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OBJECTIVE To identify the optimal AUSDRISK threshold score to screen for pre-diabetes and diabetes. METHODS A total of 406 adult patients not diagnosed with diabetes were screened in General Practices (GP) between May and October 2019. All patients received a point of care (POC) HbA1c test. HbA1c test results were categorised into diabetes (≥6.5% or ≥48 mmol/mol), pre-diabetes (5.7-6.4% or 39-47 mmol/mol), or normal (

Background Diabetes is one of the major public health concerns. Prediabetes can increase the risk of developing some non-communicable diseases such as type 2 diabetes. Given the increasing trend of prediabetes, it is critical to control it and prevent its complications. Curcumin is a major bioactive component of turmeric. Zinc is an antioxidant nutrient. The present trial aimed to evaluate the effect of curcumin and zinc co-supplementation along with a loss-weight diet on serum lipid profiles in overweight or obese patients with prediabetes. Methods Eighty-four participants were randomized to four groups (curcumin (500 mg/day), zinc (30 mg/day), “curcumin and zinc”, and placebo) for 90 days. Serum total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), non-HDL, HDL/LDL ratio, weight, BMI, waist circumstance (WC), hip circumstance (HC), physical activity (PA) and dietary intake were determined pre and post-intervention. This study will be conducted at Yazd Diabetes Research Clinic, Shahid Sadoughi University of Medical Sciences. Results Totally, 82 participants were included in the final analysis. After the adjusted PA effect, changes in serum TG (adjusted p = 0.001), LDL (adjusted p = 0.035), non-HDL (adjusted p = 0.003), HDL/LDL ratio (adjusted p = 0.002), and HDL (adjusted p Conclusion The beneficial effects of “curcumin and zinc” co-supplementation was reported for the changes of some lipid profiles (TG, LDL, HDL, non-HDL, and HDL to LDL ratio), BMI, and weight with no positive effects on TC, dietary intake, PA, WC, and HC. Therefore, it may play a potential role in the prevention of macro and microvascular complications. Trial registration The project is a registered clinical trial (Registration number: IRCT20190902044671N1, Iranian Registry of Clinical Trials (IRCT), registered October 11, 2019.

Background and Objective In the medical field, data techniques for prediction and finding patterns of prevalent diseases are of increasing interest. Classification is one of the methods used to provide insight into predicting the future onset of type 2 diabetes of those at high risk of progression from pre-diabetes to diabetes. When applying classification techniques to real-world datasets, imbalanced class distribution has been one of the most significant limitations that leads to patients’ misclassification. In this paper, we propose a novel balancing method to improve the prediction performance of type 2 diabetes mellitus in imbalanced electronic medical records (EMR). Methods A novel undersampling method is proposed by utilizing a fixed partitioning distribution scheme in a regular grid. The proposed approach retains valuable information when balancing methods are applied to datasets. Results The best AUC of 80% compared to other classifiers was obtained from the logistic regression (LR) classifier for EMR by applying our proposed undersampling method to balance the data. The new method improved the performance of the LR classifier compared to existing undersampling methods used in the balancing stage. Conclusion The results demonstrate the effectiveness and high performance of the proposed method for predicting diabetes in a Canadian imbalanced dataset. Our methodology can be used in other areas to overcome the limitations of imbalanced class distributions.

The prevalence of diabetes mellitus (DM) is rising in sub-Saharan Africa, including Nigeria. A previous study in Abia State, Nigeria, showed a high prevalence of diabetes, with no significant difference in urban and rural communities. This study aimed at investigating the prevalence and risk factors for impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), which represent reversible and preventable early signs of DM. A cross-sectional comparative study of 2800 adult residents of Abia State, comprising equal number of urban and rural respondents. Interviewer-administered semi-structured questionnaires were used for data collection. Fasting blood glucose was performed for all the respondents, while oral glucose tolerance test (OGTT) was done for 2424 respondents, comprising 1117 urban residents and 1307 rural residents. Data was analyzed using SPSS version 20. Mean age of the respondents was 48.54 ± 13.24 years: rural = 54.23 ± 14.26 years and urban = 42.85 ± 13.24 years, p

Continued rise in incidence and prevalence of diabetes globally warrants an effective strategy for its prevention and control. Prevention of diabetes seems more logical to attempt seeing its health care burden, long dormancy, systemic affliction and poor general awareness. Pre-diabetes is the intermediate state of erratic glucose metabolism without overt features of diabetes. This state seems to be a crossroad having a possibility to either convert into clinical diabetes, remain dormant or return to normal glucose control depending upon the efforts made. Unfortunately, due to the paucity of apparent clinical symptoms, this state embedded with reversal possibility, remains unexplored. Ayurveda account of prameha purvarupa (subclinical features of diabetes) may be proposed as the foundation upon which clinic-based pre-diabetes identification and subsequent prevention may be explored. Knowing the symptoms for their reliable proximity with upcoming diabetes may turn to be sensible sensitizers prompting the people to abort the disease process in an effective and timely manner. Considering diabetes from its purvarupa to complications as disease continuum and exploring the opportunities to intervene in order to prevent, or manage the disease on the basis of shada kriyaa kaala therefore, has a huge translational potential warrants an urgent exploration.

