Search

With the increasing burden of diabetes as a cause of macro- and microvascular disease linked to the epidemics of obesity, attention is being paid to dysglycaemic states that predict and precede the development of type 2 diabetes. Such conditions, termed pre-diabetes, are characterized by fasting plasma glucose, or plasma glucose levels on an oral glucose tolerance test, or values of glycated haemoglobin intermediate between 'normal' values and those characterizing diabetes. These last are by definition associated, in epidemiological terms, with a higher incidence of microvascular disease—mostly retinopathy. Pre-diabetes overlaps with the components of the 'metabolic syndrome'—among which are excess visceral adiposity; hypertension; hypertriglyceridaemia; high levels of small, dense low-density lipoproteins; and metabolic-associated fatty liver disease. There is little doubt that pre-diabetes has important prognostic implications, especially for the occurrence of myocardial infarction, ischaemic stroke, and peripheral arterial disease. It is disputed, however, whether pre-diabetes is itself an actionable disease entity, in addition to the risk factors characterizing it. Because of this uncertainty, the latest European Society of Cardiology guidelines chose not to include pre-diabetes as a treatment target for atherosclerotic cardiovascular disease, at variance from the three previous editions of such guidelines. This is spurring a debate, the Pro and Contra arguments featured in the present debate article. [ABSTRACT FROM AUTHOR]

Copyright of Baghdad Science Journal is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The prevalence of pre-diabetes is increasing in rapidly urbanizing cities, especially in individuals aged 25 − 45 years old. Studies also indicate that this condition is associated with aberrant immune responses that are also influenced by environmental factors. This study sought to investigate changes in the concentration of immune cells and select inflammatory markers in patients with pre-diabetes in Durban, South Africa. Blood samples collected from King Edward Hospital, after obtaining ethics approval, were divided into non-diabetic (ND), pre-diabetic (PD) and type 2 diabetic (T2D) using ADA criteria. In each sample, the concentration of immune cells and select inflammatory markers were determined. The results showed a significant increase in eosinophil and basophil levels in the PD group as compared to the ND group. Compared to ND, the PD and T2D groups had significant increases in serum TNFα, CD40L and fibrinogen concentrations. Additionally, there were decreases in serum CRP, IL-6, and P-selectin in the PD group while these markers increased in the T2D group. These findings were indicative of immune activation and highlight the impact of pre-diabetes in this population. More studies are recommended with a higher number of samples that are stratified by gender and represent the gender ratio in the city. [ABSTRACT FROM AUTHOR]

Accumulation of circulating branched-chain amino acids (BCAA) is a hallmark feature of impaired insulin sensitivity. As intracellular BCAA catabolism is dependent on glycine availability, we hypothesised that the concurrent measurement of circulating glycine and BCAA may yield a stronger association with markers of insulin sensitivity than either BCAA or glycine alone. This study therefore examined the correlative relationships of BCAA, BCAA and glycine together, plus glycine alone on insulin sensitivity-related markers before and after an 8-week low energy diet (LED) intervention. This is a secondary analysis of the PREVIEW (PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World) Study New Zealand sub-cohort. Eligible participants with pre-diabetes at baseline who achieved ≥8 % body weight loss following an LED intervention were included, of which 167 paired (Week 0 and Week 8) blood samples were available for amino acid analysis. Glycemic and other data were retrieved from the PREVIEW consortium database. Repeated measures linear mixed models were used to test the association between amino acids and insulin sensitivity-related markers (HOMA2-IR, glucose, insulin, and C-peptide). Elevated BCAA was associated with impaired insulin sensitivity (p < 0.05), with strength of association (ηp2) almost doubled when glycine was added to the model. However, glycine in isolation was not associated with insulin sensitivity-related markers. The magnitude (β-estimates) of positive association between BCAA and HOMA2-IR, and inverse association between glycine and HOMA2-IR, increased when body weight was higher (Body weight∗BCAA, Body weight∗glycine, p < 0.05, both). Low serum glycine strengthened the association between BCAA and impaired insulin sensitivity. Given that glycine is necessary to facilitate intracellular BCAA catabolism, measurement of glycine is necessary to complement BCAA analysis to comprehensively understand the contribution of amino acid metabolism in insulin sensitivity. This study was registered with ClinicalTrials.gov (NCT01777893). [ABSTRACT FROM AUTHOR]

Pre-diabetes (pre-DM) is a strong predictor of diabetes (DM) over time. This study investigated how much of the recent increase in pre-DM identified among Alaska Native (AN) peoples living in urban southcentral Alaska may be due to changes in diagnostic methods. We used clinical and demographic data collected at baseline between 2004 and 2006 and at follow-up collected between 2015 and 2017 from the urban southcentral Alaska Education and Research Towards Health (EARTH) cohort. We used descriptive statistics and logistic regression to explore differences in demographic and clinical variables among the identified pre-DM groups. Of 388 participants in the follow-up study, 243 had A1c levels indicating pre-DM with only 20 demonstrating pre-DM also by fasting blood glucose (FBG). Current smoking was the sole predictor for pre-DM by A1c alone while abdominal obesity and elevated FBG-predicted pre-DM by A1c+FBG. No participants had an elevated FBG without an A1c elevation. A substantial portion of the rise in pre-DM found among urban southcentral AN peoples in the EARTH follow-up study was due to the addition of A1c testing. Pre-DM by A1c alone should be used to motivate behavioural changes that address modifiable risk factors, including smoking cessation, physical activity and weight management. [ABSTRACT FROM AUTHOR]

Background: Pre-diabetes, characterized by elevated glycemic indices, poses a high risk of diabetes development, and is increasingly linked to non-specific low back pain. While mechanisms remain incompletely understood, metabolic, inflammatory, and neurological factors are implicated. Dietary interventions, including low-glycemic and anti-inflammatory diets, alongside weight management, may improve outcomes in this population. Objectives: In this non-randomized controlled trial, we aim to evaluate the influence of decreasing HbA1c levels on reducing chronic non-specific low back pain in pre-diabetic, non-obese individuals, as well as emphasizing the importance of such a study in supporting the literature. Methods: A non-randomized controlled single-blind clinical trial was conducted among 82 participants with chronic non-specific low back pain and pre-diabetes at an outpatient clinic in Baghdad from the 30th of January to the 22nd of September. The intervention methods aimed at reducing HbA1c levels to assess the reduction impact on alleviating chronic non-specific low back pain included dietary adjustments, sleep optimization, and correction of vitamins and minerals deficiencies. The follow-up process was conducted individually for each participant, with a monthly assessment over a period of six months. Results: At 12 weeks a significant decrease in chronic non-specific low back pain severity was observed in patients with lower HbA1C levels yielding a P -value of.021. Similarly, at 24 weeks there was a decline in the number of patients who reported chronic non-specific low back pain, and the association to lower HbA1C levels was significant with a p -value of.005. Conclusion: This study suggests the presence of a statistically significant association between reduction of HbA1C levels and ensuing improvement in chronic non-specific low back pain symptoms in non-obese prediabetic patients. Plain language summary: The Effects of HbA1c Reduction on Alleviating Nonspecific Back Pain Pre-diabetes is a condition where blood sugar levels are higher than normal but not high enough to be classified as diabetes. People with pre-diabetes are at risk of developing diabetes and other health problems, including low back pain, a type of low back pain without a clear cause. Researchers believe this link might be due to problems with metabolism, inflammation, or nerve function. Changes in diet, especially focusing on lowering blood sugar levels and reducing inflammation, along with managing weight, may help people with pre-diabetes who have low back pain without a clear cause feel better. In this study, 82 people with both pre-diabetes and low back pain without a clear cause that lasted for more than 3 months took part in a clinical trial at a clinic in Baghdad. The trial lasted from January to September and was designed to see if lowering blood sugar (measured by HbA1c levels) would reduce low back pain. The participants received personalized care, which included making changes to their diet, improving their sleep, and correcting any vitamin or mineral deficiencies they had. They were followed closely for six months, with monthly check-ups. The results showed that after 12 weeks, many people who managed to lower their blood sugar levels experienced less severe low back pain. The improvement was even more noticeable after 24 weeks, as fewer people reported ongoing low back pain, and this improvement was strongly linked to lower blood sugar levels. In conclusion, the study found that reducing blood sugar levels in people with pre-diabetes who are not obese can significantly improve symptoms of low back pain. This suggests that managing blood sugar could be an important way to relieve low back pain without a clear cause. [ABSTRACT FROM AUTHOR]

