response to glucose (AIRg) from FSIGT were compared with HOMA models. Results: SI and HOMA-IR measures identified similar patterns of increasing insulin resistance in the two older groups, compared with younger people with NGT, with the greatest degree of insulin resistance in older people with IGT (P < 0.05 vs. young...

- by Marla Smith
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- Endocrinology, Medicine, Insulin Resistance, Models

The article presents the results of the study of the frequency of individual clinical symptoms characteristic of diabetes mellitus in persons with prediabetes. It was found that symptoms such as dry mouth, thirst, increased fluid intake, itching of the skin, various sensations characteristic of angiopathy, are often found in patients with prediabetes. The frequency and severity of these symptoms were associated with blood glucose levels. The authors came to the conclusion that in mass surveys of the population, at the first stage, a questionnaire should be used to identify clinical manifestations of diabetes mellitus. As a result of the survey, a high-risk group can be identified. In the future, this group should study the level of blood glucose, glycated hemoglobin, and other studies. Based on the results obtained, targeted prevention and treatment of prediabetes should be carried out.

- by Ulugbek Kayumov
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- Obesity, Diabetes, Metabolic syndrome, Overweight

Aims/hypothesis Impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are risk factors for type 2 diabetes and cardiovascular disease; however, their impact on these endpoints differs. Because liver fat and visceral fat are important determinants of glucose and lipid metabolism, we investigated whether these fat compartments and their humoral products, the adipokine adiponectin and the hepatokine fetuin-A, differ in their

Background: Nut consumption may reduce the risk of developing type 2 diabetes. The aim of the current study was to measure the acute and second-meal effects of morning almond consumption and determine the contribution of different nut fractions. Methods: Fourteen impaired glucose tolerant (IGT) adults participated in a randomized, 5-arm, crossover design study where whole almonds (WA), almond butter (AB), defatted almond flour (AF), almond oil (AO) or no almonds (vehicle -V) were incorporated into a 75 g available carbohydrate-matched breakfast meal. Postprandial concentrations of blood glucose, insulin, non-esterified free fatty acids (NEFA), glucagon-like peptide-1 (GLP-1) and appetitive sensations were assessed after treatment breakfasts and a standard lunch. Results: WA significantly attenuated second-meal and daylong blood glucose incremental area under the curve (AUCI) and provided the greatest daylong feeling of fullness. AB and AO decreased blood glucose AUCI in the morning period and daylong blood glucose AUCI was attenuated with AO. WA and AO elicited a greater secondmeal insulin response, particularly in the early postprandial phase, and concurrently suppressed the second-meal NEFA response. GLP-1 concentrations did not vary significantly between treatments. Conclusions: Inclusion of almonds in the breakfast meal decreased blood glucose concentrations and increased satiety both acutely and after a second-meal in adults with IGT. The lipid component of almonds is likely responsible for the immediate post-ingestive response, although it cannot explain the differential second-meal response to AB versus WA and AO.

- by Robert Considine
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- Physiology, Nutrition and Dietetics, Blood Glucose, Free Fatty Acid

Proteins secreted from adipose tissue are increasingly recognized to play an important role in the regulation of glucose metabolism. However, much less is known about their effect on lipid metabolism. The fasting-induced adipose factor (FIAF/angiopoietin-like protein 4/peroxisome proliferator-activated receptor angiopoietin-related protein) was previously identified as a target of hypolipidemic fibrate drugs and insulin-sensitizing thiazolidinediones. Using transgenic mice that mildly overexpress

- by Walter Wahli
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- Biological Chemistry, Gene expression, Transgenic Mice, Signal Transduction
- by Melanie Davies
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- Physical Activity, Self Care, Self Efficacy, Patient education