INTRODUCTION Certain pharmacological and lifestyle interventions have been shown to reduce progression of pre-diabetes. We aimed to perform a systematic review and meta-analyses of studies assessing the outcomes of zinc supplementation in individuals with pre-diabetes. EVIDENCE ACQUISITION A comprehensive search was conducted in PubMed, SciVerse Scopus and Web of Science databases. Controlled clinical trials in pre-diabetics, on zinc supplement with or without other nutrients, assessing at least one accepted glycaemic parameter as an outcome were deemed eligible. EVIDENCE SYNTHESIS Three papers were included in the systematic review and meta analysis, with a total of 265 participants. Duration of zinc supplementation ranged from 6-12 months. The zinc dose ranged from 20-30 mg/day. In the pooled analysis, zinc supplementation significantly reduced FBG both when given alone (-10.86 mg/dL; 95% CI, -14.74 to -6.98; p

Дуже важливим для розуміння є те, що кількість компонентів, що входять до складу метаболічного синдрому, це фактори ризику серцево-судинних захворювань, прогресування попередніх захворювань серцево-судинної системи та змін системи мікроциркуляції. Відомо, що порушення толерантності до глюкози та порушення рівня глюкози натще є проміжними стадіями розвитку цукрового діабету. Ризик ранньої смерті від серцево-судинних захворювань у пацієнтів з проміжною стадією цукрового діабету в кілька разів вище, ніж у здорових людей. У той же час, механізми взаємного впливу метаболічного синдрому та предіабетичних розладів на особливості мікроциркуляції сьогодні недостатньо вивчені. Цей факт і обумовив мету нашої роботи: зрозуміти роль предіабетичних порушень вуглеводного обміну при метаболічному синдромі в розвитку змін мікроциркуляції. З цією метою обстежено 142 людини різного віку. За ознакою поєднання компонентів метаболічного синдрому і предіабетичними розладами всіх пацієнтів поділили на різні групи. Найбільш виражені порушення метаболізму глюкози та мікроциркуляторної функції були виявлені у групи пацієнтів із поєднання 3–5 симптомів (гіпертонія, переддіабет, ожиріння та дисліпідемія). Більшість пацієнтів були у віці 60 років і старше. Хворі цієї групи характеризувались суттєво вищим рівнемь глюкози та порушеннями мікроциркуляції. Негативний вплив на параметри мікроциркуляції та вищий ризик гіперкоагуляції відзначено у пацієнтів 40–59 років. Ці зміни мають ще виражені ший характер у літніх людей, які мають предіабетичні зміни. Формування переддіабету при метаболічному синдромі залежить від кількості компонентів метаболічного синдрому. Враховуючи наявність предіабетичних змін на фоні метаболічного синдрому, виявлені зміни мікроциркуляції можна розуміти як ранні прояви мікроангіопатії задовго до розвитку цукрового діабету та його загрозливих для життя судинних ускладнень.

About 20% of MM patients have T2DM. We assessed the impact of T2DM/pre-T2DM on MM progression and OS. We collected retrospective data of newly diagnosed MM patients in Maccabi health services, Israel, between 2012 and 2016. The study included 503 MM patients, median age 67.2 years (IQR: 33.5-91.2). Median follow-up was 32 months (IQR 19.4-47). T2DM and pre-T2DM were recorded in 24.1% and 51% patients, respectively. Median TT2T and OS in the cohort were 17.5 months (95% confidence interval (CI) 15-20) and unreached, respectively. T2DM patients had shorter TT2T (HR = 1.31, 95%CI 1.0-1.72, p=.047), particularly transplanted patients; 20.2 vs. 40 months (HR = 2.09, 95%CI 1.18-3.71, p=.012). In a multivariable model, T2DM had a borderline significant risk of all-cause mortality, adjusted HR 1.38 (p=.09). Pre-diabetes had no impact on TT2T or OS. T2DM predicted a shorter TT2T, particularly in transplanted patients, and tended to be associated with shorter survival.