Hyperglycemia and tuberculosis are dual global pandemics. Each has a propulsive and amplifying effect on the other, and, because of this, we must consider hyperglycemia and tuberculosis together. Hyperglycemia is immunosuppressive and increases the risk of tuberculosis by threefold. It also leads to a more advanced presentation of pulmonary tuberculosis, thus increasing the likelihood of being smear positive and having cavitating lesions, and it impacts the duration and outcomes of treatment, with an increased one year mortality seen in patients with tuberculosis and diabetes. Additionally, any degree of hyperglycemia can have an impact on susceptibility to tuberculosis, and this effect is not limited to poorly controlled diabetes. Conversely, tuberculosis itself is associated with hyperglycemia and worsens hyperglycemia in those with diabetes mellitus. The impact of this relationship varies based on the base rates of each disease in different regions of the world. In order to successfully achieve the World Health Organization's goals of tuberculosis eradication and adequate glycemic control, we must improve our understanding, co-management, and screening of hyperglycemia and tuberculosis. This review aims to explore the current research investigating the relationship between tuberculosis and diabetes, including the changes in disease susceptibility, presentation, geographic distribution, and effects on treatment. [ABSTRACT FROM AUTHOR]

Aim: We assessed the impact of a 3-year change-percent in adiposity measures on regression and pre-diabetes (Pre-DM) progression among Iranian adults. Methods: Three-year change-percent in body weight (BW), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and visceral adiposity index (VAI) were calculated for 1458 Pre-DM subjects (mean age of 53.0 ± 13.7, 46.8% men), participated in the third examination of the Tehran Lipid and Glucose Study (2006–2008). Multinomial logistic regression models were used to estimate relative risk ratios (RRRs) of the outcomes [i.e., regression to normal glucose regulation (NGR), persistence in Pre-DM, and progression to newly diagnosed type 2 diabetes (T2D)] across 3-year change categories of adiposity measures (i.e., ≥ 5% decrease, 0–5% decrease, increase). Results: Over nine years of follow-up, 37.7 and 39.0% returned to NGR and progressed to T2D, respectively. Decreased BW (0–5 and ≥ 5%) was associated with regression to NGR (RRRs = 1.44, 95% CIs = 1.05–1.98, and 2.64, 1.63–4.28, respectively). Decreased BMI and WC ≥ 5% were also associated with regression to NGR (RRRs = 1.63, 95% CI = 1.01–2.64; 1.69, 1.20–2.37, respectively). Changes in WHR and VAI were not associated with Pre-DM regression or progression. Pre-DM subjects with ≥ 5% BW loss had a constant FSG level overtime and a lower overall mean of FSG (116 vs. 111 and 112 mg/dL, P = 0.023 and 0.009, respectively) and 2 h-SG (154 vs. 165 and 168 mg/dL) compared to those had 0–5% BW loss or BW gain. Conclusion: Short-term management of adiposity measures increases the regression probability to NGR. Targeting BW loss seems a more potent predictor of Pre-DM reversion among the adiposity measures. [ABSTRACT FROM AUTHOR]

Eriocitrin (eriodictyol 7-O-β-rutinoside), a citrus flavonoid from lemon juice and peel, reduces hyperglycemia and improves diabetes-related biomarkers in prediabetes patients. Eriocitrin is first metabolized by gut microbiota, producing energy for gut cells and short chain fatty acids that play a relevant role in glycemic control. The aim of this study was to assess the effect of Eriomin®, a nutraceutical composed of 70% eriocitrin, 5% hesperidin, and 4% naringin, on the microbiota of prediabetic patients. Patients were randomly divided into two groups and received unlabeled capsules of Eriomin® (200 mg/day) or placebo during 12 weeks. After treatment with the nutraceutical, it was a 6% decrease of hyperglycemia and 22% increase of GLP-1 blood levels of (p

Abstract Background The effectiveness of the NSW Health “Get Healthy Information and Coaching Service® ”(Get Healthy) to facilitate weight loss on a population scale has been documented, but this was based on self-reported measures. Our study aims to test the effectiveness of the Get Healthy Service on objectively measured weight, BMI, waist circumference, and changes in other health behaviours, including nutrition, physical activity and alcohol intake. Methods Men and women aged 40–70 years (n = 154) with pre-diabetes (5.7% < HbA1c

Background: Pre-diabetes is an important risk factor for the development of type 2 diabetes and is common in Nigeria. Effective intervention can reverse the underlying pathogenesis of insulin resistance in pre-diabetes. This study aimed to determine and compare the impact of moderate exercise and metformin interventions on insulin resistance among participants with pre-diabetes. Materials and Methods: Using a randomised placebo-controlled design, 54 Nigerians with pre-diabetes were selected using simple random sampling. They were offered metformin, moderate exercise or placebo treatment and followed up for 12 weeks. Insulin resistance was assessed before and after the interventions and the outcome was compared. Results: Forty-nine participants with pre-diabetes completed the study. Participants in both the exercise and metformin groups had significantly decreased insulin resistance compared to placebo after 12 weeks of intervention. However, there was a decrease in insulin resistance by 77.3% (homeostasis model assessment-insulin resistance [HOMA-IR]) and an increase in insulin sensitivity by 81.2% (quantitative insulin sensitivity check index [QUICKI]) in the exercise group. In comparison, participants in the metformin group had a decrease in insulin resistance by 66.3% (HOMA-IR) and an increase in insulin sensitivity by 76.2% (QUICKI). Conclusion: Amongst Nigerians with pre-diabetes, both moderate exercise and metformin have significantly higher efficacy than placebo in improving insulin resistance. However, moderate exercise improved insulin resistance more than the metformin intervention. Participants in this study need to be followed up for a longer period to assess the long-term effects of these interventions.

Abstract Introduction Early detection and prevention of type 2 diabetes and its complications are global health priorities. Optimal outcomes depend on individual awareness and proactive self-management of health risks. This study evaluates the effectiveness of a community-based diabetes detection and intervention program in a high-risk area in western Sydney, Australia. Research design and methods We collaborated with the Workers Lifestyle Group, Tamil Association Arts and Culture Association, and the National Aboriginal and Islanders Day Observance Committee to implement our program. Participants underwent HbA1C testing via point-of-care blood spot testing. They received personalized feedback, education on diabetes management, and were offered opportunities to enrol in lifestyle modification programs. Participants identified with pre-diabetes (HbA1C 5.7–6.4%) or diabetes (HbA1C > 6.4%) were advised to consult their General Practitioners (GPs). A follow-up questionnaire was distributed 3–8 months post-intervention to evaluate the programs usefulness and relevance and lifestyle changes implemented by the participants. Results Over eight months, 510 individuals participated. Of these, 19% had an HbA1C > 6.4%, and 38% had levels between 5.7 and 6.4%. Among those with diabetes, HbA1C levels ranged as follows: 56% 9%. Post intervention survey indicated that the program was well-received, with 62.5% of responses reporting lifestyle changes and 36.3% seeking further advice from their local healthcare providers. Conclusion The study demonstrates a significant prevalence of pre-diabetes and diabetes in the community, similar to findings from larger-scale hospital and general practice studies. Point-of-care testing combined with personalized education effectively motivated participants toward healthier lifestyle choices and medical consultations. The paper discusses the scalability of this approach for broader population.

Diabetes is a chronic disease characterized by high body sugar levels, but the body does not utilize them. Based on data from 2023, 14% of Indonesia's population has diabetes. The spread of diabetes also penetrates rural areas, posing a threat to rural areas and threatening the health of rural communities, and Saentis Village is no exception. The program "Healthy Movement Together: Blood Sugar Checking to Support the 9 Pillars of Health Transformation" is a community service initiative that aims to increase public health awareness. Some people in Saentis Village have a history of diabetes. This activity aims to provide education and conduct initial screening for diabetes. The service method is carried out by collaborating between medical personnel, local government, and the community. The activity began by providing education about the dangers and early symptoms of diabetes and continued by conducting an initial diabetes screening by checking blood sugar. Ninety-six people attended this activity. Based on the results of the examination, it was found that as many as 17 people had high blood sugar levels, and as many as 14 people experienced hyperglycemia. Based on the results of the screening that has been carried out, it is known that there are people who are not aware of the importance of maintaining a lifestyle, so there are still 14.6% of people who have pre-diabetes conditions, so it is necessary to check HbA1C.

