A study of microvascular and macrovascular complications in prediabetes
Keywords:Complications, Diabetes, Impaired glucose tolerance, Macrovascular, Microvascular, Prediabetes
Background: Prediabetes, a state defined by the presence of either impaired fasting glucose or impaired glucose tolerance is a condition in which blood glucose or haemoglobin A1c (HbA1c) levels are higher than normal but not high enough to be classified as diabetes.
Methods: The present study was conducted for a period of one year with effect from November 2014 to October 2015 and patients were recruited for study from OPD and wards of Department of General Medicine, ASCOMS Hospital, Sidhra. 50 Patients/subjects were selected as per specified inclusion criteria Method of collection of data is based on detailed history, clinical examination and routine investigations.
Results: In this study, out of 50 subjects, 8 case who were in the range of impaired glucose tolerance initially at the time of start of study gradually progressed to frank diabetes i.e. 15% over a study period of 1 year.
Conclusions: In this study, 50 Patients of impaired glucose tolerance or prediabetes were included in the study. Among 50 subjects, 80% were male and 20% were females. Majority were 30-60 yrs of age, average weight was 65±5 kg, and average height was 150±10cm. In risk factors, 20% of the subjects suffered from hypertension, 40% from lipid derangement, 30% suffered from obesity, 50% suffered from central obesity, 56% are smokers, and 60% have family history of diabetes. 10 subjects out of 50 i.e. 20% suffered from cardiovascular complications, no subject presented with peripheral neuropathy.
CDC. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: US Department of Health and Human Services CDC; 2011. Available at: http://www.cdc.gov/diabetes/pubs/factsheet11.htm. Accessed 14 February 2020.
American Diabetes Association. The prevention or delay of type 2 diabetes. Diabet Care. 2002 Apr 1;25(4):742-9.
The American Academy of Pediatrics. Available at: https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Study-Finds-23-Percent-of-Teens-Have-Prediabetes-or-Diabetes.aspx#sthash.ohay98Zl.dpuf. Accessed 21 May 2012.
National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes. 1979 Dec 1;28(12):1039-57.
American Diabetes Association. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabet Care. 1997;20:1183-97.
Abdul-Ghani MA, DeFronzo RA. Pathophysiology of prediabetes. Curr Diabetes Rep. 2009 Jun 1;9(3):193-9.
Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New Engl J Medi. 1993 Sep 30;329(14):977-86.
UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998 Sep 12;352(9131):837-53.
Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000 Aug 12;321(7258):405-12.
American Diabetes Association. Standards of medical care for diabetes-2008. Diabet Care. 2008;31(1):S12-54.
Yeboah J, Bertoni AG, Herrington DM, Post WS, Burke GL. Impaired fasting glucose and the risk of incident diabetes mellitus and cardiovascular events in an adult population: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol. 2011 Jul 5;58(2):140-6.
Emerging Risk Factors Collaboration. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010 Jun 26;375(9733):2215-22.
Plantinga LC, Crews DC, Coresh J, Miller ER, Saran R, Yee J, et al. Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes. Clini J Am Soc Nephrol. 2010 Apr 1;5(4):673-82.
Tapp RJ, Tikellis G, Wong TY, Harper CA, Zimmet PZ, Shaw JE. Longitudinal association of glucose metabolism with retinopathy: results from the Australian Diabetes Obesity and Lifestyle (AusDiab) study. Diabet Care. 2008 Jul 1;31(7):1349-54.
Tesfaye S, Boulton AJ, Dyck PJ, Freeman R, Horowitz M, Kempler P, et al. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabet Care. 2010 Oct 1;33(10):2285-93.
Grover SA, Lowensteyn I, Kaouache M, Marchand S, Coupal L, DeCarolis E, et al. The prevalence of erectile dysfunction in the primary care setting: importance of risk factors for diabetes and vascular disease. Arch Int Medi. 2006 Jan 23;166(2):213-9.
Putz Z, Tabák ÁG, Tóth N, Istenes I, Németh N, Gandhi RA, et al. Noninvasive evaluation of neural impairment in subjects with impaired glucose tolerance. Diabet Care. 2009 Jan 1;32(1):181-3.
American Diabetes Association. Standards of medical care in diabetes-2007. Diabet Care. 2007;30(1):S4-1.
Tominaga M, Eguchi H, Manaka H, Igarashi K, Kato TA, Sekikawa A. Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes Study. Diabet Care. 1999 Jun 1;22(6):920-4.
DECODE Study Group, European Diabetes Epidemiology Group. Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria. Arch Intern Medi. 2001 Feb 12;161(3):397.
Fonville S, Zandbergen AA, Vermeer SE, Dippel DW, Koudstaal PJ, Den Hertog HM. Prevalence of prediabetes and newly diagnosed diabetes in patients with a transient ischemic attack or stroke. Cerebrovasc Dis. 2013;36(4):283-9.
Jia Q, Zheng H, Liu L, Zhao X, Wang C, Jing J, et al. Persistence and predictors of abnormal glucose metabolisms in patients after acute stroke. Neurol Res. 2010 May 1;32(4):359-65.