Aims Pre-diabetes is a common condition that affects about 16.4% of Australian adults. Hyperglycaemia is a strong risk factor for the development of stroke. Metformin XR is an approved medication to treat type 2 diabetes in Australia but not pre-diabetes. Additionally, whether it is tolerated following a stroke is unclear. In this pilot study, we aimed to assess the feasibility of Metformin XR in people with stroke and pre-diabetes. Methods In this PROBE design trial, people who had recent stroke (within 3 months) with pre-diabetes were randomized to either the active arm (n = 13) receiving usual care plus Metformin XR (500 mg daily increased to a total daily dose of 1500 mg) or the control group receiving only usual care (n = 13). At baseline & after four months of intervention, clinical and biomedical characteristics, cardiovascular risk factors and medication data were recorded. At one month and 2.5 months into the study, compliance rate and side effects were determined. Results This trial showed that it is feasible to recruit, retain and monitor participants. However, the compliance rate was low. Adherence to metformin XR was 52% (IQR:42% to 61%) based on the remaining tablets in the container after 4 months of intervention. None of the reported side effects were deemed to be related to the study treatment and no significant differences were observed between the metformin XR and the control group. Conclusion Treatment with Metformin XR in participants admitted with stroke and with pre-diabetes is feasible and safe. Strategies are needed to improve adherence in future trials.

Introduction: Obesity in childhood is associated with many co-morbid conditions; one of them is alteration of glucose metabolism. Materials and Methods:This cross-sectional study was conducted among 100 overweight and obese children aged 5-16 years to determine the status of pre-diabetes (IFG and IGT) and type 2 diabetes mellitus (T2DM), attending the OPD, BSMMU, Dhaka. All overweight/obese children were included according to BMI for age and sex using CDC growth chart. Children taking steroid for any cause or having any endocrine disorder or syndrome was excluded from the study. Anthropometry and blood pressure measurement were done and skin manifestations of insulin resistance were looked for. Fasting lipid profile and oral glucose tolerance test (OGTT) was done for each child. Result: Among the studied children 62% were male and 38% female, 77% were obese and 23% were over weight. Evidence of insulin resistance were found among most of the children and most common evidence was dyslipidemia (80%) followed by acanthosis nigricans(76%). Skin manifestation of polycystic ovary syndrome (PCOS) was found in 3% of children. Impaired fasting glucose (IFG) was found in 4% and Impaired Glucose Tolerance (IGT) was found in 7% of children among them 4% had both IGT and IFT. No child was found diabetic in this study. Conclusion:Altered glucose metabolism was present in overweight and obese children of our children, so screening is recommended. Bangladesh J Child Health 2020; VOL 44 (3) :143-147

Diabetes has been on the rise in Africa. This study aimed to estimate for the first time the national prevalence and its correlates of pre-diabetes and diabetes among individuals aged 18–69 years in Zambia. Nationally representative cross-sectional data were analyzed from 3608 persons aged 18–69 years (median age: 31 years) that participated in the “2017 Zambia STEPS survey,” with complete blood glucose measurements. Results indicate that 8.8% of 18–69 year-olds had pre-diabetes and 7.2% diabetes. In adjusted multinomial logistic regression analysis, rural residence (adjusted relative risk ratio = ARRR: 2.01, 95% confidence interval = CI: 1.40–2.89), and raised total cholesterol (ARRR: 1.78, 95% CI: 1.08–2.94) were positively, and high physical activity (ARRR: 0.57, 95% CI: 0.39–0.83) was negatively associated with pre-diabetes. Being 50–69 years old (ARRR: 3.03, 95% CI: 2.03–4.52), having central obesity (ARRR: 1.90, 95% CI: 1.20–3.03), and hypertension (ARRR: 2.24, 95% CI: 1.61–3.13) were positively associated with diabetes. In addition, in the unadjusted analysis, female sex, lower education, alcohol family problems, and alcohol dependence were associated with pre-diabetes and/or diabetes. Only 8.4% of the study sample reported that they ever had their blood glucose examined by a health care professional. Having had blood glucose measured was higher among women (9.6%) than men (7.2%) were but not significant (p = 0.08). Residents in urban areas (11.8%) had significantly more often their blood glucose ever measured than residents in rural areas (5.4%) (p

The purpose of our review is to bring to the clinical specialities physicians’ attention the recommendations regarding diabetes mellitus (DM) management presented in the 2019 ESC/EASD Guidelines on diabetes, pre-diabetes and cardiovascular diseases. Key aspects from the guideline regarding blood pressure, lipid and glucose modern management are presented with focus of reducing cardiovascular risk in diabetes mellitus patients. The clinician must not forget that every DM patient is a candidate for a future cardiovascular event and that multifactorial and patient-adapted therapy is the key approach in reducing this risk.