We here describe a case of Alstrom Syndrome (AS), a rare hereditary disease, characterized by progressive pigmentary retinopathy, sensorineural hearing loss and metabolic abnormalities. These are hyperinsulinemia, potentially progressing to overt diabetes, hyperuricemia and hyperlipidemia. Other variable features of the syndrome are renal failure, cardiomyopathy, bronchial asthma, hypothyroidism, alopecia, hypertension and short stature. Infrequently an elevation in liver enzymes, probably due to an idiopathic mild active hepatitis, has been described. The patient, a 27 year-old female of northern african origin with no family history of AS or diabetes, was transferred to our hospital because of a three-week history of polydipsia and polyuria. A significant weight loss was not observed. She was blind and hearing was severely impaired. Primary amenorrhoea was stated. Her bronchial asthma was treated with inhalative beta&renoreceptor agonists and inhalative steroids. On examination she showed tmncal obesity (body mass index: 27 kg/m2) and was of short stature (139 cm). Hirsutism, acne vulgaris and acanthosis nigricans were evident. A clitoris hypettrophy was not observed. There was persistent non-ketotic hyperglycemia (range: 8.3-21.6 mmol/l). Fasting insulin (76 wU/ml) and fasting c-peptide (10.6 "g/ml) were markedly elevated. Consequently, calculated HOMA insulin resistance score (14.6) indicated severe insulin resistance. Testosterone was elevated (1.4 @g/I) but dehydroepiandrosterone levels were in lower normal range. The patient was hyperlipidemic with elevated triglyceride and LDL-cholesterol and lowered HDL-cholesterol levels. Uric acid was not elevated and renal function not altered. Liver enzymes were persistently elevated: gamma-glutamyltransferase (5 11 U/l), glutamate dehydrogenase (25.3 U/l), alanine aminotransferase (80 U/l), aspartate transaminase (75 U/l). Bilirubin, albumin and clotting tests were normal. Hepatitis-A-, -B-and -C-antibodies were negative, ferritin and ceruloplasmin levels were not elevated, (Y I-antitrypsin was normal. There was no evidence for autoimmune hepatitis, primary sclerosing cholangitis or primary biliary cirrhosis. An abdominal and cardiac ultrasound scan revealed no pathological changes. As the patient did not respond to oral hypoglycemic drugs insulin therapy was started. Under a high dose, pulsatile insulin therapy (120 U insulin lispro/day) a sufficient blood glucose control could be achieved. In summary the patient showed an Alstrom syndrome with (1) prominent insulin resistance and diabetes mellitus, (2) primary amenorrhoea probably due to hyperinsulinemia induced ovarian androgen production and (3) idiopathic hepatic dysfunction.

- by Agata Kubaszek
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- Metabolism, Polymorphism, Anthropometry, Risk

Prevalencia de diabetes mellitus y factores de riesgo relacionados en una población urbana Prevalencia de diabetes mellitus y factores de riesgo relacionados en una población urbana Prevalence of diabetes mellitus and related risk factors in an urban population SUMMARY Objective. To know the prevalence of diabetes mellitus and its risk factors in the population of an urban district of Lima city. Material and methods. It was carried out a descriptive, clustered and randomized study. The sample size was 213 subjects older than 15 year-old. The survey included measurements of blood pressure, weight, stature, waist and a fasting venous blood sample for the measurements of glucose, cholesterol and triglycerides. Results. It was found: a prevalence of diabetes mellitus de . Conclusions. There was a relative high prevalence of diabetes mellitus (7,04%) in an urban district of Lima city. The related risk factors were low physical activity, overweight, arterial hypertension and obesity. INTRODUCCIÓN La diabetes mellitus es una enfermedad emergente debido al efecto que el progreso ha traído a la sociedad desde el siglo XX; es decir, su prevalencia ha ido paralelo con el incremento de la obesidad y el sedentarismo. (1-5) ARTÍCULOS ORIGINALES RESUMEN Objetivo. Conocer la prevalencia de la diabetes mellitus y sus factores de riesgo en una población urbana de Lima ciudad. Material y métodos. Se realizó un estudio transversal descriptivo, aleatorio y por conglomerados a 213 sujetos mayores de 15 años del distrito de Breña, en Lima ciudad. Se registró los valores de presión arterial, peso, talla, medición de cintura, glicemia basal, colesterol y triglicéridos. Resultados. Se encontró: una prevalencia de diabetes mellitus de . Conclusiones. Se encontró una prevalencia relativamente alta (7,04%) de diabetes mellitus en el distrito de Breña en Lima ciudad. Los factores de riesgo relacionados a la diabetes fueron baja actividad física, sobrepeso, hipertensión arterial y obesidad. Palabras clave: Diabetes mellitus, hiperlipidemia, obesidad, intolerancia a los carbohidratos, hipertensión arterial, actividad física, factores de riesgo, prevalencia.

