Funcionamiento afectivo-motivacional de pacientes prediabéticos y diabéticos / Affective-motivational functioning in prediabetic and diabetic patients

Fundamento: El funcionamiento afectivo-motivacional influye en el control de las enfermedades crónicas y en la actitud que asumen los enfermos ante la enfermedad. Objetivo: Caracterizar las particularidades afectivo-motivacionales que diferencian la regulación del comportamiento en pacientes prediabéticos y diabéticos crónicos. Metodología: Se utilizó un paradigma mixto de investigación, con diseño exploratorio secuencial. La muestra quedó conformada por un total de 20 sujetos, distribuidos en dos grupos: uno integrado por pacientes prediabéticos y el otro por pacientes diabéticos. Se aplicó el RAMDI (S), la escala Dembo - Rubinstein, el test de completamiento de frases, la técnica de la composición. Resultados: Se revelaron diferencias afectivo-motivacionales entre ambos grupos, expresadas en la concientización o no de la enfermedad y la consecuente regulación del comportamiento. Predominó una tendencia a la sobrevaloración en la variable salud, en los pacientes prediabéticos y subvaloración en los pacientes diabéticos. Conclusiones: Los sujetos prediabéticos no se reconocen como enfermos, no valoran los riesgos que contraen con su condición y no se comprometen con un cambio de estilo de vida. El grupo de pacientes diabéticos se caracterizó por expresar conciencia de la enfermedad, compromiso afectivo y elaboración personal, como procesos que facilitan la regulación de su comportamiento.

Background: Affective-motivational functioning affects the control over chronic diseases and the attitudes that patients assume towards the disease. Objective: To characterize the affective-motivational specificities that distinguish behavioral adaptations in prediabetic and chronic diabetic patients. Methods: A mixed research paradigm was applied, with a sequential exploratory design. The sample was composed by a total number of 20 patients, distributed in two groups: one composed by prediabetic patients and the other by diabetic ones. The RAMDI (S), the Dembo-Rubinstein Scale, and the Sentence Completion Test were applied, the Composition Technique. Results: Affective-motivational differences between the two groups were detected, manifested in the consciousness or not of the disease and consequent behavior regulation. A tendency to overestimate the health variable prediabetic patients and underestimate diabetic patients prevailed. Conclusions: Prediabetic patients do not recognize themselves as sick, do not value the risks they take with their status and do not engage in a lifestyle change. The diabetic patient group was characterized by expressing disease self-consciousness, affective compromise and personal development, as the processes that facilitate the adjustment of their behavior.

Particularidades del funcionamiento afectivo-motivacional de pacientes prediabéticos / Particularities of the motivational and affective functioning in prediabetic patients

Introducción: La prevención en el progreso de la prediabetes hacia la diabetes, debe hacerse desde un enfoque holístico y considerar el funcionamiento afectivo - motivacional de quienes la padecen. Objetivo: Determinar las particularidades del funcionamiento afectivo - motivacional de pacientes prediabéticos. Métodos: Se desarrolló un estudio exploratorio descriptivo con metodología mixta, se integraron los análisis cuantitativo y cualitativo; la muestra quedó conformada por 10 sujetos prediabéticos. Para la pesquisa se realizó el análisis psicológico de los pacientes, según su historia clínica y se aplicaron el Registro de la Actividad. Método Directo e Indirecto (RAMDI), la Escala Dembo-Rubinstein, las Técnicas de Completamiento de Frases y de Composición, así como la entrevista semiestructurada. Resultados: Los sujetos prediabéticos no se reconocen como enfermos, no valoran los riesgos que contraen por esa condición y no se comprometen con un cambio de estilo de vida. Conclusiones: En los pacientes prediabéticos la categoría salud no es un motivo rector que oriente y regule su conducta de modo estable; predominó la actitud de «no aceptación de la enfermedad», con una marcada tendencia a la autovaloración inadecuada que limita la responsabilidad personal ante la condición mórbida.

Introduction: the prevention of the progression from prediabetes to diabetes must be done from a holistic approach considering the motivational and affective functioning of the patients who suffer from this condition. Objective: to determine the particularities of the motivational and affective functioning of prediabetic patients. Methods: a descriptive exploratory study was carried out with a mixed-method research where quantitative and qualitative analyzes were integrated; the sample was made up of 10 prediabetic subjects. A psychological assessment was made based on their clinical history and the Register of the Activity. Direct and Indirect Method (RAMDI in Spanish), the Dembo-Rubinstein Scale, the Sentence Completion and the Composition Techniques, as well as the semi-structured interview were applied for screening. Results: the prediabetic subjects do not recognize themselves as sick, do not value the risks they incur with their condition, and do not commit to a lifestyle change. Conclusions: health category in prediabetic patients is not a guiding motive that guides and regulates their behaviour in a stable way; a predominance of an attitude of "non-acceptance of the disease", with a marked tendency to inadequate self-assessment that limited personal responsibility for the morbid condition.

Effects of resistance-aerobic exercise on glycolipid metabolism and cardiovascular events in the patients of prediabetes mellitus / 中国医师进修杂志