With type 2 diabetes presenting at younger ages, there is a growing need to identify biomarkers of future glucose intolerance. A high (20%) prevalence of glucose intolerance at 18 years was seen in women from the Pune Maternal Nutrition Study (PMNS) birth cohort. We investigated the potential of circulating microRNAs in risk stratification for future pre-diabetes in these women. Here, we provide preliminary longitudinal analyses of circulating microRNAs in normal glucose tolerant (NGT@18y, N = 10) and glucose intolerant (N = 8) women (ADA criteria) at 6, 12 and 17 years of their age using discovery analysis (OpenArray™ platform). Machine-learning workflows involving Lasso with bootstrapping/leave-one-out cross-validation identified microRNAs associated with glucose intolerance at 18 years of age. Several microRNAs, including miR-212-3p, miR-30e-3p and miR-638, stratified glucose-intolerant women from NGT at childhood. Our results suggest that circulating microRNAs, longitudinally assessed over 17 years of life, are dynamic biomarkers associated with and predictive of pre-diabetes at 18 years of age. Validation of these findings in males and remaining participants from the PMNS birth cohort will provide a unique opportunity to study novel epigenetic mechanisms in the life-course progression of glucose intolerance and enhance current clinical risk prediction of pre-diabetes and progression to type 2 diabetes.

BACKGROUND: The present study designed to evaluate the Serum levels of CMPF, MASP1 and UA in pre-diabetic subjects was compared to normal subjects. METHODS: This research is a case-control study. We studied 44 pre-diabetics with 44 normal subjects and were evaluated serum concentration of CMPF, Masp1 and U.Ain both groups andfurthermore serum concentration FPG, BUN, Cr, Cho, TG, HDLc, LDLc, AST, ALT, ALP, HbA1c was examined and correlation between of CMPF, Masp1 and U.Aand other parameters was statistically analyzed. RESULTS: Serum levels of MASP1, CMPF, fasting plasma glucose (P

Background: Early detection of Pre-diabetes and controlling the risk factors may delay the development of Diabetes and related complications. Objectives: To estimate the prevalence of Pre-diabetes in West Tripura district of India and to study it’s associations with selected risk factors. Methods: This community based cross-sectional study was conducted in West Tripura district of India, during 1st January 2018 to 31st December 2019 among 320 individuals selected by multistage sampling. Fasting blood sugar was tested for diagnosing Pre-diabetes. Data entry and analysis were performed using SPSS-24. Result: Prevalence of Pre-diabetes in West Tripura district was 19.4%, 28.1% were hypertensive and 32.5% had high BMI. Multivariable logistic regression has identified age ≥40 yr (OR: 20.62, 95% CI: 4.97 – 85.49) higher socioeconomic status (OR: 4.99, 95% CI: 1.95 – 12.72), family history of diabetes (OR: 9.72, 95% CI: 2.51 – 37.61), higher BMI (OR: 2.79, 95% CI: 1.32 – 5.89) and physical inactivity (OR: 3.52, 95% CI: 1.66 – 7.46) as the predictors of Pre-diabetes. Conclusion: West Tripura district of India has higher prevalence of pre-diabetes than the national average. Age ≥40 yr, higher socioeconomic status, family history of diabetes, higher BMI and physical inactivity were identified as significant predictors of Pre-diabetes in this region.

Background: In Mexico, type 2 diabetes prevalence is 13.7%, which has a huge impact on Mexican public health. There is an urgent need to focus on the prevention of pre-diabetes to decrease the likelihood of type 2 diabetes onset. Gene variants predisposed to increase Fasting Blood Glucose (FBG) and glycosylated hemoglobin (HbA1c) levels could be helpful for prevention purposes. This study aimed to analyze the association of the G6PC2 rs560887 variant with pre-diabetes in a Mexican-Mestizo population. Methods: A cross-sectional case-control study was performed in 960 Mexican Mestizos participants. The association of G6PC2 rs560887 with pre-diabetes was analyzed by logistic regression and with Fasting Blood Glucose (FBG) and glycosylated hemoglobin (HbA1c) by linear regression. Results: The G6PC2 rs560887 variant was significantly associated with FBG (β -1.80, p=0.03), but not with HbA1c or the presence of pre-diabetes. Conclusion: The G6PC2 rs560887 loci could be a potential early marker of type 2 diabetes.