This retrospective cohort study aimed to confirm the previously reported inverse association between diabetes mellitus (DM) and abdominal aortic aneurysm (AAA) using large population based data. It also investigated the associations between AAA and impaired fasting glucose (IFG) and new onset DM (not yet treated). A representative dataset was obtained from the Korean National Health Insurance Service. Participants who were aged ≥ 50 years and received a national health examination in 2009 were included and followed until 31 December 2019. Glycaemic status was defined based on fasting plasma glucose level and the relevant diagnostic codes. AAA was ascertained using medical facility use records with relevant diagnostic codes or aneurysm repair surgery. A Cox proportional hazards model was used to examine the association between glycaemic status and AAA, with adjustment for confounders. Additionally, the interactions between glycaemic status and subgroups based on baseline characteristics were examined. The study population comprised 4 162 640 participants. Participants with IFG or DM were significantly more likely to be male, older, and have comorbidities compared with normoglycaemic participants at baseline. The incidence of AAA was lower in participants with IFG or DM compared with normoglycaemic participants. The AAA risk was lower in patients with DM than in patients with IFG, and decreased linearly according to glycaemic status: the adjusted hazard ratio was 0.88 (95% confidence interval [CI] 0.85 − 0.91) for IFG, 0.72 (95% CI 0.67 − 0.78) for newly diagnosed DM, 0.65 (95% CI 0.61 − 0.69) for DM duration < 5 years, and 0.47 (95% CI 0.44 − 0.51) for DM duration ≥ 5 years compared with the normoglycaemia group. Both IFG and DM were related to reduced AAA risk in all subgroups, suggesting an independent association. Both IFG and DM, even when not treated with antihyperglycaemic medication, were associated with a lower incidence of AAA. The AAA risk decreased linearly according to DM duration. [ABSTRACT FROM AUTHOR]

Aim: To investigate the correlation of the triglyceride-glucose (TyG) index and its combined obesity indicators with chest pain and cardiovascular disease (CVD) in the pre-diabetes and diabetes population. Methods: This cross-sectional investigation encompassed 6488 participants with diabetes and pre-diabetes who participated in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016. The association of the TyG and combined obesity index with chest pain and CVD was investigated using weighted logistic regression models and restricted cubic spline (RCS) analysis. The receiver operating characteristic (ROC) curve analysis was performed to compare different indicators. Results: In multivariate logistic regression fully adjusted for confounding variables, our analyses revealed significant associations between TyG, TyGBMI, TyG-WC, and TyG-WHtR and chest pain, with adjusted ORs (95% CI) of 1.21 (1.05, 1.39), 1.06 (1.01, 1.11), 1.08 (1.04, 1.14), and 1.27 (1.08, 1.48), respectively. For total-CVD, the adjusted ORs (95% CI) were 1.32 (1.08, 1.61), 1.10 (1.03, 1.17), 1.13 (1.06, 1.19), and 1.63 (1.35, 1.97), respectively, among which TyG, TyG-WC, and TyG-WHtR present curvilinear associations in RCS analysis (all P-nonlinear < 0.05). Furthermore, the ROC curve showed that TyG-WC had the most robust predictive efficacy for total-CVD, coronary heart disease (CHD), and myocardial infarction (MI), while TyG-WHtR had the best predictive ability for angina and heart failure. Conclusion: There are significant associations of TyG and its related indicators with chest pain and total-CVD among the pathoglycemia population. TyG-WC and TyG-WHtR demonstrated superior predictive capability for the incidence of cardiovascular events. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TB) remains a significant health concern in India, and its complexity is exacerbated by the rising occurrence of non-communicable diseases such as diabetes mellitus (DM). Recognizing that DM is a risk factor for active TB, the emerging comorbidity of TB and PDM (TB-PDM) presents a particular challenge. Our study focused on the impact of PDM on cytokine and chemokine profiles in patients with pulmonary tuberculosis TB) who also have PDM. Materials and methods: We measured and compared the cytokine (GM-CSF, IFN-γ, IL-1α/IL-1F1, IL-1β/IL-1F2, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12p70, IL-13, IL-17/IL-17A, IL-18/IL-1F4, TNF-α) and chemokine (CCL1, CCL2, CCL3, CCL4, CCL11, CXCL1, CXCL2, CXCL9, CXCL10, and CXCL11) levels in plasma samples of TB-PDM, only TB or only PDM using multiplex assay. Results: We observed that PDM was linked to higher mycobacterial loads in TB. Patients with coexisting TB and PDM showed elevated levels of various cytokines (including IFNγ, TNFα, IL-2, IL-17, IL-1α, IL-1β, IL-6, IL-12, IL-18, and GM-CSF) and chemokines (such as CCL1, CCL2, CCL3, CCL4, CCL11, CXCL1, CXCL9, CXCL10, and CXCL11). Additionally, cytokines such as IL-18 and GM-CSF, along with the chemokine CCL11, were closely linked to levels of glycated hemoglobin (HbA1c), hinting at an interaction between glycemic control and immune response in TB patients with PDM. Conclusion: Our results highlight the complex interplay between metabolic disturbances, immune responses, and TB pathology in the context of PDM, particularly highlighting the impact of changes in HbA1c levels. This emphasizes the need for specialized approaches to manage and treat TB-PDM comorbidity. [ABSTRACT FROM AUTHOR]

For early hominids, frequent encounters with plant foods necessitated the ability to discern bitter poisons and adjust the activity of the gastrointestinal system in anticipation of carbohydrate-rich meals. Plants bitters were also used historically to manage a variety of metabolic and digestive disorders despite an immense structural diversity of bitter phytochemicals without a common molecular target. Our study confirms these observations in a standardized C57BL/6J prediabetic mouse model using 24 model compounds by demonstrating acute lower peak blood glucose values and improved glucose tolerance following intragastric, but not intraperitoneal, treatment. The administration of the synthetic bitter compound denatonium benzoate yielded similar results that were attenuated by co-application of the allosteric inhibitor of the bitter TAS2R receptors. We also show that these effects occur dose-dependently; associate with reduced glucose uptake, increased intracellular [Ca2+] fluxes, and enhanced GLP-1 expression; and are attenuated by the TAS2R inhibitor in the neuroendocrine STC-1 intestinal cells. These findings support the view that inhibition of glucose transport from the intestinal lumen to the blood by TAS2R bitter receptor signaling in the gut may represent a common mechanism in the acute response to oral ingestion of bitter phytochemicals. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to track longitudinal changes of glycemic status in subjects with prediabetes (Pre-DM) in relation to their baseline levels of systemic nitric oxide (NO) production [i.e., measured as serum NO metabolites (NOx), crude and body weight (BW)-adjusted NOx to creatinine ratio (NOx-to-Cr)] over 9 years. Methods: This cohort study included 541 middle-aged Iranian men and women with Pre-DM, recruited in 2006-2008 and followed up to 2015-2017. The colorimetric Griess method was used to measure serum NOx concentration. Multinomial logistic regression analyses estimated the odds ratios (OR) of Pre-DM regression and progression across tertiles (tertile 3 vs. tertile 1 and tertile 2) of serum NOx, crude, and BW-adjusted NOx-to-Cr ratio. Results: Participants who regressed to normoglycemia (NG) had a higher BW-adjusted NOx-to-Cr ratio than those who developed type 2 diabetes (T2D) or those who remained Pre-DM (0.52±0.34 vs. 0.43±0.25 and 0.48±0.29, P=0.023). Higher BW-adjusted NOx-to-Cr increased chance of returning to NG (OR=2.05, 95% CI= 0.98-4.32, P=0.058) and decreased levels of 2h-serum glucose over time (Ptime×group=0.025), as well as the decreased overall mean of fasting (106, 95% CI=103-109 vs. 110, 95% CI=108-112 mg/dL, P=0.008) and 2h-serum glucose (153, 95% CI=146-159 vs. 163, 95% CI=158-168 mg/dL, P=0.018). Conclusion: A higher endogenous NO production (i.e., indirectly measured by BW- and Cradjusted serum NOx concentration) in Pre-DM subjects is associated with the chance of returning to NG. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of the NSW Health "Get Healthy Information and Coaching Service®"(Get Healthy) to facilitate weight loss on a population scale has been documented, but this was based on self-reported measures. Our study aims to test the effectiveness of the Get Healthy Service on objectively measured weight, BMI, waist circumference, and changes in other health behaviours, including nutrition, physical activity and alcohol intake. Methods: Men and women aged 40–70 years (n = 154) with pre-diabetes (5.7% < HbA1c < 6.5%) were referred from GP Practices to the Get Healthy Service, NSW Health. A subset (n = 98) participated in the "Zinc In Preventing the Progression of pre-Diabetes" (ZIPPeD) trial (ACTRN12618001120268). Results: The self-reported outcomes showed a statistically significant improvement from baseline to 12 months in weight (mean 2.7 kg loss, p < 0.001), BMI (mean 1 unit reduction, p < 0.001), and waist circumference (mean 4.3 cm reduction, p < 0.001). However, in the objectively measured outcomes from ZIPPeD, the differences were more modest, with point estimates of 0.8 kg mean weight loss (p = 0.1), 0.4 unit reduction in BMI (p = 0.03), and 1.8 cm reduction in waist circumference (p = 0.04). Bland-Altman plots indicated that discrepancies were due to a small number of participants who dramatically underestimated their weight or BMI. There were minimal changes in nutrition, physical activity, and alcohol. Conclusions: The potential benefits of Get Healthy should be interpreted with caution as we have shown significant differences between self-reported and objectively measured values. More valid and objective evidence is needed to determine the program's effectiveness and cost-effectiveness. [ABSTRACT FROM AUTHOR]

