Prediabetes: the cat is out!

Abstract

Prediabetes is a state of hyperglycemia preceding diabetes. This state is mostly reversible and hence needs special attention. The benefits of arresting the progression of prediabetes to diabetes and thus the spectrum of complications such as blindness, dialysis dependence, sexual dysfunction, amputations, loss of self-esteem, unremitting neuropathy, and in addition to changing lifestyle with daily interventions in the form of injections, monitoring outweigh any other single disease prevention. Prediabetes or intermediate hyperglycaemia is defined as dysglycemia in which the spectrum ranges from normal and diabetes.According to the American Diabetes Association, prediabetes is defined by fasting blood glucose of 100 mg to <126 mg/dl, 2-h plasma glucose of 140 to <200 mg/dl after 75-g oral glucose tolerance test or HbA1C of 5.7 to <6.5 % [1]. It is considered an at-risk state with a high probability of developing diabetes and confers a high risk of developing CVD. Prediabetes can be present for more than 10 years before the development of glycemic abnormalities characteristic of diabetes. This disorder is not benign by itself. There is an increased risk of vascular and metabolic derangements. Thus, in real terms, stopping progression to diabetes reaches the secondary stage of prevention though prediabetes is not classified as a disease.The prevalence of prediabetes is increasing worldwide and by 2035, projected 471 million people will have this condition [2]. It has attained clinical significance because of epidemiological association with macro-vascular disease and neuropathy. In the developing world, public health impetus is on eliminating the communicable disease. However, the noncommunicable diseases are also increasing with the disease already outweighing that of communicable diseases. This is an alarming situation when considering the cost incurred by diabetes. Understanding the risk factors helps to prevent or postpone the onset of diabetes.In this issue of the journal, two studies address prediabetes, its prevalence and risk factors [3,4] in the developing nations Nigeria and India. These data cover age groups from childhood to elderly. The Nigerian study involved the adult population of interior rural villages of Enugu state while the Indian study involved urban children and adolescents from Nellore in the South Indian state of Andhra Pradesh. Though a prediabetes state can exist for type 1 diabetes, the current publications here pertain to type 2 diabetes mellitus.In the Nigerian study, one in every five adults in this had prediabetes. Here, 5.8 % of the study population were classified as obese while central obesity was noted in 34 %. The authors rounded off the weight to the nearest 0.5 kg. One would like a 100-g precision. Likewise, two blood pressure readings were taken with shorter 5-min interval in contrast to the regular 15-min gap. The prevalence of diabetes of 4.8 % is much higher than (1.9 %) quoted by the International Diabetes Federation [5] for Nigeria and the semi-urban Umudike community ...

Pancreatitis-induced prediabetes and hepatic lipidosis in a mixed breed cat

“…Blood chemistry results showed prediabetes symptoms, with a blood glucose level of 248 mg/dL. Prediabetes is indicated by fasting blood glucose levels of 100-126 mg/dL or 140-200 mg/dL post-meal (Kodali & Ali, 2016). Pancreatic cell damage can also activate Toll-like Receptors (TLRs) as an inflammatory response, reducing cholesterol efflux and causing cholesterol to accumulate in the blood.…”