Transition from pre-diabetes to diabetes and predictors of risk in Mexican-Americans

Abstract

BackgroundNo studies have examined risk factors for the transition from pre-diabetes to diabetes in populations with widespread obesity and diabetes. We determined proximal changes and factors affecting the transition among Mexican-Americans with pre-diabetes.MethodsParticipants with pre-diabetes (n=285) were recruited from our randomly sampled population-based Cameron County Hispanic Cohort. These participants were followed for an average of 27 months with repeat examination every 3 to 4 months. Metabolic health was defined as having less than 2 metabolic abnormalities (e.g., hypertension, elevated low-density lipoprotein, etc). Diabetes was identified as fasting blood glucose ≥126 mg/dL, glycated hemoglobin ≥6.5% and/or on hypoglycemic medication.ResultsNinety-six of 285 (33.7%) participants transitioned to overt diabetes. The increased risk of diabetes in the metabolically unhealthy varying with follow-up time was 81% (adjusted odds ratio [OR]: 1.81; 95% CI: 1.09–3.02). The risk of diabetes increased 8% for each kg/m2 of increase in body mass index (BMI, OR: 1.08; 95% CI: 1.05–1.11) independent of covariates. Transition to diabetes was accompanied by a mean increase in BMI of 0.28 kg/m2, and deterioration in metabolic health of 9% (OR: 1.09; 95% CI: 1.003–1.18) compared with those who did not transition.ConclusionsDeteriorating metabolic health and/or increasing BMI significantly raises the risk of transitioning from pre-diabetes to diabetes. Transition itself was accompanied by further increase in BMI and deterioration in metabolic health. These data underline the importance of improving metabolic health and avoiding weight gain in pre-diabetes as simple but clear diabetes prevention targets, and emphasize the importance of lifestyle management.

Sex and age differences in prevalence and risk factors for prediabetes in Mexican-Americans

“…Consequently, we see higher levels of pre-diabetes than diabetes in those under 40 years of age but by the age over 40 years the preponderance of pre-diabetes has occurred with rapid progression to type 2 diabetes, and therefore the prevalence of pre-diabetes is lower in those over 40 years than type 2 diabetes prevalence. Metabolic health has not only a greater effect on the increased risk for type 2 diabetes [4] but our findings indicate that the entire process of the metabolic shift might be occurring faster in this population.…”

“…Prediabetes can be envisaged as an approaching tsunami of disease [1]. Approximately 34% of the adults aged 18 years or older in the U.S. have prediabetes placing them at high risk of transition to type 2 diabetes [2] with approximately 5-10% converting annually [3,4]. Diabetes is associated with cardiovascular diseases, neuropathy, retinopathy, and other https://doi.org/10.1016/j.diabres.2019.107950 0168-8227/Ó 2019 Elsevier B.V. All rights reserved.…”

Mitochondrial dysfunction and inhibition of myoblast differentiation in mice with high‐fat‐diet‐induced pre‐diabetes

“…Type 2 diabetes is an important public health issue worldwide (Caspard et al, 2018;Wu, McCormick, Curran, & Fisher-Hoch, 2017). In 2013, almost 24 million Americans were diabetic; of whom 25% were undiagnosed and 33% had pre-diabetes (Vilanova et al, 2017).…”

A Double-Blind Randomized Placebo-Controlled Study Assessing the Safety, Tolerability and Efficacy of a Herbal Medicine Containing Pycnogenol Combined with Papain and Aloe vera in the Prevention and Management of Pre-Diabetes

“…Others report that transition to overt diabetes may be as high as 38% [20]. Notwithstanding, most patients diagnosed with metabolic abnormalities (e.g., obesity, dyslipidemia) will have a high probability of future progression to T2D [21].…”