Diagnosis and Management of Prediabetes

JAMA, Год журнала: 2023, Номер 329(14), С. 1206 - 1206

Опубликована: Апрель 11, 2023

Importance Prediabetes, an intermediate stage between normal glucose regulation and diabetes, affects 1 in 3 adults the US approximately 720 million individuals worldwide. Observations Prediabetes is defined by a fasting level of 100 to 125 mg/dL, 140 199 mg/dL measured 2 hours after 75-g oral load, or glycated hemoglobin (HbA 1C ) 5.7% 6.4% 6.0% 6.4%. In US, 10% people with prediabetes progress having diabetes each year. A meta-analysis found that at baseline was associated increased mortality cardiovascular event rates (excess absolute risk, 7.36 per 10 000 person-years for 8.75 disease during 6.6 years). Intensive lifestyle modification, consisting calorie restriction, physical activity (≥150 min/wk), self-monitoring, motivational support, decreased incidence 6.2 cases 3-year period. Metformin risk among 3.2 years. most effective women prior gestational younger than 60 years body mass index 35 greater, plasma 110 higher, HbA 1c higher. Conclusions Relevance events, mortality. First-line therapy modification includes weight loss exercise metformin. Lifestyle larger benefit

Язык: Английский

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Social isolation, loneliness, and incident type 2 diabetes mellitus: results from two large prospective cohorts in Europe and East Asia and Mendelian randomization

EClinicalMedicine, Год журнала: 2023, Номер 64, С. 102236 - 102236

Опубликована: Сен. 21, 2023

Язык: Английский

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Efficacy and safety of once-weekly semaglutide 2·4 mg versus placebo in people with obesity and prediabetes (STEP 10): a randomised, double-blind, placebo-controlled, multicentre phase 3 trial

The Lancet Diabetes & Endocrinology, Год журнала: 2024, Номер 12(9), С. 631 - 642

Опубликована: Июль 29, 2024

Язык: Английский

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Pharmacological Approaches to Nonalcoholic Fatty Liver Disease: Current and Future Therapies

Diabetes Spectrum, Год журнала: 2024, Номер 37(1), С. 48 - 58

Опубликована: Фев. 1, 2024

Nonalcoholic fatty liver disease (NAFLD) and its more severe form, nonalcoholic steatohepatitis (NASH), can promote the development of cirrhosis, hepatocellular carcinoma, cardiovascular disease, type 2 diabetes. Similarly, diabetes confers greatest risk for NASH, especially when associated with obesity. Although lifestyle changes are critical to success, early implementation pharmacological treatments obesity essential treat NASH avoid progression. This article reviews current guidance regarding use agents such as pioglitazone, glucagon-like peptide 1 receptor agonists, sodium-glucose cotransporter inhibitors in setting NAFLD NASH. It also latest information on new drugs currently being investigated treatment

Язык: Английский

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Vitamin D: Evidence-Based Health Benefits and Recommendations for Population Guidelines

Nutrients, Год журнала: 2025, Номер 17(2), С. 277 - 277

Опубликована: Янв. 14, 2025

Vitamin D offers numerous under-recognized health benefits beyond its well-known role in musculoskeletal health. It is vital for extra-renal tissues, prenatal health, brain function, immunity, pregnancy, cancer prevention, and cardiovascular Existing guidelines issued by governmental organizations are bone-centric largely overlook the abovementioned extra-skeletal optimal thresholds vitamin D. In addition, they rely on randomized controlled trials (RCTs), which seldom show due to high baseline 25-hydroxyvitamin [25(OH)D] concentrations, moderate supplementation doses, flawed study designs. This review emphasizes findings from prospective cohort studies showing that higher 25(OH)D concentrations reduce risks of major diseases mortality, including pregnancy birth outcomes. Serum > 30 ng/mL (75 nmol/L) significantly lower disease mortality compared <20 ng/mL. With 25% U.S. population 60% Central Europeans having levels ng/mL, should be raised above achievable through daily with 2000 IU/day (50 mcg/day) D3, prevent deaths. Furthermore, a dose between 4000 6000 IU D3 achieve serum 40 70 would provide greater protection against many adverse Future recommendations integrate observational well-designed RCTs improve public personalized care.

