Increased incidence of pre-diabetes mellitus at a department of rheumatology: a retrospective study

Abstract

We aimed to retrospectively review the incidence of pre-diabetes mellitus (preDM), one of the factors in metabolic syndrome screening, in patients with rheumatic diseases. We examined the levels of hemoglobin A1c (HbA1c) in a total of 498 patients with rheumatic diseases between April 2007 and March 2008 at the Department of Rheumatology in Nagasaki University Hospital. Of the 498 patients, 409 (82.1%) had HbA1c levels higher than 5.6% (National Glycohemoglobin Standardization Program; NGSP) and were recommended for health guidance with a focus on metabolic syndrome. Serum HbA1c levels higher than 6.0%, a possible indicator of DM, were seen in 227 patients (45.6%). Serum HbA1c levels higher than 6.5%, which constitute a high risk for DM, were found in 115 patients (23.1%). PreDM increased gradually with age. Our results suggest that the incidence of preDM may be higher in patients with rheumatic diseases than in patients with other diseases and that these patients should receive healthcare guidance to prevent metabolic syndrome.

Musculoskeletal manifestations in diabetic versus prediabetic patients

“…They observed HbA1C > 5.6% in 82% of patients and concluded that the incidence of prediabetes might be high in patients with rheumatic disease. 29 The most common DMMM in our study was knee osteoarthritis followed by CTS and rotator cuff tendinitis. The same pattern was observed in prediabetic patients.…”

Glucocorticoid treatment and endocrine pancreas function: implications for glucose homeostasis, insulin resistance and diabetes

“…Serum HbA1c levels higher than 52 mmol/mol (7.1%) were seen in 46% of the patients and 23% of the patients had HbA1c levels as high as 57 mmol/mol (7.6%), which should be considered as a high-risk factor for diabetes. Taken together, it was found that the cumulative prednisolone dose was the only factor significantly associated with the development of steroid-induced diabetes among rheumatic patients (Origuchi et al 2011).…”

Physical Activity and Prevalence of Rheumatoid Arthritis in Korean Adults with Prediabetes in the 2009-2013 National Health Cohort Study

“…42) Additionally, the Origuchi T study reported a high RA incidence (4.3%) in adults with DM and prediabetes, but low (2.0%) incidence in adults with normal blood glucose levels aged ≥46 years in Japan. 4) These studies showed a wide variation in RA prevalence, which can be attributed to the difference in their sample stratification and methods for estimating RA prevalence. The Origuchi T study 4) collected data on subjects with prediabetes, including patients on DM drug treatment.…”

“…4-5,8-9) Pro-inflammatory cytokines 5,9) such as interferongamma (IFN-γ), interleukin (IL)-1ß, IL-2, IL-5, IL-7, IL-8, and TNF-α, granulocyte macrophage-colony stimulating factor (GM-CSF), are also known to be high in overweight patients with prediabetes. [4][5]9) With biological pharmacotherapies, modifiable behavior such as physical activity has been shown to induce the antiinflammatory myokine IL-6, 10) which induces the release of ABSTRACT Background: Rheumatoid arthritis is highly prevalent in overweight patients with type 2 diabetes mellitus and can be reduced by physical activity via altered proinflammatory parameters. However, the association between the frequency of physical activity and the prevalence of rheumatoid arthritis in prediabetic patients remains unclear and was evaluated in this study.…”