Objective:To investigate the effects of resistance-aerobic exercise on glycolipid metabolism and cardiovascular disease (CVD) in the patients of prediabetes mellitus (PDM).Methods:A total of 88 patients with PDM diagnosed and treated in Yuyao Maternal and Child Health Care Hospital from February to October 2020 were selected and divided into the observation group and the control group according to the random number table method, with 44 patients in each group. The control group adopted aerobic exercise, and the observation group adopted resistance-aerobic exercise. The changes of blood sugar, lipid levels, blood pressure, body mass index (BMI) and waist-to-hip ratio (WHR) were compared after treatment. According to the Framingham Risk Score (FRS), the 10-year incidence probability of CVD was calculated.Results:After treatment, the levels of fasting plasma glucose (FPG), 2 h postprandial blood glucose (2 h PG), glycosylated hemoglobin (HbA 1c), insulin resistance index (HOMA-IR) in the observation group were lower than those in the control group: (5.32 ± 0.54) mmol/L vs. (5.57 ± 0.60) mmol/L, (7.10 ± 1.07) mmol/L vs. (7.58 ± 1.02) mmol/L, (5.64 ± 0.36)% vs. (5.82 ± 0.40)%, 2.54 ± 0.56 vs. 2.89 ± 0.75, there were statistical differences ( P<0.05). After treatment, the levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL-C) in the observation group were lower than those in the control group, and high density lipoprotein (HDL-C) was higher than that in the control group: (4.80 ± 0.62) mmol/L vs. (5.14 ± 0.74) mmol/L, (1.50 ± 0.62) mmol/L vs. (1.80 ± 0.70)mmol/L, (2.80 ± 0.52) mmol/L vs. (3.04 ± 0.59) mmol/L, (1.90 ± 0.44) mmol/L vs. (1.72 ± 0.40) mmol/L, there were statistical differences ( P<0.05). After the treatment, the systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the observation group were lower than those in the control group: (128.42 ± 13.74) mmHg (1 mmHg = 0.133 kPa) vs. (134.98 ± 14.56) mmHg, (74.64 ± 8.02) mmHg vs.(78.25 ± 8.53) mmHg ( P<0.05); the BMI and WHR in the observation group were lower than those in the control group: (23.28 ± 1.66) kg/m 2 vs. (24.15 ± 2.02) kg/m 2, 0.84 ± 0.05 vs. 0.86 ± 0.03, P<0.05. The FRS score and 10-year incidence of CVD in the observation group were significantly lower than those in the control group: [(12.15 ± 1.52) scores vs.(12.84 ± 1.59) scores, (6.42 ± 1.52)% vs. (7.23 ± 1.79)%, P<0.05. Conclusions:The effect of resistance-aerobic exercise on PDM is obvious, which can significantly improve glycolipid metabolism and reduce the risk of CVD.

Effect of experiential health education on diet control of college students with type 2 pre diabetes mellitus / 中国学校卫生

Objective@#To understand the influence of experiential health education on diet control of college students with pre diabetes mellitus, and to provide reference for healthy eating habits promotion among college students.@*Methods@#According to the method of random number table, 78 pre diabetic college students screened from Changzhi Medical College from September 2020 to June 2021 were randomly assigned to observation group and control group (39 students in each group). The control group received routine health education for 10 months, once a week for 1 hour each time; On the basis of the above, the observation group received experiential health education once a week for 1 hour, including diet experience, exercise experience, blood sugar test experience and chronic complications experience. Blood glucose and lipids level, body mass index (BMI), dietary control as well as the stages of change for dietary control behavior were compared between the two groups.@*Results@#There was significant difference between the observation group and the control group in the stages of change for dietary control behavior 10 months after intervention ( χ 2=8.92, P <0.05). The compliance score of the observation group was significantly higher than that of the control group in the same period 10 months after the intervention ( t =3.74, P <0.01), the score of the knowledge of diet control in the observation group 10 months after intervention was significantly higher than that in the control group ( t =11.51, P <0.05). The levels of BMI, TG and TC in the observation group were significantly lower than those in the control group at 5 and 10 months after intervention, and the differences were statistically significant ( P <0.05).@*Conclusion@#Experiential health education helps to promote awareness of diabete related knowledge, enhance self management behavior and good diet control habits, and is effective for blood glucose control.

Papel do Jejum Intermitente e da Dieta Restrita em Carboidratos na Prevenção de Doenças Cardiovasculares em Pacientes Pré-Diabéticos / The Value of Intermittent Fasting and Low Carbohydrate Diet in Prediabetic Patients for the Prevention of Cardiovascular Diseases

Resumo Fundamentos: Pacientes pré-diabéticos têm alto risco de doenças cardiovasculares e complicações microvasculares e macrovasculares. O Jejum Intermitente (JI) e a dieta restrita em carboidratos (dieta low-carb, DLC) são estratégias dietéticas promissoras nesse grupo. Objetivos: Analisar os benefícios da combinação do JI com DLC sobre desfechos microvasculares e macrovasculares em pacientes pré-diabéticos. Métodos: O estudo incluiu 485 pacientes pré-diabéticos sem história de doença cardiovascular. Os pacientes foram divididos em dois grupos: grupo I (n = 240) submetidos ao JI (16 horas de JI, F 3-4 dias por semana) combinado com DLC (<130 g de carboidratos por dia), e grupo II (n = 245) que consumiram alimentos à vontade (grupo controle). Os dois grupos foram acompanhados por dois anos para avaliação de complicações macrovasculares e microvasculares. Um valor p < 0,05 foi considerado estatisticamente significativo. Resultados: Houve uma redução significativa no peso corporal, índice de massa corporal, porcentagem de gordura corporal e hemoglobina glicada no grupo I. A incidência de progressão de pré-diabetes para diabetes foi significativamente menor no grupo I (2,1%) que no grupo II (6,9%) (p = 0,010). Ainda, um aumento significativo na incidência de complicações microvasculares e macrovasculares foi observado no grupo II, incluindo retinopatia, neuropatia e angina instável. A análise de regressão multivariada revelou que peso corporal aumentado, e níveis elevados de glicemia de jejum, hemoglobina glicada e lipoproteína de baixa densidade foram fatores de risco independentes de desfechos microvasculares e macrovasculares. Conclusões: Em pacientes pré-diabéticos, o JI, combinado com DLC, associou-se com menor progressão para diabetes mellitus e menor incidência de complicações microvasculares e macrovasculares.

Abstract Background: Prediabetic patients are at increased risk for cardiovascular diseases and the development of microvascular and macrovascular complications. Intermittent fasting (IF) and low-carbohydrate diet (LCD) are promising dietary plans. Objectives: Our aims to analyze the benefits of IF combined with LCD on microvascular and macrovascular outcomes in prediabetic patients. Methods: The study included 485 prediabetic patients with no history of cardiovascular diseases divided into group I: (n = 240 patients) who underwent IF (16 h IF 3-4 days per week) combined with LCD (<130 g of carbohydrate per day), and group II: (n = 245 patients) with ad libitum calorie intake. The two groups were followed-up for two years for assessment of micro and macrovascular complications. A p-value < 0.05 was considered statistically significant. Result: There was a significant reduction in body weight, body mass index, waist circumference, body fat percentage and glycated hemoglobin in group I. The incidence of progression from prediabetes to diabetes was significantly lower in group I (2.1% vs. 6.9% in group II, p = 0.010). In addition, a significant increase in the incidence of microvascular and macrovascular complications was observed in group II, including retinopathy, neuropathy and unstable angina. Multivariate regression analysis revealed that increased body weight, fasting glucose, glycated hemoglobin and low-density lipoprotein were independent risk factors impacting microvascular and macrovascular outcomes. Conclusions: In prediabetic patients, IF, combined with LCD, was associated with lower progression to diabetes mellitus and lower incidence of microvascular and macrovascular complications.