Background Pre–diabetes mellitus (DM) is associated with proteinuria, a risk factor for chronic kidney disease. While people with human immunodeficiency virus (HIV; PWH) have a higher risk of proteinuria than people without HIV (PWOH), it is unknown whether incident proteinuria differs by HIV serostatus among prediabetic persons. Methods The urine protein-to-creatinine ratio was measured at semiannual visits among men in the Multicenter AIDS Cohort Study since April 2006. Men with pre-DM on or after April 2006 and no prevalent proteinuria or use of antidiabetic medications were included. Pre-DM was defined as a fasting glucose level of 100–125 mg/dL confirmed within a year by a repeated fasting glucose or hemoglobin A1c measurement of 5.7%–6.4%. Incident proteinuria was defined as a urine protein-to-creatinine ratio (UPCR) >200 mg/g, confirmed within a year. We used Poisson regression models to determine whether incident proteinuria in participants with pre-DM differed by HIV serostatus and, among PWH, whether HIV-specific factors were related to incident proteinuria. Results Between 2006 and 2019, among 1276 men with pre-DM, proteinuria developed in 128 of 613 PWH (21%) and 50 of 663 PWOH (8%) over a median 10-year follow-up. After multivariable adjustment, the incidence of proteinuria in PWH with pre-DM was 3.3 times (95% confidence interval, 2.3–4.8 times) greater than in PWOH (P <.01). Among PWH, current CD4 cell count <50/µL (P <.01) and current use of protease inhibitors (P =.03) were associated with incident proteinuria, while lamivudine and integrase inhibitor use were associated with a lower risk. Conclusions Among men with pre-DM, the risk of incident proteinuria was 3 times higher in PWH. Strategies to preserve renal function are needed in this population. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background and Objective: Diabetic-range hyperglycemia has been reported for the first time in many patients during their hospitalization with coronavirus disease 2019 (COVID-19). This study was undertaken to determine the proportion of such patients who actually have new-onset diabetes mellitus rather than transient hyperglycemia during acute illness. Methods: This descriptive study included patients with diabetic-range hyperglycemia first detected at or during admission for COVID-19 but no prior history of diabetes. The study protocol involved patient identification, data recording from the case-notes, and telephonic follow-ups. Blood sugar levels done at least two weeks after discharge or the last dose of steroids, whichever was later, were recorded, and patients were categorized as diabetic, pre-diabetic, or non-diabetic accordingly Results: Out of 86 patients, ten (11.6%) were found to have developed diabetes, and 13 (15.1%) had pre-diabetes on follow-up. About 63 (73.3%) patients had become normoglycemic. Eight (80%) out of the ten patients with new-onset diabetes were on treatment, with five (50%) achieving the target glycemic levels. The associations of new-onset diabetes with age, gender, comorbidities, intensive care stay, and steroid administration were not found to be statistically significant (p -values 0.809, 0.435, 0.324, 0.402, and 0.289, respectively). Interpretation and Conclusions: While a majority of post-COVID patients with diabetic-range hyperglycemia returned to a normoglycemic state after the acute illness had settled down, one in ten developed new-onset diabetes, and an additional one in seven had impaired glucose tolerance. Thus, regular glucose screening is crucial for such patients and lifestyle modifications should be encouraged to reduce the risk of diabetes. Loss to follow-up and reliance on a single set of blood sugar readings for classification were some of the limitations of this study. [ABSTRACT FROM AUTHOR]

Type 2 diabetes (T2D) is the predominant metabolic epidemic posing a major threat to global health. Growing evidence indicates that gut microbiota (GM) may critically influence the progression from normal glucose tolerance, to pre-diabetes, to T2D. On the other hand, regular exercise contributes to the prevention and/or treatment of the disease, and evidence suggests that a possible way regular exercise favorably affects T2D is by altering GM composition toward health-promoting bacteria. However, research regarding this potential effect of exercise-induced changes of GM on T2D and the associated mechanisms through which these effects are accomplished is limited. This review presents current data regarding the association of GM composition and T2D and the possible critical GM differentiation in the progression from normal glucose, to pre-diabetes, to T2D. Additionally, potential mechanisms through which GM may affect T2D are presented. The effect of exercise on GM composition and function on T2D progression is also discussed. [ABSTRACT FROM AUTHOR]

The lifestyle modifications in the pre-diabetic stage can not only delay the development of diabetes mellitus by ≥10 years, but it can also prevent the development of the disease if there is no strong family history of diabetes mellitus. Hence, the diagnosis of prediabetic stage is the prime aim of the present study. All 91 subjects (staff of a medical college) were enrolled in the present study. Control group comprising of 38 subjects of age 35-50 years. Test group comprising of total 53 prediabetic (n=32) and not known diabetic patients (n=21) of same age group. Biochemical parameters like Fasting Blood Glucose level, Serum Insulin levels, Glycated hemoglobin (HbA1c) level, and complete lipid profile were analyzed in all groups. The HbA1c values were significantly increased (P<0.001) in prediabetic as well as diabetic group as compared to control group. Positive correlation of HbA1c was found with serum insulin, total cholesterol, TG and LDL-Cholesterol in both prediabetic and diabetic groups. However, HDL-cholesterol shows negative co-relation in prediabetic (r = -0.15) and diabetic group (-0.09). Therefore, HbA1c is the important diagnostic tool for screening of prediabetic condition. [ABSTRACT FROM AUTHOR]

The prevalence of diabetes is increasing rapidly and is now recognized as a significant global health problem. Diabetes occurs when a person does not produce enough insulin due to an imbalance in insulin production. This can lead to the failure of organs and tissues such as the kidneys, heart, blood vessels, eyes, nerves, and kidneys. As a result, early diagnosis and classification of type 2 diabetes mellitus (T2DM) are critical to aiding physician assessments. Subsequently, the current study aims to determine irisin levels in patients with T2DM and pre-DM as early predictors for disease cases. The current study included 138 subjects divided into three groups based on fasting blood glucose (FBG) and glycosylated hemoglobin criteria, including T2DM, 46 patients, pre-diabetes, 46 participants, and healthy subject groups, 46 persons) when they enrolled in the National Diabetes Center/ Al-Mustansiriya University. Enzyme-linked immunosorbent assays were used to detect the levels of irisin and insulin, and spectrophotometric techniques were used to determine the levels of FBG and lipid profile. The results of irisin revealed significant differences among the studied groups. Also, the insulin results showed substantial differences between the diabetic and control groups. Moreover, the results of HOM-IR and HOMA-IS and lipid profiles showed significant differences between the studied groups. The results showed that irisin can serve as an early indicator of pre-diabetes. These results were reinforced by the results of the ROC analysis, which indicated that irisin is an excellent indicator for diagnosing the studied condition.

Abstract Objective: To assess associations between dietary fat quality indices and risk of pre-diabetes and type 2 diabetes mellitus (T2DM) among Iranian adults. Design: Daily intakes of fatty acids were estimated using a validated FFQ with 168 food items. Adjusted hazard ratios (HR) and 95 % CI for pre-diabetes and T2DM were calculated across tertile categories of dietary fat quality indices including the atherogenic index, thrombogenic index, health-promoting index, ratio of PUFA to SFA (PUFA:SFA) and ratio of hypo- and hypercholesterolaemia (h:H). Setting: Tehran Lipid and Glucose Study. Participants: Iranian men and women. Results: The mean (sd) age of the 2042 pre-diabetes-free participants in pre-diabetes analysis was 38·84 (12·97), and 55·2 % were women. In T2DM analysis, the mean (sd) age of the 2295 T2DM-free participants was 40·06 (13·42), and 54·6 % of them were women. In the crude model, the PUFA:SFA ratio was positively associated with T2DM incidence (HR = 1·43; 95 % CI 1·04, 1·98). However, after adjustment for confounding variables, there were no significant associations between dietary fat quality indices and risk of pre-diabetes and T2DM. Conclusions: We found no significant association between fat quality indices and risk of pre-diabetes and T2DM. Further prospective and clinical trial studies are needed to clarify the issue.