Background: The diabetes pandemic continues to cause both patient and economic burden. Globally, strategies to improve glycaemic control in patients with diabetes are highly sought after. One such ...

Objectives: To determine the prevalence of diabetes mellitus and pre-diabetes among patients with NAFLD having BMI ≥ 25 kg/m2and compare it with the control group with non-fatty liver with same BMI. Study Design: Prospective, Analytical and Cross-sectional study. Setting: Department of Medicine, Civil Hospital Karachi. Period: January 2015 to October 2016. Material & Methods: The study was conducted among two groups of patients, one with non-alcoholic fatty liver disease (NAFLD), having BMI of ≥25kg/m2and they were compared with a control group having BMI≥25kg/m2 but without fatty liver on ultrasound. Result: Out of 201 NAFLD participants, 82.08% had pre-diabetes and diabetes mellitus, while 82.51% of participants from non-NAFLD (n=101) had pre-diabetes or diabetes mellitus. Insulin resistance was more common among non-NAFLD group than NAFLD group. Most of the metabolic parameter analysed in the study among two groups having slight difference, and they were statistically significant. Conclusion: Pre-diabetes and diabetes mellitus is a frequently reported problem among NAFLD and overweight/obese patients. Insulin resistance was found to be a significant predictor of diabetes mellitus.

Pre-diabetes carries a cardiovascular risk. Beverley Bostock-Cox considers the interventions that can improve this risk in people with pre-diabetes Pre-diabetes is a state of impaired glucose regulation where the body moves from normal levels of blood glucose to a position where increasing levels of insulin resistance result in higher and harmful sugar levels in the bloodstream. As its name suggests, it is a precursor of type 2 diabetes. Cardiovascular risk is also likely to be higher, mainly because of the links between hyperglycaemia and other known cardiovascular risk factors such as hypertension and dyslipidaemia. In people with pre-diabetes, the aim should be to treat all the modifiable risk factors through lifestyle interventions, especially by encouraging weight loss and increasing physical activity levels. Pharmacological interventions can be considered in addition to lifestyle change.

Yu-qing Huang,1,* Lin Liu,1,* Cheng Huang,1,* Yu-ling Yu,1 Kenneth Lo,1,2 Jia-yi Huang,1 Chao-lei Chen,1 Ying-ling Zhou,1 Ying-qing Feng1 1Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou 510080, People’s Republic of China; 2Department of Epidemiology, Centre for Global Cardio-Metabolic Health, Brown University, Providence, Rhode Island, NY, USA*These authors contributed equally to this workCorrespondence: Ying-qing Feng; Ying-ling ZhouDepartment of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou 510080, People’s Republic of ChinaTel/ Fax +86-20-83827812Email 651792209@qq.com; drcacocolacai@gmail.comBackground: Among the population without cardiovascular diseases (CVD), it is unclear whether pre-diabetes and/or prehypertension elevated the risk of all-cause and cardiovascular mortality.Methods: All participants without CVD at baseline were recruited from the 1999– 2014 National Health and Nutrition Examination Survey (NHANES), with survival status being updated until 31 December 2015. Cox proportional hazards models and subgroup analyses were performed to estimate hazard ratios (HRs) and 95% confidence interval (CI).Results: There were 23,622 participants (11,233 [47.6%] male) with mean age of 37.2 years. Compared to participants without prehypertension or pre-diabetes, the HRs for all-cause mortality among participants with prehypertension alone, pre-diabetes alone, and combined pre-diabetes and prehypertension were 1.04 (95% CI: 0.88, 1.24), 0.96 (95% CI:0.76, 1.21), and 1.19 (95% CI:0.98, 1.46), respectively. The corresponding HRs for cardiovascular mortality were 1.51 (95% CI: 0.83, 2.77), 1.40 (95% CI: 0.64, 3.06), and 1.70 (95% CI: 0.88, 3.27), respectively. A subgroup analysis showed that participants with combined pre-diabetes and prehypertension had a higher risk of all-cause mortality among younger participants, higher BMI, white population, and people with elevated non-HDLC. Moreover, the association between combined pre-diabetes and prehypertension and cardiovascular death was only significant among people with elevated non-HDLC.Conclusion: Pre-diabetes combined with prehypertension might elevate the risk of all-cause mortality among subjects, particularly for those with elevated body weight, high non-HDLC, younger participants or white population.Keywords: pre-diabetes, prehypertension, cardiovascular disease, CVD, all-cause mortality, cardiovascular mortality