Язык: Английский

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Mechanisms of weight loss-induced remission in people with prediabetes: a post-hoc analysis of the randomised, controlled, multicentre Prediabetes Lifestyle Intervention Study (PLIS)

The Lancet Diabetes & Endocrinology, Год журнала: 2023, Номер 11(11), С. 798 - 810

Опубликована: Сен. 25, 2023

Язык: Английский

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Insulin resistance drives cognitive impairment in hypertensive pre-diabetic frail elders: the CENTENNIAL study

European Journal of Preventive Cardiology, Год журнала: 2023, Номер 30(12), С. 1283 - 1288

Опубликована: Май 17, 2023

Abstract Aims Pre-diabetes is a condition that confers an increased cardiovascular risk. Frailty very common in hypertensive patients, and insulin resistance has been linked to frailty older adults with diabetes. On these grounds, our aim was evaluate the association between cognitive impairment pre-diabetic frail adults. Methods results We studied consecutive elders presenting at Avellino local health authority of Italian Ministry Health (ASL AV) from March 2021 2022. All them fulfilled following inclusion criteria: previous diagnosis hypertension no clinical or laboratory evidence secondary causes, confirmed pre-diabetes, age &gt;65 years, Montreal Cognitive Assessment (MoCA) Score &lt;26, frailty. enrolled 178 which 141 successfully completed study. observed strong inverse correlation (r = −0.807; P &lt; 0.001) MoCA Homeostatic Model for Insulin Resistance (HOMA-IR). The were by linear regression analysis using as dependent variable, after adjusting several potential confounders. Conclusion Taken together, data highlight first time global function pre-diabetes.

Язык: Английский

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Advances in the management of type 2 diabetes in adults

BMJ Medicine, Год журнала: 2023, Номер 2(1), С. e000372 - e000372

Опубликована: Сен. 1, 2023

Type 2 diabetes is a chronic and progressive cardiometabolic disorder that affects more than 10% of adults worldwide major cause morbidity, mortality, disability, high costs. Over the past decade, pattern management has shifted from predominantly glucose centric approach, focused on lowering levels haemoglobin A

Язык: Английский

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Association between estimated glucose disposal rate and cardiovascular mortality across the spectrum of glucose tolerance in the US population

Diabetes Obesity and Metabolism, Год журнала: 2024, Номер unknown

Опубликована: Сен. 18, 2024

Abstract Aims To determine if estimated glucose disposal rate (eGDR) can predict cardiovascular disease mortality risk at different levels of glycaemic tolerance. Materials and Methods The eGDR 11 656 individuals aged 45–79 years from the National Health Nutrition Examination Survey cycles 1999 to 2010 were analysed. Associations between all‐cause examined using Cox proportional hazards Fine Gray models, respectively. Results After a median follow‐up 12.8 years, total 2852 participants died, with 777 those deaths attributed causes. When comparing values ≤4 mg/kg/min falling within ranges 4–6, 6–8 >8 mg/kg/min, it was found that latter groups exhibited lower hazard ratios for both (0.61 [0.52–0.72], 0.61 [0.52–0.72] 0.46 [0.39–0.55]) (0.44 [0.33–0.57], 0.45 [0.34–0.59] 0.30 [0.23–0.40]). A U‐shaped relationship observed, an inflection point 9.54 mg/kg/min. Conclusions In general population, association reduced independently significant, contributing identification high tolerances.

Язык: Английский

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Promise of Lifestyle Medicine for Heart Disease, Diabetes Mellitus, and Cerebrovascular Diseases

Mayo Clinic Proceedings Innovations Quality & Outcomes, Год журнала: 2024, Номер 8(2), С. 151 - 165

Опубликована: Фев. 26, 2024

The burden of noncommunicable chronic diseases has relevant and negative consequences to persons, health care systems, economies worldwide. Chronic are the leading cause disability mortality responsible for 90% expenditure. most common diabetes mellitus (DM), cardiovascular disease, cerebrovascular disease (stroke vascular cognitive impairment). Modifiable risk factors (MRFs) these conditions include hypertension, hyperlipidemia, smoking, poor diet, low-physical activity; with hypertension being prevalent MRF. Most MRFs can be successfully targeted through lifestyle medicine (LSM), which is a medical specialty that addresses root causes its primary, secondary, tertiary preventative approaches. Lifestyle comprises 6 pillars (nutrition, physical activity, sleep health, stress reduction, social connections, substance use) various behavioral approaches, focus on regular healthy eating, good quality quantity sleep, meaningful connections coupled reduction use. This paper will briefly review evidence promise individual LSM in addressing underlying DM, (specifically stroke holds great comprehensive much improved population health. However, adoption at societal scale requires multifaceted approach widespread integration would galvanize paradigm shift prevent, treat or reverse from achieve equity.

Язык: Английский

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