Pre-diabetes (pre-DM) is a strong predictor of diabetes (DM) over time. This study investigated how much of the recent increase in pre-DM identified among Alaska Native (AN) peoples living in urban southcentral Alaska may be due to changes in diagnostic methods. We used clinical and demographic data collected at baseline between 2004 and 2006 and at follow-up collected between 2015 and 2017 from the urban southcentral Alaska Education and Research Towards Health (EARTH) cohort. We used descriptive statistics and logistic regression to explore differences in demographic and clinical variables among the identified pre-DM groups. Of 388 participants in the follow-up study, 243 had A1c levels indicating pre-DM with only 20 demonstrating pre-DM also by fasting blood glucose (FBG). Current smoking was the sole predictor for pre-DM by A1c alone while abdominal obesity and elevated FBG-predicted pre-DM by A1c+FBG. No participants had an elevated FBG without an A1c elevation. A substantial portion of the rise in pre-DM found among urban southcentral AN peoples in the EARTH follow-up study was due to the addition of A1c testing. Pre-DM by A1c alone should be used to motivate behavioural changes that address modifiable risk factors, including smoking cessation, physical activity and weight management.

Claus B Juhl,1– 4 Else Marie Bladbjerg,3,5 Bibi Gram,3 Torben Knudsen,3,6 Mette Munk Lauridsen,3,6 Niels-Peter Brøchner Nygaard,1,3,7 Nina Drøjdahl Ryg,1,2,4 Lars Skadhauge,3,8 Anna-Marie Bloch Münster3,5 1Department of Endocrinology, University Hospital of Southern Denmark, Esbjerg, Denmark; 2Steno Diabetes Center Odense, University Hospital of Southern Denmark, Odense, Denmark; 3University of Southern Denmark, Department of Regional Health Research, Odense, Denmark; 4OPEN, Open Patient Data Explorative, Odense University Hospital, Odense, Denmark; 5Department of Clinical Biochemistry, University Hospital of Southern Denmark, Esbjerg, Denmark; 6Department of Gastroenterology, University Hospital of Southern Denmark, Esbjerg, Denmark; 7Department of Neurology, University Hospital of Southern Denmark, Esbjerg, Denmark; 8Department of Occupational Medicine, University Hospital of Southern Denmark, Esbjerg, DenmarkCorrespondence: Claus B Juhl, Department of Endocrinology, University Hospital Southern Denmark, Esbjerg, DK-6700, Denmark, Tel +45 6086 7172, Email Claus.Bogh.Juhl@rsyd.dkPurpose: The prevalence of obesity continues to rise. People with obesity are at increased risk of several diseases. We tested an algorithm-based screening program for people with a BMI above 30 kg/m2 and present data on the prevalence of previously undiagnosed obesity-related diseases.Patients and Methods: Seven hundred and sixty-nine persons with BMI > 30 kg/m2 and age 18– 60 years were screened for diabetes (assessed by glycosylated hemoglobin and oral glucose tolerance test at HbA1c 43– 48 mmol/mol), sleep apnea (screened by questionnaires and assessed by cardiorespiratory monitoring at indication of sleep disorder), liver steatosis or liver fibrosis (assessed by biochemistry and fibroscan) and arterial hypertension (assessed by both office and 24-hour blood pressure measurement). A reference group of people with a BMI of 18.5– 29.9 kg/m2 was established.Results: Of those referred, 73.0% were women. We identified new diabetes in 4.2%, prediabetes in 9.1%, moderate-to-severe sleep apnea in 25.1%, increased liver fat and increased liver stiffness in 68.1% and 17.4%, respectively, and hypertension or masked hypertension in 19.0%. The prevalence of diseases was much higher among men and increased with BMI. Except for hypertension, we found few participants with undiagnosed disease in the reference group.Conclusion: An algorithm-based screening program is feasible and reveals undiagnosed obesity-related disease in a large proportion of the participants. The disproportional referral pattern calls for a tailored approach aiming to include more men with obesity.Trial Registration: Inclusion of the non-obese group was approved by the Scientific Ethics Committee of The Region of Southern Denmark (project identification number: S-20210091), and the study was reported at clinicaltrials.gov (NCT05176132).Plain Language Summary: The number of people with obesity is going up, and they are at a higher risk for various diseases. We tested a screening program for people referred with a BMI over 30 kg/m2 and presented the prevalence of diseases related to obesity. We screened 769 people aged 18 to 60 years with a BMI over 30 kg/m2 for diabetes (biochemistry and glucose tolerance test), sleep apnea (both questionnaires and home monitoring), liver disease (biochemistry and liver scan) and high blood pressure (office and 24-hour readings). We also tested a reference group of people with BMI 18.5-30 kg/m2. Among those screened, 73.0% were women. We found new cases of diabetes in 4.2%, prediabetes in 9.1%, sleep apnea in 25.1%, increased liver fat in 68.1%, increased liver stiffness in 17.4%, and hypertension or masked hypertension in 19.0%. The diseases were more common in men and increased with both higher BMI and age. Except for hypertension, we found few cases in the reference groups. The screening program uncovered undiagnosed obesity-related diseases in a large group of individuals. The uneven distribution of referrals suggests we need a customized approach to include more men with obesity.Keywords: diabetes, pre-diabetes, sleep apnea, metabolic dysfunction-associated steatotic liver disease, hypertension

Manabu Saito,1,&ast; Hiroshi Uchino,1,&ast; Yoko Iwata,1 Ayako Fuchigami,1 Genki Sato,1 Fukumi Yoshikawa,1 Masahiko Miyagi,1 Taito Miyazaki,2 Yoshihisa Urita,2 Kotaro Aoki,3 Yoshikazu Ishii,3 Kazuhiro Tateda,3 Takahisa Hirose1 1Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Graduate School of Medicine, Tokyo, Japan; 2Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan; 3Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan&ast;These authors contributed equally to this workCorrespondence: Hiroshi Uchino, Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Graduate School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan, Tel +81-3-3762-4151, Fax +81-3-3765-6488, Email h.uchino@med.toho-u.ac.jpPurpose: The severe pathogenic ancient-type COVID-19, SARS-CoV-2/WA-1/2020 was the predominant gene variant in early 2020 in Japan, however, its transmissibility was uncertain. The period before the public commenced using any personal protective equipment (PPE) was evaluating to describe the transmissibility of the SARS-CoV-2/WA-1/2020. We analyzed the secondary attack rate (SAR) among close contacts and the risk factor for SAR.Methods: This retrospective cohort study included a total of 539 patients who were anticipated for the SARS-CoV-2/WA-1/2020 infection at Toho University Medical Center Omori Hospital from February to May 2020. We selected 54 patients with 1) exclude other pathogens infection, 2) include “Three Cs” condition: crowded places between distance< 6 feet, closed spaces indoor and close contact settings involving contact > 15min with a person tested positive for SARS-CoV-2/WA-1/2020 without PPE. We evaluated alternative infection risks: the body mass index (BMI) and diabetes (DM) status (non-DM, pre-DM, and DM) as demographic determinants of transmissibility and infectivity of SARS-CoV2/WA-1/2020 cases during the incubation period.Results: The calculated SAR was 79.3%. BMI was significantly associated with the PCR positivity rate, which was significant in the univariate (CI 95%, 1.02– 1.51; P = 0.03) and multivariate (CI 95%, 1.02– 1.60; P = 0.03) analyses. Comparing the different BMI groups, the highest BMI group (25.5− 35.8 kg/m2) had an elevated risk of SAR compared to the lowest BMI group (14.0– 22.8 kg/m2), with an odds ratio of 1.41 (95% CI, 1.02– 1.59; P = 0.03). There were no significant differences in the risk of SAR among different DM statuses.Conclusion: The transmissibility of SARS-CoV2/WA-1/2020 was high (79.3%) among household members without PPE who had “Three Cs” exposure. Although pre-DM and established DM did not confer a risk for transmissibility, higher BMI was associated with an increased risk of SAR.Trial Registration: UMIN Clinical Trials Registry, UMIN0000 50905.Keywords: obesity, pre-diabetes, SARS-CoV-2 transmission

Abstract Background Circulating atherogenic index of plasma (AIP) levels has been proposed as a novel biomarker for dyslipidemia and as a predictor of insulin resistance (IR) risk. However, the association between AIP and the incidence of new-onset stroke, particularly in individuals with varying glucose metabolism status, remains ambiguous. Methods A total of 8727 participants aged 45 years or older without a history of stroke from the China Health and Retirement Longitudinal Study (CHARLS) were included in this study. The AIP was calculated using the formula log [Triglyceride (mg/dL) / High-density lipoprotein cholesterol (mg/dL)]. Participants were divided into four groups based on their baseline AIP levels: Q1 (AIP ≤ 0.122), Q2 (0.122 0.562). The primary endpoint was the occurrence of new-onset stroke events. The Kaplan–Meier curves, multivariate Cox proportional hazard models, and Restricted cubic spline analysis were applied to explore the association between baseline AIP levels and the risk of developing a stroke among individuals with varying glycemic metabolic states. Results During an average follow-up of 8.72 years, 734 participants (8.4%) had a first stroke event. The risk for stroke increased with each increasing quartile of baseline AIP levels. Kaplan–Meier curve analysis revealed a significant difference in stroke occurrence among the AIP groups in all participants, as well as in those with prediabetes mellitus (Pre-DM) and diabetes mellitus (DM) (all P values 0.05). Restricted cubic spline analysis also demonstrated that higher baseline AIP levels were associated with higher hazard ratios for stroke in all participants and those with glucose metabolism disorders. Conclusions An increase in baseline AIP levels was significantly associated with the risk of stroke in middle-aged and elderly individuals, and exhibited distinct characteristics depending on the individual’s glucose metabolism status.

