2. Classification and Diagnosis of Diabetes:<i>Standards of Medical Care in Diabetes—2021</i>

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doi:10.2337/dc21-s002

Cited by 2,234 publications

(1,332 citation statements)

References 199 publications

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“…Undiagnosed T2DM was defined as HbA1c ≥6.5% and PreDM as HbA1c 5.70%-6.49% in cases without previously diagnosed PreDM according to the ADA criteria. 18 De novo/intrahospital hyperglycemia was defined as FPG ≥140 mg/dL in cases without diabetes and normal HbA1c. 19 Follow-up time was estimated from date of symptom onset to last follow-up (censoring) or death, whichever occurred first.…”

Section: Clinical Information and Definition Of Outcomesmentioning

confidence: 99%

Impact of undiagnosed type 2 diabetes and pre-diabetes on severity and mortality for SARS-CoV-2 infection

Vargas‐Vázquez

Bello‐Chavolla

Ortíz-Brizuela

et al. 2021

BMJ Open Diab Res Care

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IntroductionDiabetes and hyperglycemia are risk factors for critical COVID-19 outcomes; however, the impact of pre-diabetes and previously unidentified cases of diabetes remains undefined. Here, we profiled hospitalized patients with undiagnosed type 2 diabetes and pre-diabetes to evaluate its impact on adverse COVID-19 outcomes. We also explored the role of de novo and intrahospital hyperglycemia in mediating critical COVID-19 outcomes.Research design and methodsProspective cohort of 317 hospitalized COVID-19 cases from a Mexico City reference center. Type 2 diabetes was defined as previous diagnosis or treatment with diabetes medication, undiagnosed diabetes and pre-diabetes using glycosylated hemoglobin (HbA1c) American Diabetes Association (ADA) criteria and de novo or intrahospital hyperglycemia as fasting plasma glucose (FPG) ≥140 mg/dL. Logistic and Cox proportional regression models were used to model risk for COVID-19 outcomes.ResultsOverall, 159 cases (50.2%) had type 2 diabetes and 125 had pre-diabetes (39.4%), while 31.4% of patients with type 2 diabetes were previously undiagnosed. Among 20.0% of pre-diabetes cases and 6.1% of normal-range HbA1c had de novo hyperglycemia. FPG was the better predictor for critical COVID-19 compared with HbA1c. Undiagnosed type 2 diabetes (OR: 5.76, 95% CI 1.46 to 27.11) and pre-diabetes (OR: 4.15, 95% CI 1.29 to 16.75) conferred increased risk of severe COVID-19. De novo/intrahospital hyperglycemia predicted critical COVID-19 outcomes independent of diabetes status.ConclusionsUndiagnosed type 2 diabetes, pre-diabetes and de novo hyperglycemia are risk factors for critical COVID-19. HbA1c must be measured early to adequately assess individual risk considering the large rates of undiagnosed type 2 diabetes in Mexico.

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Section: Clinical Information and Definition Of Outcomesmentioning

confidence: 99%

Impact of undiagnosed type 2 diabetes and pre-diabetes on severity and mortality for SARS-CoV-2 infection

Vargas‐Vázquez

Bello‐Chavolla

Ortíz-Brizuela

et al. 2021

BMJ Open Diab Res Care

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“…Prediabetes is a metabolic condition with serious health consequences that needs to be screened [7]. As blood-based testing methods are expensive and time-consuming, non-invasive methods have been proposed, with particular interest in estimating body composition [10,12,33].…”

Section: Discussionmentioning

confidence: 99%

“…According to American Diabetes Association guidelines, normal glucose metabolism was well-defined as HbA1c < 39 mmol/mol (<5.7%), and prediabetes as HbA1c between 39 and 47 mmol/mol (5.7 to 6.4%) [7]. The evaluation of HbA1c was done in capillary blood using a point-of-care device (Cobas B 101 ® , Roche Diagnostics S.L., Sant Cugat del Vallès, Spain), based on a latex agglutination inhibition immunoassay method that meets the generally recognized performance criteria for HbA1c [28].…”

Section: Prediabetes Screeningmentioning

confidence: 99%

“…In addition, prediabetes is also associated with an accumulation of metabolic abnormalities, an increased risk of microangiopathy and cardiovascular disease, dementia, cancer, and lung dysfunction that occur before fasting plasma glucose reaches the threshold diagnosis of type 2 diabetes mellitus [3][4][5][6]. Therefore, So, this long asymptomatic stage needs more attention, and the detection of prediabetes in patients with a high metabolic risk should be considered [7]. One way to test this screening may be by assessing body composition.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Usefulness of Anthropometric Indices to Predict the Presence of Prediabetes. Data from the ILERVAS Cohort