Particularidades de la esfera afectivo motivacional en pacientes diabéticos crónicos

Introducción : La diabetes mellitus, debe abordarse desde un enfoque holístico, donde se considere el funcionamiento afectivo motivacional de los pacientes que la padecen. Objetivo: Determinar las particularidades afectivo motivacionales en pacientes diabéticos crónicos. Métodos: Se realizó un estudio exploratorio descriptivo con un paradigma de investigación mixto, donde se integraron los análisis cuantitativo y cualitativo. La muestra quedó conformada por 10 sujetos diabéticos crónicos, no se pretendió que los hallazgos derivados de su estudio fuesen generalizados a la población, pero sí, por su carácter inductivo, reflejaran la perspectiva de aquel que vivencia el fenómeno objeto de estudio. Para la pesquisa se aplicó el análisis psicológico de la historia clínica, el RAMDI (S), la Escala Dembo -Rubinstein, el test de completamiento de frases, la técnica de la composición, así como la entrevista semiestructurada. Resultados: Se constató conciencia de la enfermedad, se manifestó una adecuada valoración de la misma, acompañado de un compromiso afectivo y una elaboración personal en sus reflexiones, donde se conjugan sus vivencias y experiencias de vida, que da una orientación afectivo-motivacional a su comportamiento. Conclusiones: La categoría salud aparece como un motivo central y jerárquico en estos sujetos, pero a pesar de esto no todos logran regular su comportamiento de una manera efectiva y saludable.

Introduction: Diabetes mellitus should be approached from a holistic approach, where the motivational affective functioning of patients suffering from it is considered. Objective: To determine the motivational affective characteristics in chronic diabetic patients. Methods: A descriptive exploratory study was carried out with a mixed research paradigm, where quantitative and qualitative analyzes were integrated. Responding to this approach, the sample was made up of 10 chronic diabetic subjects, not intending that the findings derived from their study were generalized to the population, but yes, due to their inductive nature, they reflected the perspective of the person experiencing the phenomenon under study. For the research, the psychological analysis of the clinical history, the RAMDI (S), the Dembo-Rubinstein Scale, the Phrase Completion Test, the Composition Technique, as well as the semi-structured interview were applied. Results: Awareness of the disease was found, showing an adequate assessment of it, accompanied by an emotional commitment and personal elaboration in their reflections, where their experiences and life experiences are combined, and giving an emotional-motivational orientation to their behavior. Conclusions: The health category appears as a central and hierarchical motive in these subjects, but despite this, not everyone manages to regulate their behavior in an effective and healthy way.

Clinical characteristics among patients with pulmonary tuberculosis complicated by prediabetes mellitus / 中国基层医药

Objective:To analyze the clinical characteristics of pulmonary tuberculosis (PTB) in patients with prediabetes mellitus (PreDM) and improve the understanding and diagnosis of pulmonary tuberculosis complicated by prediabetes mellitus (PreDM-PTB).Methods:The clinical data of 109 inpatients with PTB who underwent glycated hemoglobin A1c (HbA1c) examination admitted to Beijing Chest Hospital, Capital Medical University from January 2015 to January 2016 were retrospectively analyzed. These patients were divided into the PreDM-PTB group ( n = 45) and the non-PreDM-PTB group (N-PreDMPTB group, n = 64) according to HbA1c test results. Patient demographic data, clinical features, imaging data, bacteriological results, and other laboratory results were collected from all patients. Results:The mean age and body mass index (BMI) were higher in the PreDM-PTB group than the N-PreDMPTB group. The proportion of patients having a smoking history was higher in the PreDM-PTB group than the N-PreDMPTB group (46.7% vs. 25.0%). The proportions of patients who had a cough (88.9%), fever (55.6%), anorexia (17.8%), chest tightness (31.1%), shortness of breath (28.9%), weight loss (40.0%), and pleural effusion (22.2%) were higher in the PreDM-PTB group than the N-PreDMPTB group. Patients with PreDM-PTB were more prone to develop anemia (55.6%), hypoproteinemia (55.6%), and increased low-density lipoprotein (26.7%) compared with patients with N-PreDMPTB. The levels of D-Dimer (93.2%), C-reactive protein (86.7%), and erythrocyte sedimentation rate (79.1%) were increased in the PreDM-PTB group compared with the N-PreDMPTB group. Sputum smear results showed that the positivity of mycobacterium tuberculosis was higher in the PreDM-PTB group (74.4%) compared with the N-PreDMPTB group. There was no significant difference in drug resistance between the two groups ( P > 0.05). The positivity of blood tuberculosis antibody and blood T-cell spot test for tuberculosis infection were 60.9% and 84.6% respectively in the PreDM-PTB group and they were 50.9% and 95.2% respectively in the N-PreDMPTB group. There were no significant differences in these two indices between the two groups ( P = 0.321, 0.066). Conclusion:Patients with Pre-DMPTB have different clinical manifestations and auxiliary examination characteristics compared with patients with N-PreDMPTB patients, which should be paid more attention to by clinicians. Early intervention should be actively adopted to prevent diabetes development from pre-DM.