- by Freddy Cancino
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- Physical Activity, Arterial hypertension, Diabetes mellitus, Blood Pressure
- by Carsten Sloth
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- Glucose, Blood Glucose, Insulin, Glucose Metabolism

Background: Diabetes and increased age are known risk factors for physical disability. With the increasing prevalence of diabetes within our aging population, the future burden of disability is expected to increase. To date, there has not been a pooled estimate of the risk for disability associated with diabetes or its precursor states, impaired glucose tolerance and impaired fasting glucose. We aim to conduct a systematic review and meta-analysis of the association between prediabetes and diabetes with disability, and quantify the risk of association. Methods/design: We will search for relevant studies in Medline via Pubmed, Embase, Cochrane library and Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as scan reference lists from relevant reviews and publications included in our review. We will review all publications that include studies on human adults (18 years and older) where information is included on diabetes status and at least one measure of disability (Activities of Daily Living (ADL), Instrumental ADL (IADL) or functional/mobility limitation), and where a risk association is available for the relationship between diabetes and/or prediabetes with disability, with reference to those without diabetes. We will further conduct a meta-analysis to pool estimates of the risk of disability associated with prediabetes and diabetes. Sensitivity analysis will be conducted to assess for publication bias and study quality.Findings from this systematic review and meta-analysis will be widely disseminated through discussions with stake-holders, publication in a peer-reviewed journal and conference presentation.

- by Jessica Harding
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- Epidemiology, Research Design, Diabetes, Medicine

Summary This study provides information on the prevalence of diabetes mellitus in a group of elderly Chinese subjects aged 60 and above living in the community in Hong Kong, and investigates the sensitivity of the urine sugar, random blood glucose, glycosylated haemoglobin, and fructosamine measurements compared to a glucose tolerance test in screening for diabetes mellitus in this population. Four hundred

- by C. Cockram
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- Hong Kong, Blood Glucose, Diabetes mellitus, Clinical Sciences

Aims: to examine the incidence rate of progression to Type 2 diabetes and baseline prognostic risk factors, focusing on hypertension and antihypertensive medication, in a cohort (n =207) with impaired glucose tolerance (IGT). Methods: after 2 and 4.6 (1.9-6.4) years new cases of diabetes were diagnosed by the oral glucose tolerance test (OGTT). Hypertension (BP 160/95 or antihypertensive medication) was included in multiple regression analyses to assess the effect of risk factors on the development of diabetes. Results: diabetes developed in 32 subjects (19%), an incidence of 41/1000 (95% CI 28-57/1000) person-years. In univariate analyses, progression to diabetes was associated with a high (\ 9.0 mmol/l) 2-h OGTT value (P =0.008), a high fasting insulin (\ 12.0 mU/l) level (P= 0.000), a high triglyceride (] 1.3 mmol/l) level (P = 0.028), a high BMI (] 28.0 kg/m 2) (P= 0.013) and hypertension (P = 0.003). The risk for the development of diabetes was not increased in hypertensive subjects without antihypertensive medication compared with normotensive subjects (OR 0.8, 95% CI 0.3-2.6). However, it was increased in subjects with on medication, especially diuretics alone or in combination with other drugs. Hypertensive subjects on diuretics had higher levels of fasting insulin and triglycerides and higher BMIs at baseline than normotensive subjects. After adjustment for 2-h OGTT, fasting insulin, triglycerides and BMI, the OR for diabetes was 7.7 (95% CI 2.1-28.2) in hypertensive subjects using diuretics alone or in combination with other drugs and 2.6 (95% CI 1.0-6.7) in those using other drugs compared with normotensive subjects. The OR of diabetes corresponding to a one-unit increase in the 2-h OGTT concentration was 2.5 (95% CI 1.6-4.0) in the whole cohort. Conclusions: the rate of progression from IGT to Type 2 diabetes in this population was similar to that seen in other studies among Caucasian populations. The use of antihypertensive medication, especially diuretics, and a high 2-h OGTT level were significant predictors of subsequent deterioration to diabetes.

- by S. Keinänen-kiukaanniemi
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- Diabetes, Medicine, Finland, Hypertension

Although most commonly used drugs such as biguanides, sulfonylureas, and more recently, thiazolidinediones, are effective in controlling fasting hyperglycemia, a high percentage of patients have sustained elevated hemoglobin A 1c because of persistent elevation of postprandial plasma glucose (PPPG).-Glucosidase inhibitors (AGIs) specifically target PPPG. AGIs have been shown in several randomized controlled trials to be effective in controlling blood glucose, whether they are used as monotherapy or in combination with other antidiabetic medications. Among the AGIs, acarbose has also been shown to decrease the risk of progressing to diabetes in subjects with impaired glucose tolerance (IGT). Studies have also suggested that acarbose could decrease the risk of cardiovascular disease, both in IGT and in diabetes. Furthermore, AGIs are very safe and are nontoxic drugs. Their only side effects are gastrointestinal, such as flatulence and diarrhea; however, these can be minimized by the "start low, go slow" approach. AGIs should be considered whenever postprandial hyperglycemia is the dominant metabolic abnormality.

