One-hour plasma glucose combined with skin autofluorescence identifies subjects with pre-diabetes: the DIAPASON study

Abstract

IntroductionThe major challenge for diabetes prevention is early identification of individuals at risk to allow for implementation of measures to delay the onset of future disease. Measures such as fasting plasma glucose (FPG), 2-hour plasma glucose (2hPG), and glycosylated hemoglobin (HbA1c) are equally appropriate for identifying pre-diabetes and diabetes, but do not all identify the disease in the same individual. We tested the utility of a diagnostic method combining FPG, 2hPG and HbA1c for early evaluation and easy identification of pre-diabetes.Research design and methods531 subjects underwent skin autofluorescence (SAF) and glycemia analyses. We created two classification groups based on the American Diabetes Association diagnosis guidelines: (1) based on 2hPG and (2) based on a new combination of three glycemia parameters (the three-criteria strategy (3-c)). Logistic regression modeling was used to estimate the associations.ResultsSAF showed high associations for both 3-c definition and 2hPG definition alone. These associations appeared stronger in 3-c than those in 2hPG. The non-invasive SAF measurement outperformed 2hPG in the detection of dysglycemia or pre-diabetes. Stepwise selections identified 1-hour postload glucose (1hPG) as variable identifying pre-diabetes using the 2hPG criterion, and the model based on 1hPG plus SAF appeared to be the best association using the 3-c strategy.Conclusions1hPG coupled with SAF showed a strong association in the evaluation of pre-diabetes using the 3-c method.

Weak Association between Skin Autofluorescence Levels and Prediabetes with an ILERVAS Cross-Sectional Study

“…Furthermore, in both the NSEEDS and ENGINE studies, SAF was compared with FPG and HbA1c for the detection of abnormal glucose tolerance in subjects at risk for type 2 diabetes but without an established diagnosis [18,19]. Finally, 1 h post-glucose load plus SAF appeared to be the best combination in the assessment of prediabetes among the Diabetes Prediction and Screening Observational (DIAPASON) study cohort, which included subjects aged 40 to 75 years and a FINDRISC ≥ 9, [17]. However, in our study, although we showed slightly elevated levels of SAF in the ILERVAS population when prediabetes was defined according to HbA1c criteria, we did not observe this clinical utility This study has some limitations.…”

“…Among individuals at high risk for type 2 diabetes, SAF has previously been shown to have equal or superior diagnostic performance for prediabetes compared to FPG and HbA1c [ 15 , 16 , 17 , 18 , 19 , 20 , 30 ]. In the study by Maynard et al involving 351 subjects with one or more diabetes risk factors, the sensitivity differential indicated that SAF was able to identify 28.8% more individuals with 2-h OGTT values ≥140 mg/dL than FPG testing and 17.1% more than HbA1c testing [ 16 ].…”

“…Thus, measures such as FPG, 2 h plasma glucose, and HbA1c are equally suitable for identifying prediabetes and diabetes, but not all of them identify the disease in the same individual [ 14 ]. The measurement of AGEs seems to be a suitable way to assess the effects of years of chronic non-diabetic hyperglycemia, and subcutaneous AGE deposition has been previously evaluated in populations at risk for diabetes with positive results [ 15 , 16 , 17 , 18 , 19 , 20 ]. However, it remains to be elucidated whether the measurement of AGE deposition in subcutaneous tissue can help to differentiate subjects with prediabetes from those with normal glucose metabolism.…”

Lower miR-21/ROS/HNE levels associate with lower glycemia after habit-intervention: DIAPASON study 1-year later

“…Glucose intolerance is detected using a 75-g glucose load test where IGT is defined as a 2-h plasma glucose (2hPG) value of 140–199 mg/dL (7.7–11.1 mmol/L), or IFG of 100–125 mg/dL, or HbA1c of 5.7–6.4% (39–46 mmol/mol) [ 4 , 5 ]. Recently, the measurements of 1hPG are emerging to define the prediabetic and diabetic status [ 6 , 7 ] although the consensus on the diagnostic definition of pre-diabetes is still debated [ 8 ].…”

Role of Advanced Glycation End Products in Assessment of Diabetes Mellitus as a Risk Factor for Retinal Vein Occlusion

“…A receptor for AGEs (RAGE) plays an important role in inflammatory processes and tumor cell invasion [21,22]. Therefore, the increased concentration of AGE is associated with diseases such as DM, cardiovascular diseases, rheumatoid arthritis, and neurological/mental health conditions, such as depression and Alzheimer's disease [23][24][25]. Moreover, because of the high anaerobic metabolism of glucose in cancer cells, the connection between the hyperglycemic condition and increased formation of AGEs occurs, which takes place in brain tumors [26].…”