Baipás gástrico versus manga gástrica para el controlde diabetes tipo 2 en pacientes obesos / Gastric bypass versus gastric sleeve for the management of type 2 diabetes in obese patients

Introducción. La diabetes mellitus tipo 2 y la obesidad son enfermedades con alta prevalencia, gran morbi-mortalidad y elevados costos en salud. La cirugía bariátrica ha demostrado efectividad para inducir pérdida de peso y un control adecuado de la glicemia. Métodos. Estudio observacional analítico retrospectivo, realizado entre 2014 y 2019 en una institución de alta complejidad. Se incluyeron pacientes prediabéticos y diabéticos sometidos a cirugía bariátrica tipo baipás gástrico en Y-de-Roux o manga gástrica. Se analizaron la mejoría o resolución de la diabetes y la pérdida del exceso de peso a los 6, 12, 24 y 36 meses luego de la cirugía. Resultados. Se incluyeron 103 pacientes en el estudio, 45 pacientes diabéticos y 58 pacientes prediabéticos. La única variable perioperatoria con diferencia estadísticamente significativa fue el tiempo quirúrgico mayor en el baipás (70 vs. 47,5 minutos; p<0,001). La pérdida de exceso de peso fue mayor en el baipás. Los pacientes diabéticos sometidos a baipás tuvieron un mayor porcentaje de resolución o control comparados con los sometidos a manga gástrica. En los pacientes prediabéticos hubo resolución en ambos grupos luego de 24 meses de seguimiento. Conclusión. El baipás gástrico y la manga gástrica presentan excelentes resultados en cuanto a pérdida de peso y control metabólico en pacientes con diabetes mellitus tipo 2 y prediabetes, pero en nuestros pacientes se lograron resultados superiores en ambos aspectos con el baipás gástrico

Introduction. Type 2 diabetes mellitus and obesity are diseases with high prevalence, high morbidity and mortality and high health costs. Bariatric surgery has proven effective in inducing weight loss and adequate glycemic control. Methods. Retrospective analytical observational study conducted between 2014 and 2019 in a high-complex institution. Prediabetic and diabetic patients undergoing Roux-en-Y gastric bypass or gastric sleeve were included; analyzing the improvement or resolution of diabetes and the loss of excess weight at 6, 12, 24 and 36 months after surgery. Results. One-hundred and three patients were included in the study, 45 diabetic patients and 58 pre-diabetic patients. The only perioperative variable with a statistically significant difference was the longer surgical time in the bypass (70 vs. 47.5 min; p<0.001). Loss of excess weight was always greater in bypass. Diabetic patients who underwent bypass had a higher percentage of resolution or control compared to those who underwent the sleeve procedure. In pre-diabetic patients, there was 100% resolution in both groups after 24 months of follow-up. Conclusion. Gastric bypass and gastric sleeve present excellent results in terms of weight loss and metabolic control in patients with type 2 diabetes mellitus and pre-diabetes, but superior results in both aspects were achieved with the first technique in our patients

O Nível de Endocan Sérico pode ser Usado como Biomarcador para Prever Aterosclerose Subclínica em Pacientes Pré-Diabéticos? / Can the Serum Endocan Level Be Used as a Biomarker to Predict Subclinical Atherosclerosis in Patients with Prediabetes?

Resumo Fundamento Pacientes pré-diabéticos têm um risco aumentado de doença cardiovascular aterosclerótica, e, portanto, a detecção precoce é importante. Objetivo Nosso estudo teve o objetivo de revelar a usabilidade dos níveis de endocan sérico como biomarcador no diagnóstico de aterosclerose subclínica em pacientes pré-diabéticos, com base em medições de EIMC. Métodos Os participantes foram classificados de acordo com a presença (n=42) ou ausência (n=42) de pré-diabetes. Os valores de endocan sérico, glicemia em jejum, insulina em jejum e hemoglobina glicada (HbA1c) dos pacientes foram examinados e a EIMC foi medida. O nível de significância para a análise estatística foi 0,05. Resultados Apesar de se ter determinado que os níveis de endocan sérico são mais baixos em pacientes pré-diabéticos em comparação com o grupo de controle (p=0,042), determinou-se que os valores de EIMC são mais altos (p=0,046). A avaliação do endocan sérico por análise regressiva multivariada detectou que seu nível estava associado à EIMC, independentemente de outros parâmetros (p=0,007). Encontramos uma correlação negativa entre insulina plasmática em jejum e níveis de endocan (r=-0,320, p=0,001). Conclusões Este estudo demonstrou que a espessura íntima-média de carótida é mais alta e o nível de endocan sérico é mais baixo em pacientes pré-diabéticos. Os níveis de endocan sérico diminuídos em pacientes pré-diabéticos podem ser um fator que contribui para os mecanismos de formação de aterosclerose.

Abstract Background Patients with prediabetes have an increased risk of atherosclerotic cardiovascular disease; therefore, early detection is important. Objective The present study aimed to reveal the usability of serum endocan levels as a biomarker in the diagnosis of subclinical atherosclerosis in patients with prediabetes, based on CIMT measurements. Methods Participants were classified according to the presence (n=42) or absence (n=42) of prediabetes. Serum endocan, fasting blood sugar, fasting insulin, and glycated hemoglobin (HbA1c) values of patients were examined, and CIMT was measured. The level of significance for statistical analysis was 0.05. Results While serum endocan levels were found to be lower in patients with prediabetes, when compared to the control group (p=0.042), CIMT values were found to be higher (p=0.046). When evaluated by multivariate regression analysis, the serum endocan level was found to be associated with CIMT, regardless of other parameters (p=0.007). A negative correlation was found between plasma fasting insulin and endocan levels (r=-0.320, p=0.001). Conclusions Carotid intima media thickness was found to be high and the serum endocan level was low in patients with prediabetes. Decreased serum endocan levels in patients with prediabetes may be a contributing factor to atherosclerosis formation mechanisms.