AIM to evaluate if a nutraceutical compound containing Ilex paraguariensis, White Mulberry and Chromium Picolinate can ameliorate glycemic status in patients with pre-diabetes. METHODS we enrolled patients with IFG or IGT, not taking other hypoglycemic compounds. Patients were randomized to take placebo or the nutraceutical compound for 3 months, in a randomized, double-blind, placebo-controlled design. Both treatments were self-administered once a day, 1 tablet during the breakfast. RESULTS a reduction of FPG was observed with the nutraceutical combination (-7.8%). Furthermore, there was a decrease of HOMA-IR with the nutraceutical combination (-7.9%). M value was higher (p

Background: Diabetes mellitus is a leading cause of morbidity and mortality worldwide, imposing a considerable burden on health systems and societies as it affects both individuals and their families and has a large impact on the economic and social development of a country. Objectives: The purpose of this study was to study the prevalence of diabetes and pre-diabetes among the Dubai population and associations with diabetes risk factors. Methodology: A cross-sectional Diabetes Household Survey was carried out in the Emirates of Dubai during 2017 as a complementary stage of the Dubai Household Survey, 2014, which was a randomly selected, multistage, stratified, cluster survey. The sampling technique was selected to assess the rates of undiagnosed diabetes as well as the rates of pre-diabetes through screening with HbA1c. The size of the 2017 survey sample was estimated at 300 individuals for Emirati and 300 for non-Emirati. An additional 200 individuals were added to address non-response cases. These were added to those who were identified as diabetics in the 2014 Household Health Survey and then weighted to give a representative sample for the Dubai population. Results: The study revealed that the prevalence of diabetes in Dubai among UAE nationals was 19%, and it was 14.7% for expats. Consequently, the overall prevalence of diabetes in Dubai is 15.2%. Undiagnosed diabetes was 10% in UAE nationals and 10.9% in expats. Pre-diabetes in UAE national males was lower than in females, although this pattern was not observed among expats. Younger age, normal weight, and exercise were associated with lower rates of diabetes and pre-diabetes in UAE nationals and expats. Hypertension was associated with higher rates of diabetes regardless of nationality. Conclusions: The study concluded that the prevalence of diabetes among the Dubai population is alarmingly high and that a large proportion of the population are not aware of their diagnosis. A higher prevalence of diabetes is associated with multiple factors, such as age, male gender, hypertension, higher BMI, lack of exercise, and lower level or no education, as well as a family history of diabetes mellitus. Many of these factors can be easily modified, which could lead to a decrease in the burden of the disease.

Background: Prediabetes is increasingly being studied in the context of its association with cardiovascular disease (CVD). Besides raised HbA1c and sugar levels, the major underlying defect seems to be insulin resistance (IR). Subclinical atherosclerosis, measured by high sensitivity C reactive protein (hsCRP) and carotid artery intima media thickness (CIMT) underlies the pathogenesis of CVD in prediabetes. Heart-type fatty acid binding protein (H-FABP), a novel cardiac biomarker also might have a role in predictin prediabetic heart disease. Aims: The aim of the study is to compare serum levels of H-FABP in prediabetics and controls and correlate them with the atherosclerotic markers, hsCRP and CIMT. Setting and Design: 50 prediabetic patients and 50 age, sex and BMI matched controls were employed in the case control study. Serum F & PPBS, (HbA1c), fasting insulin levels were measured in cases and controls. Serum H-FABP was measured in both cases and controls. All cases and controls were subjected to bilateral CIMT measurements and Serum hsCRP levels. The values were compared between both the groups and subjected to appropriate statistical analysis. Statistical Analysis Used: Categorical variables were presented in number and percentage (%) and continuous variables were presented as mean ± SD and median. Normality of data was tested by Kolmogorov-Smirnov test. If the normality was rejected then non parametric test was used. Quantitative variables were compared using Independent t test/Mann-Whitney Test (when the data sets were not normally distributed) between the two groups. Qualitative variables were correlated using Chi-Square test/Fisher's Exact test. Spearman rank correlation coefficient was used to find out the correlation of various parameters with each other. Univariate linear regression was used to find out the cause and effect relationship between various parameters. A p

The prevalence of diabetes mellitus (DM) is steadily increasing all over the world. DM is associated with a doubling of cardiovascular (CV) risk independently of other risk factors. The European Society of Cardiology (ESC) in collaboration with the European Association for the Study of Diabetes (EASD) presented a new set of guidelines on diabetes, pre-diabetes and cardiovascular diseases at the ESC 2019 Congress in Paris. The most important changes in the guidelines include a new assessment of CV risk in DM patients, an algorithm for glucose-lowering treatment, prevention of CV diseases including new targets for the treatment of dyslipidemia taking into account CV risk and recommendations for antiplatelet/antithrombotic drugs. Furthermore, attention focused on the management of DM concomitant with coronary artery disease and heart failure, as well as individualized therapeutic strategies for diabetic patients with arterial hypertension.