Background: Insulin resistance plays a crucial role in the onset of type 2 diabetes, with body mass index (BMI) being a significant determinant. Aims and Objectives: This study examines the link between BMI and insulin resistance in pre-diabetic individuals to inform strategies for early diabetes intervention. Materials and Methods: This cross-sectional study involved 100 pre-diabetic participants. Data on demographic characteristics, BMI, insulin resistance (measured by the Homeostatic Model Assessment for Insulin Resistance, HOMA-IR), lipid profiles, and blood pressure (BP) were collected. Participants were categorized into normal weight, overweight, and obese groups to explore the relationship between BMI and insulin resistance and its impact on metabolic and cardiovascular health. Results: The average participant age was 45.8 years (SD=12.3), with a slight majority being female (52%) and an average BMI of 28.4 kg/m² (SD=4.5). A significant positive correlation (r=0.64, P

Abstract Background The relationship between the triglyceride–glucose (TyG) index and the risk of cardiovascular disease (CVD) in the U.S. population under 65 years of age with diabetes or prediabetes is unknown. The purpose of this study was to investigate the relationship between baseline TyG index and CVD risk in U.S. patients under 65 years of age with diabetes or prediabetes. Methods We used data from the 2003–2018 National Health and Nutrition Examination Survey (NHANES). Multivariate regression analysis models were constructed to explore the relationship between baseline TyG index and CVD risk. Nonlinear correlations were explored using restricted cubic splines. Subgroup analysis and interaction tests were also conducted. Results The study enrolled a total of 4340 participants with diabetes or pre-diabetes, with a mean TyG index of 9.02 ± 0.02. The overall average prevalence of CVD was 10.38%. Participants in the higher TyG quartiles showed high rates of CVD (Quartile 1: 7.35%; Quartile 2: 10.04%; Quartile 3: 10.71%; Quartile 4: 13.65%). For CVD, a possible association between the TyG index and the risk of CVD was observed. Our findings suggested a linear association between the TyG index and the risk of CVD. The results revealed a U-shaped relationship between the TyG index and both the risk of CVD (P nonlinear = 0.02583) and CHF (P nonlinear = 0.0208) in individuals with diabetes. Subgroup analysis and the interaction term indicated that there was no significant difference among different stratifications. Our study also revealed a positive association between the TyG index and comorbid MetS in the U.S. population under 65 years of age with prediabetes or diabetes. Conclusions A higher TyG index was linked to an increased likelihood of CVD in the U.S. population aged ≤ 65 years with prediabetes and diabetes. Besides, TyG index assessment will contribute to more convenient and effective screening of high-risk individuals in patients with MetS. Future studies should explore whether interventions targeting the TyG index may improve clinical outcomes in these patients.

Prebiotic fibre represents a promising and efficacious treatment to manage pre-diabetes, acting via complementary pathways involving the gut microbiome and viscosity-related properties. In this study, we evaluated the effect of using a diverse prebiotic fibre supplement on glycaemic, lipid and inflammatory biomarkers in patients with pre-diabetes. Sixty-six patients diagnosed with pre-diabetes (yet not receiving glucose-lowering medications) were randomised into treatment (thirty-three) and placebo (thirty-three) interventions. Participants in the treatment arm consumed 20 g/d of a diverse prebiotic fibre supplement, and participants in the placebo arm consumed 2 g/d of cellulose for 24 weeks. A total of fifty-one and forty-eight participants completed the week 16 and week 24 visits, respectively. The intervention was well tolerated, with a high average adherence rate across groups. Our results extend upon previous work, showing a significant change in glycated haemoglobin (HbA1c) in the treatment group but only in participants with lower baseline HbA1c levels (< 6 % HbA1c) (P = 0·05; treatment –0·17 ± 0·27 v. placebo 0·07 ± 0·29, mean ± sd). Within the whole cohort, we showed significant improvements in insulin sensitivity (P = 0·03; treatment 1·62 ± 5·79 v. placebo –0·77 ± 2·11) and C-reactive protein (P FWE = 0·03; treatment –2·02 ± 6·42 v. placebo 0·94 ± 2·28) in the treatment group compared with the placebo. Together, our results support the use of a diverse prebiotic fibre supplement for physiologically relevant biomarkers in pre-diabetes. [ABSTRACT FROM AUTHOR]

Background and Objective: Patients with tuberculosis and diabetes have a higher risk of unfavourable anti‐tuberculosis treatment outcomes. In the present study, we aimed to evaluate the effects of various diabetes statuses on the outcomes of patients with pulmonary tuberculosis. Methods: Among the patients with pulmonary tuberculosis enrolled in the Korea Tuberculosis Cohort (KTBC) registry and the multicentre prospective cohort study of pulmonary tuberculosis (COSMOTB), those with diabetes and complicated diabetes were identified. The primary and secondary outcomes were unfavourable outcomes and mortality, respectively. The effect of diabetes and complicated diabetes on the outcomes was assessed using multivariable logistic regression analysis. Using COSMOTB, subgroup analyses were performed to assess the association between various diabetes statuses and outcomes. Results: In the KTBC, diabetes (adjusted odds ratio [aOR] = 1.93, 95% CI = 1.64–2.26) and complicated diabetes (aOR = 1.96, 95% CI = 1.67–2.30) were significantly associated with unfavourable outcomes, consistent with the COSMOTB data analysis. Based on subgroup analysis, untreated diabetes at baseline was an independent risk factor for unfavourable outcomes (aOR = 2.72, 95% CI = 1.26–5.61). Prediabetes and uncontrolled diabetes increased unfavourable outcomes and mortality without statistical significance. Conclusion: Untreated and complicated diabetes at the time of tuberculosis diagnosis increases the risk of unfavourable outcomes and mortality. The effect of various stages of diabetis mellitus (DM) on the outcomes of patients with tuberculosis (TB) was analysed. Untreated and complicated DM at the time of TB diagnosis increased the risk of unfavourable outcomes. See relatededitorial [ABSTRACT FROM AUTHOR]

Background: Pre-diabetes is an important risk factor for the development of type 2 diabetes and is common in Nigeria. Effective intervention can reverse the underlying pathogenesis of insulin resistance in pre-diabetes. This study aimed to determine and compare the impact of moderate exercise and metformin interventions on insulin resistance among participants with pre-diabetes. Materials and Methods: Using a randomised placebo-controlled design, 54 Nigerians with pre-diabetes were selected using simple random sampling. They were offered metformin, moderate exercise or placebo treatment and followed up for 12 weeks. Insulin resistance was assessed before and after the interventions and the outcome was compared. Results: Forty-nine participants with pre-diabetes completed the study. Participants in both the exercise and metformin groups had significantly decreased insulin resistance compared to placebo after 12 weeks of intervention. However, there was a decrease in insulin resistance by 77.3% (homeostasis model assessment-insulin resistance [HOMA-IR]) and an increase in insulin sensitivity by 81.2% (quantitative insulin sensitivity check index [QUICKI]) in the exercise group. In comparison, participants in the metformin group had a decrease in insulin resistance by 66.3% (HOMA-IR) and an increase in insulin sensitivity by 76.2% (QUICKI). Conclusion: Amongst Nigerians with pre-diabetes, both moderate exercise and metformin have significantly higher efficacy than placebo in improving insulin resistance. However, moderate exercise improved insulin resistance more than the metformin intervention. Participants in this study need to be followed up for a longer period to assess the long-term effects of these interventions. [ABSTRACT FROM AUTHOR]