La prediabetes y su impacto sobre la salud cardiovascular: artículo de revisión / Prediabetes and its impact on cardiovascular health: A review article

Introducción: La prediabetes es un estado intermedio de hiperglicemia, con una alta prevalencia en la población colombiana. Su relación con enfermedad cardiovascular y complicaciones macro y microvasculares se ha establecido, incrementando la evidencia científica en la literatura reciente. Objetivo: Describir las enfermedades cardiovasculares (complicaciones macrovasculares) relacionadas con prediabetes, su diagnóstico, fisiopatología, el enfoque de manejo y el tratamiento avalado para prevenir estas complicaciones. Materiales y métodos: Se realizó una revisión narrativa de la literatura, mediante búsqueda de artículos científicos en Medline entre 2015 y 2021. Resultados: Se seleccionaron 83 artículos. Se describe la relación de prediabetes con enfermedad cardiovascular, mortalidad, diagnóstico y tratamiento conforme a la literatura actualizada. Conclusiones: La importancia de la prediabetes radica en su asociación con complicaciones macrovasculares y su mortalidad, lo que pone en evidencia la importancia de estudiarla, seguirla y tratarla para evitar la progresión a diabetes mellitus, el desarrollo de desenlaces que finalizan en aumento de la morbimortalidad, alteración de la calidad de vida e incremento de los costos en salud.

Introduction: Prediabetes is an intermediate state of hyperglycemia with a high prevalence in the Colombian population. The relationship between prediabetes and cardiovascular disease as well as its association with macro and microvascular complications has been established, with scientific evidence increasing in recent literature. Objective: To describe cardiovascular diseases (macrovascular complications) related to prediabetes, their diagnosis, physiopathology, management approach, and treatment to prevent those complications. Materials and methods: A narrative review of the literature was conducted, searching for scientific articles in Medline during the 2015-2021 period. Results: 83 articles were selected, which described the relationship between prediabetes with cardiovascular disease, mortality, diagnosis, and treatment based on recent reports. Conclusions: The importance of prediabetes lies in its association with macrovascular complications and its mortality. This association highlights the importance of studying, monitoring, and treating this disease to avoid its progression to diabetes mellitus, the development of outcomes that end in increased morbidity and mortality, diminished quality of life, and increased health care costs.

The prevalence and related factors of pre?diabetes and diabetes among overweight and obese children in Urban schools

Objective: This study aimed to determine the prevalence of pre?diabetes and diabetes among overweight and obese children in urban schools and factors associated with them, in Batticaloa District, Sri Lanka. Methods: A school based cross?sectional descriptive study was conducted to collect data on socio-demographic information, eating habits and physical activities, using a validated, pre-tested questionnaire. In addition, anthropometric measurements and glycosylated haemoglobin (HbA1c) test were performed. Multivariate logistic regression analyze was performed to identify the factors associated with glycemic status by using SPSS v23. Results: Out of the 269 children recruited, 59% were obese. Prevalence of pre?diabetes (HbA1c 5.7%�4%) and diabetes (HbA1c ? 6.5%) were 20.1% (95% CI 15.5%�.4%) and 3.3% (95% CI 1.5%�3%) respectively. Multivariate regression shows that having a BMI of ? 27.5Kg/m2 (AOR=2.69), male gender (AOR=2.71) and ethnicity (AOR = 2.58) were found to be significant factors for higher HbA1c (?5.7%). Conclusions: Prevalence of prediabetes and diabetes among overweight and obese school children was high and mainly associated with body weight which is a modifiable risk factor. Lifestyle modifications focusing on weight reduction among overweight and obese school children especially boys, need to be carried out.

Prevalence of prediabetes in adults and its association with sociodemographic, nutritional, metabolic and mental disorders factors: Home Health Survey, Piauí, Brazil / Prevalência de pré-diabetes em adultos e sua associação com fatores sociodemográficos, nutricionais, metabólicos e transtornos mentais: Inquérito de Saúde Domiciliar, Piauí, Brasil

ABSTRACT Objective To estimate prevalence of prediabetes and to investigate its associated factors in adults living in Teresina, Piauí, Brazil Methods Cross-sectional, home-based study, with both genders adults in Teresina, Piauí. The prevalence of prediabetes was estimated using the fasting glucose test, and was classified according to the American Diabetes Association standards (≥100mg/dL; <126mg/dL). The associations between prediabetes and the variables: sociodemographic, anthropometric, food consumption, blood pressure levels, triglycerides and common mental disorders were tested. In addition, a variable was created to verify the association of the simultaneous presence of risk factors in the same individual. Data were reviewed using Pearson's chi-square test and Poisson regression for crude and adjusted prevalence ratios, considering a significance level of 5%. Results A total of 224 adults participated in the study, of which 154 (68.7%) were female, aged between 20 and 39 years (53.1%). An 8.04% prevalence of prediabetes was observed. A statistically significant association (p<0.05) was found between lower education (0 to 8 years of study; 17.3%) and increased triglycerides levels (≥150mg/dL; 13.7%). Higher gross prevalence (PR: 2.53; CI 95%: 1.05-6.05) prediabetes ratios were observed with 5 or more simultaneous risk factors when compared to individuals who had up to 4 simultaneous risk factors. Conclusion Low schooling, hypertriglyceridemia and the presence of five or more simultaneous risk factors were associated with prediabetes; however, these risk factors are subject to intervention. Therefore, this study points to the need for changes in lifestyle habits as a strategy for glycemic control and diabetes prevention.

RESUMO Objetivo Estimar a prevalência de pré-diabetes e investigar os fatores associados em adultos residentes em Teresina, Piauí, Brasil. Métodos Estudo transversal de base domiciliar com adultos de ambos os sexos em Teresina, Piauí. A prevalência de pré-diabetes foi estimada pelo teste de glicemia em jejum, e classificado de acordo com a Associação Americana de Diabetes (≥100mg/dL; <126mg/dL). Foram testadas as associações entre pré-diabetes e as variáveis: sociodemográficas, antropométricas, consumo alimentar, níveis pressóricos, triglicerídeos e transtornos mentais comuns. Além disso, foi criada uma variável para verificar a associação da presença simultânea dos fatores de risco no mesmo indivíduo. Os dados foram analisados com o teste do qui-quadrado de Pearson e regressão de Poisson para razões de prevalência bruta e ajustada, considerando nível de significância de 5%. Resultados Participaram do estudo 224 adultos, sendo 154 (68,7%) do sexo feminino, entre 20 e 39 anos (53,1%). Verificou-se prevalência de pré-diabetes de 8,04%, com associação significativa (p<0,05) com a menor escolaridade (17,3%), e triglicerídeos elevados (13,7%). Observou-se maior razão de prevalência bruta (RP: 2,53; IC 95%: 1,05-6,05) de pré-diabetes nos indivíduos com 5 ou mais fatores de risco simultâneos quando comparados àqueles com até 4 fatores simultâneos. Conclusão A baixa escolaridade, a hipertrigliceridemia e a presença de cinco ou mais fatores de risco simultâneos apresentaram-se associados ao pré-diabetes. Entretanto, os fatores de risco encontrados são passíveis de intervenção. Este estudo aponta a necessidade de mudanças de hábitos de vida comportamentais como estratégia para o controle da glicemia e prevenção do diabetes.