OBJECTIVE: Clinically, type 2 diabetes mellitus (T2DM) is heterogeneous, but the prevailing pathophysiologic hypothesis nevertheless contends that components of metabolic syndrome are central to all cases of T2DM. Here, we re-evaluated this hypothesis. RESEARCH DESIGN AND METHODS: We conducted a cross-sectional analysis of 138 women from the monocenter, post gestational diabetes study PPSDiab, 73 of which had incident prediabetes or T2DM. Additionally, we examined all the 412 incident cases of T2DM in phases 3 to 9 of the Whitehall II study in comparison to healthy controls. Our analysis included a medical history, anthropometrics, oral glucose tolerance testing, and laboratory chemistry in both studies. Additional analyses from the PPSDiab Study consisted of cardiopulmonary exercise testing, magnetic resonance imaging, auto-antibody testing, and the exclusion of glucokinase maturity-onset diabetes of the young. RESULTS: We found that 33 (45%) of the women with prediabetes or T2DM in the PPSDiab study displayed no components of metabolic syndrome. They reached no point for metabolic syndrome in the National Cholesterol Education Program Adult Treatment Panel III score other than hyperglycemia and, moreover, had levels of liver fat content, plasma triglycerides, high-density lipoprotein cholesterol, c-reactive protein, and blood pressure that were comparable to healthy controls. In the Whitehall II study, 62 (15%) of the incident T2DM cases fulfilled the same criteria. In both studies, these cases without metabolic syndrome revealed insulin resistance and inadequately low insulin secretion. CONCLUSIONS: Our results contradict the hypothesis that components of metabolic syndrome are central to all cases of T2DM. Instead, they suggest the common occurrence of a second, unrelated pathophysiology.

PURPOSE: In this study, the prevalence of diabetes and pre-diabetes (pre-DM) has been estimated; also, some factors related to diabetes and pre-diabetes in the city of Kharameh, southern Iran, were investigated. METHODS: This cross-sectional study was conducted on a total of 10,474 subjects aged 40–70 years who participated in phase one of PERSIAN Kharameh cohort carried out between 2015 and 2016. Eligible individuals were included in the study by census method. RESULTS: Prevalence of diabetes is 20.17% (95% CI: 19.95–20.39) and that of pre-diabetes is 15.74% (95% CI 15.54–15.93). Multivariate logistic regression results showed that the prevalence of diabetes had a direct relationship with increasing age (p

Bariatric surgery (BS) can lead to remission of type 2 diabetes mellitus (T2DM), however, the evidence on the influence of preoperative serum magnesium levels on this reversal is scarce. To study the influence of preoperative serum magnesium levels on the pre-T2DM and T2DM remission one year after BS. Retrospective study carried out among 1656 patients with obesity who underwent BS in the Centro Hospitalar Universitário São João. T2DM and pre-T2DM remission were defined as being normal glycaemic measures of at least one year's after BS and without pharmacological therapy. To assess the association between preoperative serum magnesium levels and pre- and T2DM remission, logistic regression models, crude and adjusted for sex, age and body mass index were computed. Patients with normoglycaemia presented hypomagnesaemia less often than those patients with pre-T2DM and T2DM (17.0% vs. 21.3% vs. 39.9%) (p < 0.001). One year after BS, 62.9% of patients with pre-T2DM or T2DM before BS showed remission. Adequate magnesium levels were positively associated with T2DM and pre-T2DM remission, one year after BS (OR 1.79; 95% CI 1.34-2.38), independently of sex, age, and body mass index. Adequate preoperative serum magnesium levels showed to be an important clinical parameter for pre-T2DM and T2DM remission. Isabel Maia holds a PhD Grant (ref:SFRH/BD/117371/2016/PT), which is co-funded by the Foundation for Science and Technology (FCT) and the POCH/FSE Program.