Sánchez

Bermúdez-López

et al. 2021

Nutrients

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Prediabetes is closely related to excess body weight and adipose distribution. For this reason, we aimed to assess and compare the diagnostic usefulness of ten anthropometric adiposity indices to predict prediabetes. Cross-sectional study with 8188 overweight subjects free of type 2 diabetes from the ILERVAS project (clinicaltrials.gov: NCT03228459). Prediabetes was diagnosed by levels of glycated hemoglobin (HbA1c). Total body adiposity indices [BMI, Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) and Deurenberg’s formula] and abdominal adiposity (waist and neck circumferences, conicity index, waist to height ratio, Bonora’s equation, A body shape index, and body roundness index) were calculated. The area under the receiver-operating characteristic (ROC) curve, the best cutoff and the prevalence of prediabetes around this value were calculated for every anthropometric index. All anthropometric indices other than the A body adiposity were higher in men and women with prediabetes compared with controls (p < 0.001 for all). In addition, a slightly positive correlation was found between indices and HbA1c in both sexes (r ≤ 0.182 and p ≤ 0.026 for all). None of the measures achieved acceptable levels of discrimination in ROC analysis (area under the ROC ≤ 0.63 for all). Assessing BMI, the prevalence of prediabetes among men increased from 20.4% to 36.2% around the cutoff of 28.2 kg/m2, with similar data among women (from 29.3 to 44.8% with a cutoff of 28.6 kg/m2). No lonely obesity index appears to be the perfect biomarker to use in clinical practice to detect individuals with prediabetes.

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“…The HbA1c and the initial OGTT (OGTT 0 ) values were "technically normal" based on the ADA criteria. 20 Follow-up laboratory examinations after discharge were recommended because the fasting C-peptide (0.2 nmol/L) and insulin (17.66 pmol/L) levels were borderline low during the OGTT 0 (normal: fasting C-peptide, 0.27-1.28 nmol/L; fasting insulin, 35-145 pmol/L). The fasting plasma glucose levels were within the normal range during the follow-up examinations in the OGTT 1.5y and OGTT 3y despite the 180 min glucose levels (2.82 mmol/L) in the OGTT 1.5y being below the normal range (3.36 mmol/L).…”

Section: Case Reportmentioning

confidence: 99%

Islet Autoantibodies in the Patients with Sjogren’s Syndrome and Thyroid Disease and Risk of Progression to Latent Autoimmune Diabetes in Adults: A Case Series

Wen¹,

Jiang²,

Zhou³

2021

DMSO

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The glutamic acid decarboxylase 65 antibody (GAD65-Ab) is an autoimmune marker in some diseases such as diabetes or autoimmune disorders of the central nervous system such as stiff-man syndrome. It can appear with other pancreatic autoantibodies, such as insulin autoantibodies (IAA), presenting as early signs of pancreatic islet β-cells impairing, and play roles in the pathogenesis of type1 diabetes (T1D) and latent autoimmune diabetes in adults (LADA). Positive GAD65-Ab is rarely observed in insulin-dependent diabetic patients with other acquired autoimmune diseases, such as Sjogren’s syndrome (SS). Besides, LADA revealed by islet autoantibodies such as GAD65-Ab can also be complicated with Hashimoto’s thyroiditis (HT), another autoimmune thyroid disease. To date, whether GAD65-Ab positive in patients with autoimmune diseases predicts the onset or progression to T1D or LADA remains unknown. Herein, two unique cases of middle-aged Chinese Han women free from diabetes for three years are described despite their blood tests persistently testing positive for GAD65-Ab or IAA. Both patients suffered from HT and SS. Follow-up OGTTs (oral glucose tolerance test) for three years revealed that the patients had a well-controlled glycemic level and normal pancreatic function. However, one of the patients had a temporary increase of postprandial glucose after a short-term loss of diet control. The presence of auto-immune antibodies in these patients had little impact on glucose tolerance or insulin secretion in 3 years. The study postulate that both the primary immune injury caused by serum GAD65-Ab positive, an autoimmune marker, and increased body weight contribute to the progression of LADA.

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2. Classification and Diagnosis of Diabetes:Standards of Medical Care in Diabetes—2021

Cited by 2,234 publications

References 199 publications

Impact of undiagnosed type 2 diabetes and pre-diabetes on severity and mortality for SARS-CoV-2 infection

Impact of undiagnosed type 2 diabetes and pre-diabetes on severity and mortality for SARS-CoV-2 infection

Clinical Usefulness of Anthropometric Indices to Predict the Presence of Prediabetes. Data from the ILERVAS Cohort

Islet Autoantibodies in the Patients with Sjogren’s Syndrome and Thyroid Disease and Risk of Progression to Latent Autoimmune Diabetes in Adults: A Case Series

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