Observation of the efficacy and safety of the Song-Relaxing and Zhen-Vibrating abdomen manipulation for patients with prediabetes / 针灸推拿医学（英文版）

Objective: To observe the safety of the Song-Relaxing and Zhen-Vibrating abdomen manipulation in treating patients with prediabetes and its effects on blood glucose and lipid metabolism.Methods: One hundred and two patients with prediabetes were divided into a manipulation group and a control group according to the random number table method, with 51 cases in each group. All patients received the general behavioral intervention for prediabetes, with additional Song-Relaxing and Zhen-Vibrating abdomen manipulation in the manipulation group and oral metformin hydrochloride tablets in the control group. Both groups received the intervention for six months. Results: Fourteen patients dropped out during the treatment, and a total of 88 patients completed the trial, including 45 cases in the manipulation group and 43 cases in the control group. After the treatment, the prediabetes control rate was 93.3％ in the manipulation group and 74.4％ in the control group, and the difference between the two groups was statistically significant (P<0.05); no patient in the manipulation group progressed to diabetes, while the rate of conversion to diabetes in the control group was 6.9％, with a significant difference between the two groups (P<0.05). After the treatment, the body mass index (BMI), glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), 2-hour postload plasma glucose (2hPG) level during an oral glucose tolerance test (OGTT), fasting insulin (FINS), homeostasis model assessment-2 of insulin resistance (HOMA2-IR), total cholesterol (TC), and triglycerides (TG) decreased in both groups versus baseline, with significant differences within the groups; the levels of all indicators were lower in the manipulation group than in the control group (P<0.05), and the differences between the two groups were more prominent at the sixth month (P<0.01). At the sixth month, the high-density lipoprotein cholesterol (HDL-C) in the manipulation group was increased, while there was no significant change in the control group. In the control group, three patients reported mild gastrointestinal reactions at the initial dosing, which improved after medication adjustment. No other adverse events were observed in either group. Conclusion: Both metformin hydrochloride tablets and the Song-Relaxing and Zhen-Vibrating abdomen manipulation can improve blood glucose and lipid metabolism and reduce insulin resistance and clinical discomfort in patients with prediabetes, but the Song-Relaxing and Zhen-Vibrating abdomen manipulation has higher efficacy and safety.

Usuarios de un programa de ejercicio físico y el riesgo de prediabetes / Usuários de um programa de exercícios físicos e o risco de pré-diabetes / Users of a physical exercise program and risk of prediabetes

Objetivo: estimar el riesgo de prediabetes según los factores que presentan los participantes de un programa de ejercicio físico de la provincia de Chota, Perú. Metodología: estudio observacional, transversal y retrospectivo, desarrollado con 112 participantes pertenecientes a un programa de ejercicio físico. Se utilizó una guía de interpretación para analizar los factores de riesgo y la prediabetes en los participantes, la cual fue adaptada de una asociación norteamericana y dos instituciones de salud peruanas. Las pruebas estadísticas utilizadas fueron el odds ratio de prevalencia (ORP), la fracción etiológica poblacional (FEP) y el chi cuadrado de independencia. Resultados: el sedentarismo (ORP = 3,62), el exceso de triglicéridos (TGC) (ORP = 2,26) y el sobrepeso (ORP = 2,22) fueron los factores de riesgo identificados en los participantes. Según la FEP, si se interviene de manera adecuada y oportuna sobre estos factores, disminuiría la frecuencia de prediabetes en 8,57, 15,24 y 21,40 %, respectivamente. Conclusiones: los factores de riesgo de prediabetes en los usuarios estudiados fueron el sedentarismo, el exceso de TGC y el sobrepeso, resaltando al sedentarismo como el de mayor implicancia. Estos factores de riesgo, que reportaron una relación estadísticamente significativa con la prediabetes, pueden ser controlados y modificados. Por lo tanto, las intervenciones preventivas y promocionales en el primer nivel de atención deben fortalecerse y efectuarse mediante un trabajo integral y sostenible, con la finalidad de disminuir las cifras de prediabetes y condiciones conexas.

Objetivo: estimar o risco de prédiabetes de acordo com os fatores apresentados pelos participantes de um programa de exercícios físicos na província de Chota, Peru. Metodologia: estudo observacional, transversal, retrospectivo, desenvolvido com 112 participantes pertencentes a um programa de exercícios físicos. Um guia de interpretação foi utilizado para analisar os fatores de risco e o pré-diabetes nos participantes, o guia foi adaptado de uma associação norteamericana e duas instituições de saúde peruanas. Os testes estatísticos utilizados foram a razão de chances (odds ratio) de prevalência (ORP), a fração etiológica populacional (FEP) e o qui-quadrado de independência. Resultados: sedentarismo (ORP = 3,62), excesso de triglicerídeos (TGC) (ORP = 2,26) e sobrepeso (ORP = 2,22) foram os fatores de risco identificados nos participantes. De acordo com o FEP, se houver intervenção adequada e oportuna sobre esses fatores de risco a frequência de pré-diabetes diminuiria em 8,57 %, 15,24 % e 21,40 %, respectivamente. Conclusões: os fatores de risco para pré-diabetes nos usuários estudados foram sedentarismo, excesso de TGC e sobrepeso, destacando-se o sedentarismo como o de maior implicação. Esses fatores de risco que obtiveram relação estatisticamente significativa com o pré-diabetes podem ser controlados e modificados; portanto, as intervenções preventivas promocionais no primeiro nível de atenção devem ser fortalecidas e realizadas por meio de um trabalho abrangente e sustentável, a fim de reduzir o número de pré-diabetes e doenças relacionadas.