Background: Circulating atherogenic index of plasma (AIP) levels has been proposed as a novel biomarker for dyslipidemia and as a predictor of insulin resistance (IR) risk. However, the association between AIP and the incidence of new-onset stroke, particularly in individuals with varying glucose metabolism status, remains ambiguous. Methods: A total of 8727 participants aged 45 years or older without a history of stroke from the China Health and Retirement Longitudinal Study (CHARLS) were included in this study. The AIP was calculated using the formula log [Triglyceride (mg/dL) / High-density lipoprotein cholesterol (mg/dL)]. Participants were divided into four groups based on their baseline AIP levels: Q1 (AIP ≤ 0.122), Q2 (0.122 < AIP ≤ 0.329), Q3 (0.329 < AIP ≤ 0.562), and Q4 (AIP > 0.562). The primary endpoint was the occurrence of new-onset stroke events. The Kaplan–Meier curves, multivariate Cox proportional hazard models, and Restricted cubic spline analysis were applied to explore the association between baseline AIP levels and the risk of developing a stroke among individuals with varying glycemic metabolic states. Results: During an average follow-up of 8.72 years, 734 participants (8.4%) had a first stroke event. The risk for stroke increased with each increasing quartile of baseline AIP levels. Kaplan–Meier curve analysis revealed a significant difference in stroke occurrence among the AIP groups in all participants, as well as in those with prediabetes mellitus (Pre-DM) and diabetes mellitus (DM) (all P values < 0.05). After adjusting for potential confounders, the risk of stroke was significantly higher in the Q2, Q3, and Q4 groups than in the Q1 group in all participants. The respective hazard ratios (95% confidence interval) for stroke in the Q2, Q3, and Q4 groups were 1.34 (1.05–1.71), 1.52 (1.19–1.93), and 1.84 (1.45–2.34). Furthermore, high levels of AIP were found to be linked to an increased risk of stroke in both pre-diabetic and diabetic participants across all three Cox models. However, this association was not observed in participants with normal glucose regulation (NGR) (p > 0.05). Restricted cubic spline analysis also demonstrated that higher baseline AIP levels were associated with higher hazard ratios for stroke in all participants and those with glucose metabolism disorders. Conclusions: An increase in baseline AIP levels was significantly associated with the risk of stroke in middle-aged and elderly individuals, and exhibited distinct characteristics depending on the individual's glucose metabolism status. [ABSTRACT FROM AUTHOR]

Background: Although the importance and benefit of heme oxygenase-1 (HO-1) in diabetes rodent models has been known, the contribution of HO-1 in the prediabetic patients with hyperlipidemia risk still remains unclear. This cross-sectional study aims to evaluate whether HO-1 is associated with hyperlipidemia in pre-diabetes. Methods: Serum level of HO-1 was detected using commercially available ELISA kit among 1,425 participants aged 49.3--63.9 with pre-diabetes in a multicenter Risk Evaluation of cAncers in Chinese diabeTic Individuals: A lONgitudinal (REACTION) prospective observational study. Levels of total cholesterol (TC) and triglyceride (TG) weremeasured and used to defined hyperlipidemia. The association between HO-1 and hyperlipidemia was explored in different subgroups. Result: The level of HO-1 in pre-diabetic patients with hyperlipidemia (181.72 ± 309.57 pg/ml) was obviously lower than that in pre-diabetic patients without hyperlipidemia (322.95 ± 456.37 pg/ml). High level of HO-1 [(210.18,1,746.18) pg/ ml] was negatively associated with hyperlipidemia (OR, 0.60; 95% CI, 0.37--0.97; p = 0.0367) after we adjusted potential confounding factors. In subgroup analysis, high level of HO-1 was negatively associated with hyperlipidemia in overweight pre-diabetic patients (OR, 0.50; 95% CI, 0.3--0.9; p = 0.034), especially in overweight women (OR, 0.42; 95% CI, 0.21--0.84; p = 0.014). Conclusions: In conclusion, elevated HO-1 level was negatively associated with risk of hyperlipidemia in overweight pre-diabetic patients, especially in female ones. Our findings provide information on the exploratory study of the mechanism of HO-1 in hyperlipidemia, while also suggesting that its mechanism may be influenced by body weight and gender. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the relationship between the haemoglobin glycation index (HGI), and cardiovascular disease (CVD) and all‐cause mortality in adults with pre‐diabetes and diabetes. Methods: This study included 10 267 adults with pre‐diabetes and diabetes from the National Health and Nutrition Examination Survey (NHANES) 1999‐2018. Sex‐differentiated relationships between HGI and mortality were elucidated using multivariate Cox proportional hazards models, restricted cubic splines and a two‐piecewise Cox proportional hazards model. Results: During the median follow‐up time of 103.5 months, a total of 535 CVD deaths and 1918 all‐cause deaths were recorded. After multivariate adjustment, in males with pre‐diabetes and diabetes, there was a U‐shaped relationship between HGI and CVD mortality and all‐cause mortality, with threshold points of −0.68 and −0.63, respectively. Before the threshold point, HGI was negatively associated with CVD mortality [hazard ratio (HR) 0.60; 95% confidence interval (CI) 0.41, 0.89] and all‐cause mortality (HR 0.56; 95% CI 0.43, 0.74), and after the threshold point, HGI was positively associated with CVD mortality (HR 1.46; 95% CI 1.23, 1.73) and all‐cause mortality (HR 1.40; 95% CI 1.23, 1.59). In contrast, HGI had an L‐shaped relationship with all‐cause mortality and no significant association with CVD mortality in females. To the left of the threshold points, the risk of all‐cause mortality decreased (HR 0.50; 95% CI 0.35, 0.71) progressively with increasing HGI. Conclusions: In the cohort study, HGI in pre‐diabetic and diabetic populations was found to have a U‐shaped association with CVD mortality and all‐cause mortality in males and an L‐shaped association with all‐cause mortality only in females. Further prospective and mechanistic studies are warranted. [ABSTRACT FROM AUTHOR]

Plant protein is considered a sustainable health-promoting strategy to prevent metabolic syndrome. Lifestyle changes (including dietary patterns and exercise) have been demonstrated to exert an effect on human health by modulating the biochemical status in humans. The objective of this study was to assess whether supplementation with hemp protein within a Mediterranean diet context together with exercise could help to ameliorate the metabolic statuses of patients prone to developing metabolic syndrome. For this study, 23 patients followed with Mediterranean diet and engaged in aerobic exercise according to the WHO's recommendations, while also being supplemented with hemp protein, for 12 weeks. A comparison of anthropometric, biochemical, and mineral data as well as amino acid values was made between the start and the end of the study, with the subjects acting as their own control group. Statistical analyses included a paired t-test, Wilcoxon paired test, Pearson correlation coefficient, and Sparse Partial Least Squares Discriminant Analysis to evaluate significant differences and correlations among parameters. There were statistically significant changes in total cholesterol, HDL-C (+52.3%), LDL-C (−54.0%), and TAG levels (−49.8%), but not in glucose plasma levels. Following the intervention, plasma concentrations of some amino acids, including α-aminoadipic acid, phosphoethanolamine, and 1-metylhistidine, increased, whereas those of asparagine and alanine declined. Different correlations between amino acids and the other parameters evaluated were reported and discussed. A Mediterranean diet combined with regular aerobic exercise, together with protein supplementation, can highly improve the metabolic parameters and anthropometric parameters of subjects with obesity and impaired glucose levels, ameliorating their health status and likely delaying the development of metabolic syndrome. [ABSTRACT FROM AUTHOR]

Background: The relationship between the triglyceride–glucose (TyG) index and the risk of cardiovascular disease (CVD) in the U.S. population under 65 years of age with diabetes or prediabetes is unknown. The purpose of this study was to investigate the relationship between baseline TyG index and CVD risk in U.S. patients under 65 years of age with diabetes or prediabetes. Methods: We used data from the 2003–2018 National Health and Nutrition Examination Survey (NHANES). Multivariate regression analysis models were constructed to explore the relationship between baseline TyG index and CVD risk. Nonlinear correlations were explored using restricted cubic splines. Subgroup analysis and interaction tests were also conducted. Results: The study enrolled a total of 4340 participants with diabetes or pre-diabetes, with a mean TyG index of 9.02 ± 0.02. The overall average prevalence of CVD was 10.38%. Participants in the higher TyG quartiles showed high rates of CVD (Quartile 1: 7.35%; Quartile 2: 10.04%; Quartile 3: 10.71%; Quartile 4: 13.65%). For CVD, a possible association between the TyG index and the risk of CVD was observed. Our findings suggested a linear association between the TyG index and the risk of CVD. The results revealed a U-shaped relationship between the TyG index and both the risk of CVD (P nonlinear = 0.02583) and CHF (P nonlinear = 0.0208) in individuals with diabetes. Subgroup analysis and the interaction term indicated that there was no significant difference among different stratifications. Our study also revealed a positive association between the TyG index and comorbid MetS in the U.S. population under 65 years of age with prediabetes or diabetes. Conclusions: A higher TyG index was linked to an increased likelihood of CVD in the U.S. population aged ≤ 65 years with prediabetes and diabetes. Besides, TyG index assessment will contribute to more convenient and effective screening of high-risk individuals in patients with MetS. Future studies should explore whether interventions targeting the TyG index may improve clinical outcomes in these patients. [ABSTRACT FROM AUTHOR]

