Treatment Recommendations for Prediabetes

Ratner, Robert E.; Sathasivam, Anpalakan

doi:10.1016/j.mcna.2010.11.007

Cited by 16 publications

(15 citation statements)

References 46 publications

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“…Other randomized trials also show that weight loss is the key, if not critical, intervention to reduce diabetes risk (11–13). Thus, weight loss appears to take center stage when it comes to lifestyle modification delaying the onset of diabetes (14). …”

Section: Can We Prevent or Delay Diabetes Outside Of A Clinical Trial?mentioning

confidence: 99%

“…With one exception, no clinical outcome benefits using pharmacotherapy to prevent diabetes have been reported. In the Study to Prevent Non-Insulin-Dependent Diabetes Mellitus (STOP-NIDDM) trial, a reduction in cardiovascular events was reported, but the overall event rate was very low and the finding was not considered important to even mention by those reviewing pharmacologic options to prevent diabetes (14,42). …”

Section: The Impact Of Diabetes Prevention On Clinical Outcomesmentioning

confidence: 99%

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The Reality of Type 2 Diabetes Prevention

Kahn

Davidson

2014

Diabetes Care

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Efforts to reduce the burden of type 2 diabetes include attempts to prevent or delay the onset of the disease. Landmark clinical trials have shown that lifestyle modification programs focused on weight loss can delay the onset of type 2 diabetes in subjects at high risk of developing the disease. Building on this knowledge, many community-based studies have attempted to replicate the trial results and, simultaneously, payers have begun to cover diabetes prevention services. This article focuses on the evidence supporting the premise that community prevention efforts will be successful. Unfortunately, no study has shown that diabetes can be delayed or prevented in a community setting, and efforts to replicate the weight loss achieved in the trials have been mostly disappointing. Furthermore, both the clinical trials and the community-based prevention studies have not shown a beneficial effect on any diabetes-related clinical outcome. While the goal of diabetes prevention is extremely important, the absence of any persuasive evidence for the effectiveness of community programs calls into question whether the use of public funds or national prevention initiatives should be supported at this time.

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Section: Can We Prevent or Delay Diabetes Outside Of A Clinical Trial?mentioning

confidence: 99%

Section: The Impact Of Diabetes Prevention On Clinical Outcomesmentioning

confidence: 99%

The Reality of Type 2 Diabetes Prevention

Kahn

Davidson

2014

Diabetes Care

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“…Now that new treatments to delay or prevent the progression of prediabetes to diabetes are available , screening high‐risk patients for early diagnosis and management of glycaemic abnormalities becomes ever more important.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of diabetes in our sample (58.25 cases/1000 person-years) is comparable with that reported in similar cohorts [34][35][36], and therefore our methodology and conclusions may be extensible to other populations. Now that new treatments to delay or prevent the progression of prediabetes to diabetes are available [37][38][39][40][41], screening high-risk patients for early diagnosis and management of glycaemic abnormalities becomes ever more important.…”

Section: Discussionmentioning

confidence: 99%

Glucose time series complexity as a predictor of type 2 diabetes

Castro

Vigil

Vargas

et al. 2016

Diabetes Metabolism Res

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BackgroundComplexity analysis of glucose profile may provide valuable information about the gluco‐regulatory system. We hypothesized that a complexity metric (detrended fluctuation analysis, DFA) may have a prognostic value for the development of type 2 diabetes in patients at risk.MethodsA total of 206 patients with any of the following risk factors (1) essential hypertension, (2) obesity or (3) a first‐degree relative with a diagnosis of diabetes were included in a survival analysis study for a diagnosis of new onset type 2 diabetes. At inclusion, a glucometry by means of a Continuous Glucose Monitoring System was performed, and DFA was calculated for a 24‐h glucose time series. Patients were then followed up every 6 months, controlling for the development of diabetes.ResultsIn a median follow‐up of 18 months, there were 18 new cases of diabetes (58.5 cases/1000 patient‐years). DFA was a significant predictor for the development of diabetes, with ten events in the highest quartile versus one in the lowest (log‐rank test chi2 = 9, df = 1, p = 0.003), even after adjusting for other relevant clinical and biochemical variables. In a Cox model, the risk of diabetes development increased 2.8 times for every 0.1 DFA units. In a multivariate analysis, only fasting glucose, HbA1c and DFA emerged as significant factors.ConclusionsDetrended fluctuation analysis significantly performed as a harbinger of type 2 diabetes development in a high‐risk population. Complexity analysis may help in targeting patients who could be candidates for intensified treatment. Copyright © 2016 The Authors. Diabetes/Metabolism Research and Reviews Published by John Wiley & Sons Ltd.

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“…This indicates some innate biological predisposition to impaired glucose utilization and, since deficit schizophrenia may have a unique pathophysiology (3–5), people with deficit schizophrenia may show a different risk for diabetes when separated out from schizophrenia as a whole. Negative symptoms such as decreased activity, goals, and an absence of important relationships may also impair the ability of someone with deficit schizophrenia to implement the diet and exercise changes recommended for prediabetes (fasting blood sugar between 100–125 mg/dL) (6), leading to higher rates of progression to diabetes in this group.…”

Section: Introductionmentioning

confidence: 99%