- by Jean-louis Chiasson
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- Cardiovascular disease, Metformin, Blood Glucose, Randomized Controlled Trial

To extend access to diabetic eye care and characterize the extent of diabetic retinopathy {DR) and other ocular findings using the Joslin Vision Network (JVN). • DESIGN: Retrospective observational cohort study. • METHODS: Outpatients at the Togus VA Medical Center with diabetes mellitus, impaired fasting glucose, or impaired glucose tolerance underwent JVN protocol imaging. Images were transmitted to the Joslin Diabetes Center for grading and recommended treatment plan. • RESULTS: The study included 1,219 patients (2,437 eyes); 1,536 eyes (63.0%) had no (DR), 389 (16.0%) had mild nonproliferative DR (NPDR), 105 (4.3%) moderate NPDR, 35 (1.4%) severe NPDR, 20 (0.8%) very severe NPDR, and 21 (0.9%) had proliferative DR (PDR). Regarding diabetic macular edema (DME), 1,907 eyes (78.3%) had no DME, 34 (1.4%) had early DME, and 16 (0.7%) had clinically significant macular edema

- by Jerry Cavallerano
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- Health Care, Diabetes mellitus, Diabetic Retinopathy, Retina

Prevalencia de diabetes mellitus y factores de riesgo relacionados en una población urbana

- by Raquel Cancino
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- Physical Activity, Arterial hypertension, Diabetes mellitus, Blood Pressure

The objective was to develop clinical practice guidelines for the primary prevention of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) in patients at metabolic risk. Healthcare providers should incorporate into their practice concrete measures to reduce the risk of developing CVD and T2DM. These include the regular screening and identification of patients at metabolic risk (at higher risk for both CVD and T2DM) with measurement of blood pressure, waist circumference, fasting lipid profile, and fasting glucose. All patients identified as having metabolic risk should undergo 10-yr global risk assessment for either CVD or coronary heart disease. This scoring will determine the targets of therapy for reduction of apolipoprotein B-containing lipoproteins. Careful attention should be given to the treatment of elevated blood pressure to the targets outlined in this guideline. The prothrombotic state associated with metabolic risk should be treated with lifestyle modificat...

- by Edward Horton
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- Risk assessment, Cardiovascular disease, Diabetes mellitus, Low Dose

The mechanisms by which the enteroinsular axis influences β-cell function have not been investigated in detail. We performed oral and isoglycemic intravenous (IV) glucose administration in subjects with normal (NGT; n = 11) or impaired glucose tolerance (IGT; n = 10), using C-peptide deconvolution to calculate insulin secretion rates and mathematical modeling to quantitate β-cell function. The incretin effect was taken to be the ratio of oral to IV responses. In NGT, incretin-mediated insulin release [oral glucose tolerance test (OGTT)/IV ratio = 1.59 ± 0.18, P = 0.004] amounted to 18 ± 2 nmol/m2 (32 ± 4% of oral response), and its time course matched that of total insulin secretion. The β-cell glucose sensitivity (OGTT/IV ratio = 1.52 ± 0.26, P = 0.02), rate sensitivity (response to glucose rate of change, OGTT/IV ratio = 2.22 ± 0.37, P = 0.06), and glucose-independent potentiation were markedly higher with oral than IV glucose. In IGT, β-cell glucose sensitivity (75 ± 14 vs. 156 ±...

- by Giuseppe Seghieri
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- Biological Sciences, Blood Glucose, Insulin, Hormones

interventions in people with impaired glucose tolerance. We undertook a qualitative study, nested within the EDIPS in Newcastle-upon-Tyne, UK, aiming to understand the experience of participants who maintained behaviour change, in order... more

- by Linda Penn
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- Health Behavior, Diabetes, Health Behaviour Change, Physical Activity

One thousand three hundred thirty-five men representing a representative sample of the man’s population in the age of 20-69 years are
surveyed. Within 12 years among them, the register of mortality was carried out. The parameters
of death were studied concerning the general number died in examined groups. It is shown that the
presence of various components of metabolic syndrome (MS) conjugates to the increased risk of total mortality. The structure of the risk of overall death in the different age periods is ambiguous. At
a young age, the highest risk of dying is connected to smoking and arterial hypertension (AG). The
next years the importance of arterial hypertension and glucose intolerance (GI) grows. Among the
persons of elderly age, the most critical risk factors of total mortality are AG, GI, and increased
mass of a body (IMB). After 30 years, ascending the importance of the GI is marked. This component
MS, in many respects, determines a degree of risk of total mortality. Its essence is essentially
enlarged at a combination of other parts of MS and smoking.

- by Ulugbek Kayumov
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- Obesity, Diabetes, Metabolic syndrome, Overweight