Background: Persistent uncontrolled hyperglycemia is recognized as one of the risk factors for cognitive disorders. Accordingly, both type 1 and type 2 diabetes may predispose individuals to cognitive impairment, particularly in cases where glycemic control is insufficient. The objective of this comprehensive study is to separately assess cognitive dysfunctions in diabetic and non-diabetic older adults. Methods: This cross-sectional study is part of phase 2 of the Bushehr elderly health program (BEHP). Cognitive function was evaluated using the Mini-cog and categorical verbal fluency tests (CFTs). Patients were classified as non-diabetics, pre-diabetics, or diabetics based on the diagnostic criteria for diabetes mellitus (DM). To compare the means of the two groups, we utilized the t-test or the Mann-Whitney test. Additionally Multivariable logistic regression models were used to determine the association between pre-diabetes or DM and cognitive impairment. Results: Out of 1533 participants, 693 (45.2%) were identified as having cognitive impairment. The average hemoglobin A1C was higher in participants with cognitive impairment compared to those without cognitive impairment. (5.8 ± 1.6% vs. 5.5 ± 1.4%, P = 0.004). Furthermore, the mean blood glucose levels were found to be more elevated in cases of cognitive impairment (108.0 ± 47.4 mg/dL vs. 102.1 ± 0.35 mg/dL, P = 0.002). After adjusting for age, gender, body mass index (BMI), waist circumference, amount of physical activity, and smoking, the multivariable logistic regression model, declared an association between diabetes and cognitive impairment (OR = 1.48, P = 0.003). In addition, older patients, females, widows, and individuals with elevated LDL-Cs and those with high blood pressure were found to be more vulnerable to cognitive impairment. Conclusion: The Bushehr Elderly Health Program (BEHP) study revealed that individuals affected with cognitive impairment may exhibit higher levels of HbA1c. This suggests a positive correlation between elevated HbA1c and cognitive impairment. [ABSTRACT FROM AUTHOR]

The first 1000 days of life and before the age of five years is a critical period of nutritional opportunity and vulnerabilitya. Only few have studies that trace individuals from childhood to adolescence examined the influence of childhood undernutrition on diabetes risk. This research was a retrospective cohort study using secondary data from IFLS (Indonesian Family Life Survey) involving 373 adolescents at IFLS-5 (2014) that folllowed at IFLS-3 (2000) and at IFLS-2 (1997). The effect of childhood undernutrition on the risk of pre-diabetes and diabetes in adolescents was analyzed using multinomial logistic regression. The results of this study showed that the prevalence of pre-diabetes was 12.6% and diabetes was 15.0%. The risk factor for pre-diabetes is frequent consumption of fast food (aOR=4.38). Meanwhile, recovering from stunting was a protective factor in adolescents (aOR=0.05). Risk factors for diabetes were stunting (aOR=2.71), deteriorated nutritional status during childhood (aOR=3.85), experienced wasting during childhood (aOR=3.55), and frequent fast food consumption (aOR=3.11). Meanwhile, vegetable consumption was a protective factor of diabetes (aOR=0.37). In conclusion, this study showed that childhood undernutrition on the risk of diabetes. Improvement point is through nutrition programs in childhood and adolescence. [ABSTRACT FROM AUTHOR]

Background Pre-diabetes (PD) contributes importantly to the disease burden worldwide and is a precursor to stroke, cardiovascular diseases, as well as type-2 diabetes mellitus. Objective In this project, the efficacy of individualized homeopathic medicines (IHMs) was explored against placebos in the treatment of PD. Methods A 6-month, double-blind, randomized, placebo-controlled trial was conducted at the outpatient departments of a homeopathic medical college and hospital in India. Sixty participants with PD were randomized to receive either IHMs (n = 30) or identical-looking placebos (n = 30). Concomitant care measures were advised to both groups of participants in terms of dietary advice, yoga, meditation and exercise. The primary outcome measures were fasting blood sugar (FBS) and the oral glucose tolerance test (OGTT); the secondary outcome was the Diabetes Symptom Checklist-Revised (DSC-R) score. All the outcomes were measured at baseline and after 3 and 6 months of treatment. Inter-group differences and effect sizes (Cohen's d) were calculated using two-way repeated measures analysis of variance models after adjusting baseline differences using analysis of co-variance on the intention-to-treat data. Results Between-group differences for FBS were statistically significant, favoring IHMs against placebos (F1,58 = 7.798, p = 0.007), but not for OGTT (F1,58 = 1.691, p = 0.199). The secondary outcome, DSC-R total score, favoring IHMs significantly compared with placebos (F1,58 = 15.752, p < 0.001). Calcarea Carbonicum , Thuja occidentalis and Sulphur were the most frequently prescribed medicines. No harm or serious adverse events were recorded from either of the participant groups. Conclusion IHMs produced significantly better results than placebos in FBS and in DSC-R scores but not in OGTT. Independent replications with larger sample sizes are warranted to substantiate the findings. Trial registration CTRI/2019/10/021711 [ABSTRACT FROM AUTHOR]

Background: Insulin resistance plays a crucial role in the onset of type 2 diabetes, with body mass index (BMI) being a significant determinant. Aims and Objectives: This study examines the link between BMI and insulin resistance in pre-diabetic individuals to inform strategies for early diabetes intervention. Materials and Methods: This cross-sectional study involved 100 pre-diabetic participants. Data on demographic characteristics, BMI, insulin resistance (measured by the Homeostatic Model Assessment for Insulin Resistance, HOMA-IR), lipid profiles, and blood pressure (BP) were collected. Participants were categorized into normal weight, overweight, and obese groups to explore the relationship between BMI and insulin resistance and its impact on metabolic and cardiovascular health. Results: The average participant age was 45.8 years (SD=12.3), with a slight majority being female (52%) and an average BMI of 28.4 kg/m² (SD=4.5). A significant positive correlation (r=0.64, P<0.001) between BMI and the HOMA-IR index highlighted the association between increased BMI and insulin resistance. Obese individuals had a notably higher HOMA-IR index (3.5±1.3) compared to those overweight (2.5±1.0) and of normal weight (1.9±0.8). In addition, the study found worsening lipid profiles and increased BP with higher BMI categories. Gender did not significantly affect insulin resistance, whereas a slight increase in HOMA-IR with age was noted (r=0.23, P=0.02). Conclusion: The findings highlight the strong correlation between higher BMI and increased insulin resistance in pre-diabetics. They emphasize the importance of managing body weight to mitigate the risk of diabetes and cardiovascular diseases. [ABSTRACT FROM AUTHOR]

AimTo investigate the correlation of the triglyceride-glucose (TyG) index and its combined obesity indicators with chest pain and cardiovascular disease (CVD) in the pre-diabetes and diabetes population.MethodsThis cross-sectional investigation encompassed 6488 participants with diabetes and pre-diabetes who participated in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016. The association of the TyG and combined obesity index with chest pain and CVD was investigated using weighted logistic regression models and restricted cubic spline (RCS) analysis. The receiver operating characteristic (ROC) curve analysis was performed to compare different indicators.ResultsIn multivariate logistic regression fully adjusted for confounding variables, our analyses revealed significant associations between TyG, TyG-BMI, TyG-WC, and TyG-WHtR and chest pain, with adjusted ORs (95% CI) of 1.21 (1.05, 1.39), 1.06 (1.01, 1.11), 1.08 (1.04, 1.14), and 1.27 (1.08, 1.48), respectively. For total-CVD, the adjusted ORs (95% CI) were 1.32 (1.08, 1.61), 1.10 (1.03, 1.17), 1.13 (1.06, 1.19), and 1.63 (1.35, 1.97), respectively, among which TyG, TyG-WC, and TyG-WHtR present curvilinear associations in RCS analysis (all P-nonlinear < 0.05). Furthermore, the ROC curve showed that TyG-WC had the most robust predictive efficacy for total-CVD, coronary heart disease (CHD), and myocardial infarction (MI), while TyG-WHtR had the best predictive ability for angina and heart failure.ConclusionThere are significant associations of TyG and its related indicators with chest pain and total-CVD among the pathoglycemia population. TyG-WC and TyG-WHtR demonstrated superior predictive capability for the incidence of cardiovascular events.