Objective: To estimate the risk of prediabetes in the participants of a physical exercise program in the province of Chota, Peru. Methodology: Observational, cross-sectional and retrospective study, developed with 112 participants in a physical exercise program. An interpretation guide was used to examine risk factors and prediabetes in the participants. This guide was adapted from a North American association and two Peruvian health institutions. The statistical tests used were the prevalence odds ratio (ORP), the population etiological fraction (PEF), and the chi square of independence. Results: A sedentary lifestyle (ORP = 3.62), the excess of triglycerides (TGC) (ORP = 2.26), and overweight (ORP = 2.22) were the main risk factors identified in participants. According to the FEP, if adequate and timely intervention is made over such factors, the frequency of prediabetes would decrease by 8.57, 15.24 and 21.40, respectively. Conclusions: Prediabetes risk factors in the studied population were a sedentary lifestyle, excess of TGC and overweight, highlighting sedentary lifestyle as that with the greatest effects on health. The identified risk factors, which reported a statistically significant relationship with prediabetes, can be controlled and modified. Therefore, promotional and preventive interventions at the first level of health care must be strengthened and carried out through comprehensive and sustainable work, in order to reduce the figures of prediabetes and its related conditions.

Prevalência de pré-diabetes e hiperglicemia intermediária em adultos e fatores associados, Pesquisa Nacional de Saúde / Prediabetes and intermediate hyperglycemia prevalence in adults and associated factors, Health National Survey

Resumo O objetivo deste estudo foi avaliar a prevalência de pré-diabetes e hiperglicemia intermediária em adultos brasileiros, considerando diferentes critérios diagnósticos, e estabelecer fatores associados à sua ocorrência. Análise dos dados laboratoriais da Pesquisa Nacional de Saúde, coletados em 2014 e 2015. Foram calculadas as prevalências das condições conforme critérios da Associação Americana de Diabetes (ADA) - Hemoglobina Glicada (HbA1c) 5,7 a 6,4% - e da Organização Mundial de Saúde (OMS), de 6 - 6,4% entre aqueles que não tinham critério para diabetes. Razões de prevalência (RP) brutas e ajustadas e IC 95% foram calculados por regressão de Poisson com variância robusta. A prevalência de pré-diabetes pelo critério ADA foi de 18,5% e de 7,5% pelo critério da OMS. Verificou-se um gradiente de aumento das prevalências segundo a idade da população e presença de fatores de risco como hipertensão arterial, obesidade, circunferência abdominal elevada e baixo colesterol HDL. Os menos escolarizados e os declarados pretos apresentaram prevalências superiores. Este estudo aponta um intervalo entre 7,5 a 18,5% de adultos brasileiros que apresentam pré-diabetes e hiperglicemia intermediária, além de identificar um escore de risco para a ocorrência dessa condição.

Abstract This study aimed to evaluate the prevalence of prediabetes and intermediate hyperglycemia in Brazilian adults, according to different diagnostic criteria, and establish associated factors to its occurrence. We analyzed the National Health Survey laboratory data collected from 2014 to 2015. The prevalence of the conditions was calculated according to the American Diabetes Association (ADA) diagnostic criteria based on glycated hemoglobin (HbA1c) 5.7%-6.4%, and the World Health Organization (WHO) 6-6.4%, among those without criteria for diabetes. Crude and adjusted prevalence rates (PR) and 95% CI were calculated using Poisson regression with robust variance. The prevalence of prediabetes by ADA and WHO criteria was 18.5 and 7.5%, respectively. We observed a gradient of increased prevalence by the age of the population and risk factors, like arterial hypertension, obesity, elevated waist circumference, and low HDL cholesterol levels. Less educated people and the self-declared black had a higher prevalence. This study pointed out a range from 7.5 to 18.5% of Brazilian adults with prediabetes and intermediate hyperglycemia and identified a risk score to this condition's occurrence.

Periodontitis and identification of undiagnosed hyperglycemia / Periodontite e identificação da hiperglicemia não diagnosticada

Introduction Individuals with pre-diabetes have altered glycemic levels, are generally asymptomatic, and are at increased risk for developing type 2 diabetes mellitus. Objective Identify the prevalence of periodontal individuals with undiagnosed hyperglycemia and associated impact factors. Material and method Fifty-six patients with periodontitis and without diabetes self-report, users of dental clinic services at Federal University of Juiz de Fora were included in this research, during one year and a half of experimental evaluation. Socioeconomic and demographic data, anthropometric patterns, fasting capillary blood glucose, and complete periodontal examination (six sites per tooth) were evaluated. Result The sample consisted of 58.9% female, mean age 53 years old, 58.9% obese/overweight and 45.3% had a low level of education. A total of 28.6% (n=16) participants had undiagnosed hyperglycemia (between 100 to 160 mm / dL), of which 81.3% were obese/overweight, 25% were smokers, 56.3% reported having a history of diabetes in the family, 93.8% had a family income up to 2 brazilian´s minimum wages. BMI values ​​were higher in the group of patients with hyperglycemia (29.8 ± 5.7, p = 0.03) compared to the group without hyperglycemia (26.6 ± 5.6). Patients with hyperglycemia had a greater number of sites with clinical attachment loss (CAL) between 4 and 6 mm (p = 0.04) when compared with the normoglycemic group. Conclusion Undiagnosed CAL attachment loss between 4 and 6 mm due to periodontitis than normoglycemic individuals.