Background-First adipocyte derived biomarker istumor necrosis factor alphawhich connect the link between inflammation and diabetes. It expresses m-RNA which is contributing to the development of insulin resistance.However, the relationship between tumor necrosis factor alpha, pre-diabetes and Type2diabetes mellitus is still contradictory and restricted. Material & Methods: This study washospital based analytical cross-sectional study. Total 900 subjects were distributed into three groups (300 pre-diabetic subjects, 300 type 2 diabetic subjects and 300 healthy subjects) as per ADA criteria. The biochemical parameters as Fasting Blood Glucose, 2-hr glucose (after 75 gm oral glucose intake), HbA1c and fasting insulin were analyzed. HOMA-IR was used to calculate insulin resistance mathematically. Anthropometric measurements were done.Tumor necrosis factor alphawas done by ELISA method. Results:Tumor necrosis factor alphaconcentration was significantly increased in patients with type 2 diabetes mellitus and pre-diabetes in comparison to the control group at p value < 0.001 and showed a positive correlation with HOMA -IR. In conclusion, our findings suggested thatsystemic inflammation has an important role in the pathogenesis of pre diabetic condition. There is a progressive raises value oftumor necrosis factor alphain pre diabetic and diabetic patients. Therefore, inflammation reflects the severity of the disease and signifies the presence of ongoing disease process.

Background Hypertension and diabetes are among the most important risk factors of cardiovascular diseases. Klotho and SIRT1 are known as anti-aging factors with beneficial effects on cardiovascular system. In this study we investigated the serum Klotho and SIRT1 levels in pre-diabetic and pre-hypertensive individuals and then in diabetic and hypertensive patients to see their relationship with these diseases. Method 229 individuals divided into six groups with similar gender and age distribution 1—Control (normal BP and FBS) 2—pre-diabetic (FBS between 100 and 125 mg/dl) 3—diabetic (FBS ≥ 126 mg/dl), 4—pre-hypertensive (SBP 120–139 or DBP 80–89 mm Hg) 5—hypertensive (SBP ≥ 140 or DBP ≥ 90 mm Hg), and 6—patients with combined hypertension/diabetes. Serum levels of Klotho and SIRT1 were measured by ELISA method. Results Serum Klotho and STRT1 levels decreased in pre-diabetes and returned to normal in diabetic patients. Their concentration increased in pre-hypertension and recovered to normal in hypertension. In the physiologic range of FBS there is a negative correlation between Klotho and SIRT1 with FBS. When pathologic ranges of FBS added to analysis, the negative correlation abolished/U shaped. Also an inverse U shape correlation observed between Klotho and SIRT1 with MAP in the range of normal to hypertensive BP levels. There was an overall positive relationship between the serum levels of Klotho and SIRT1 themselves. Conclusion The serum levels of the anti-aging proteins Klotho and SIRT1 increases or reduces at the onset of the disease, as a compensatory mechanism, but as the disease progresses their level recovers.

ObjectiveDiabetic retinopathy in type 2 diabetes is preceded by retinal nerve fiber layer (RNFL) thinning, an index of neurodegeneration. We investigated whether glucose metabolism status (GMS), measures of glycemia, and daily glucose variability (GV) are associated with RNFL thickness over the entire range of glucose tolerance.Research design and methods We used cross-sectional data from The Maastricht Study (up to 5,455 participants, 48.9% men, mean age 59.5 years and 22.7% with type 2 diabetes) to investigate the associations of GMS, measures of glycemia (fasting plasma glucose [FPG], 2-hour post-load glucose [2-h PG], HbA1c, advanced glycation endproducts [AGEs] assessed as skin autofluorescence [SAF]) and indices of daily GV (incremental glucose peak [IGP] and continuous glucose monitoring [CGM]-assessed standard deviation [SD]) with mean RNFL thickness. We used linear regression analyses and, for GMS, P for trend analyses. We adjusted associations for demographic, cardiovascular risk and lifestyle factors, and, only for measures of GV, for indices of mean glycemia. Results After full adjustment, type 2 diabetes and prediabetes (versus normal glucose metabolism) were associated with lower RNFL thickness (standardized beta [95%CI], respectively -0.16[-0.25;-0.08]; -0.05[-0.13;0.03]; Ptrend=0.001). Greater FPG, 2-h PG, HbA1c, SAF, IGP and CGM-assessed SD were also associated with lower RNFL thickness (per SD, respectively -0.05 [-0.08; -0.01]; -0.06 [-0.09; -0.02]; -0.05 [-0.08; -0.02]; -0.04 [-0.07; -0.01]; -0.06 [-0.12; -0.01]; and -0.07 [-0.21; 0.07]).Conclusion In this population-based study, a more adverse GMS and, over the entire range of glucose tolerance, greater glycemia and daily GV were associated with lower RNFL thickness. Hence, early identification of individuals with hyperglycemia, early glucose-lowering treatment, and early monitoring of daily GV may contribute to the prevention of RNFL thinning, an index of neurodegeneration and precursor of diabetic retinopathy.