Introdução Indivíduos com pré-diabetes apresentam níveis glicêmicos alterados, geralmente são assintomáticos e apresentam risco aumentado para desenvolver diabetes mellitus tipo 2. Objetivo Identificar a prevalência de indivíduos periodontais com hiperglicemia não diagnosticada e os fatores de impacto associados. Material e método Cinquenta e seis pacientes com periodontite e sem autorrelato de diabetes, usuários de serviços de clínica odontológica da Universidade Federal de Juiz de Fora foram incluídos nesta pesquisa, durante um ano e meio de avaliação experimental. Foram avaliados dados socioeconômicos e demográficos, padrões antropométricos, glicemia capilar de jejum e exame periodontal completo (seis sítios por dente). Resultado A amostra foi composta por 58,9% do sexo feminino, média de idade de 53 anos, 58,9% obesidade / sobrepeso e 45,3% com baixa escolaridade. Um total de 28,6% (n=16) participantes tinham hiperglicemia não diagnosticada (entre 100 a 160 mm / dL), dos quais 81,3% eram obesos / com sobrepeso, 25% eram fumantes, 56,3% relataram ter histórico de diabetes na família, 93,8% tinham renda familiar de até 2 salários mínimos brasileiros. Os valores de IMC foram maiores no grupo de pacientes com hiperglicemia (29,8 ± 5,7, p = 0,03) em comparação ao grupo sem hiperglicemia (26,6 ± 5,6). Pacientes com hiperglicemia apresentaram maior número de sítios com perda clínica de inserção (CAL) entre 4 e 6 mm (p = 0,04) quando comparados ao grupo normoglicêmico. Conclusão A perda de inserção de CAL não diagnosticada entre 4 e 6 mm devido à periodontite do que indivíduos normoglicêmicos.

Frecuencia de factores de riesgo para el desarrollo de prediabetes en el personal sanitario

RESUMEN Introducción: los factores de riesgo importantes para el desarrollo de y diabetes tipo 2 son la obesidad, la dislipidemia y la hiperglucemia. El incremento de la frecuencia las enfermedades crónicas no transmisibles es un fenómeno mundial y Paraguay no es la excepción. Objetivos: determinar la frecuencia de desarrollar prediabetes con respecto a patrones alimentarios, identificando trastornos en el metabolismo de los hidratos de carbono en el personal de blanco, teniendo en cuenta el horario laboral y actitudes alimentarias. Metodología: estudio analítico, prospectivo, observacional, de corte trasversal. Estudio enfocado en el personal de blanco del Hospital San Pablo (Asunción, Paraguay), de ambos sexos, quienes aceptaron voluntariamente participar de una encuesta de factores de riesgo para el desarrollo de durante el período de julio a diciembre de 2017. Resultados: se encontró una elevada frecuencia de factores de riesgo para en una población joven y dedicada al cuidado de la comunidad. En cuanto a la evaluación de conocimientos de los encuestados, todos describían la influencia negativa de los factores de riesgo, desconociendo ciertas peculiaridades sobre aspectos relacionados con el consumo de hidratos de carbono simples o complejos o el valor de sus niveles de lípidos. En cuanto a la percepción sobre el peso y la actividad física, manifestaron su preocupación. Conclusiones: se halló una elevada frecuencia de factores de riesgo para desarrollar prediabetes. En cuanto a la evaluación de conocimientos de los encuestados, todos describían la influencia negativa de los factores de riesgo, desconociendo ciertas peculiaridades sobre aspectos relacionados con el consumo de hidratos de carbono simples o complejos o el valor de sus niveles de lípidos

ABSTRACT Introduction: The important risk factors for the development of type 2 diabetes are obesity, dyslipidemia and hyperglycemia. The increase in the frequency of chronic noncommunicable diseases is a worldwide phenomenon and Paraguay is no exception. Objectives: To determine the frequency of developing prediabetes with respect to dietary patterns, identifying disorders in the metabolism of carbohydrates in health personnel, taking into account working hours and eating attitudes. Methodology: Analytical, prospective, observational and cross-sectional study. Study focused on the health staff of the San Pablo Hospital (Asunción, Paraguay), males and females, who voluntarily agreed to participate in a survey of risk factors for development during the period from July to December 2017. Results: A high frequency of risk factors was found in a young population dedicated to community care. In relation to the evaluation of the knowledge of respondents, all described the negative influence of the risk factors, ignoring certain peculiarities about aspects related to the consumption of simple or complex carbohydrates or the value of their lipid levels. Regarding the perception of weight and physical activity, they expressed concern. Conclusions: A high frequency of risk factors was found to develop prediabetes. Regarding the evaluation of the knowledge of respondents, all described the negative influence of risk factors, ignoring certain peculiarities about aspects related to the consumption of simple or complex carbohydrates or the value of their lipid levels.

Discrepancies between Glycosylated Hemoglobin and Fasting Plasma Glucose for Diagnosing Impaired Fasting Glucose and Diabetes Mellitus in Korean Youth and Young Adults

BACKGROUND: Glycosylated hemoglobin (HbA1c) has been recommended as a diagnostic test for prediabetes and diabetes. Here, we evaluated the level of agreement between diagnoses based on fasting plasma glucose (FPG) versus HbA1c levels and determined optimal HbA1c cutoff values for these diseases in youth and young adults. METHODS: The study included 7,332 subjects (n=4,129, aged 10 to 19 years in youth group; and n=3,203 aged 20 to 29 years in young adult group) from the 2011 to 2016 Korea National Health and Nutrition Examination Survey. Prediabetes and diabetes were defined as 100 to 125 mg/dL (impaired fasting glucose [IFG]) and ≥126 mg/dL for FPG (diabetes mellitus [DM] by FPG [DMFPG]), and 5.7% to 6.4% and ≥6.5% for HbA1c, respectively. RESULTS: In the youth group, 32.5% with IFG had an HbA1c level of 5.7% to 6.4%, and 72.2% with DMFPG had an HbA1c ≥6.5%. In the young adult group, 27.5% with IFG had an HbA1c level of 5.7% to 6.4%, and 66.6% with DMFPG had an HbA1c ≥6.5%. Kappa coefficients for agreement between the FPG and HbA1c results were 0.12 for the youth group and 0.19 for the young adult group. In receiver operating characteristic curve analysis, the optimal HbA1c cutoff for IFG and DMFPG were 5.6% and 5.9% in youths and 5.5% and 5.8% in young adults, respectively. CONCLUSION: Usefulness of HbA1c for diagnosis of IFG and DMFPG in Koreans aged <30 years remains to be determined due to discrepancies between the results of glucose- and HbA1c-based tests. Additional testing might be warranted at lower HbA1c levels to detect IFG and DMFPG in this age group.