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.

Intermittent fasting for health care, a review / El ayuno intermitente, ¿un éxito o una desventaja para el cuidado de la salud?

The incidence of obesity and overweight in the world has been increasing in recent years due to poor diet and lack of physical activity; people suffering obesity and overweight, related with malnutrition due to excess, often resort to calorie restriction diets that are usually not very effective. In this context, intermittent fasting (IF) has become popular due to the possibilities for weight loss that it offers. This diet consists of alternating periods of fasting with unrestricted eating; however, its effectiveness and consequences are unknown to most users. This narrative review analyzes whether intermittent fasting contributes to the improvement of body and metabolic composition. The purpose of the review was to examine the available data on the contribution of intermittent fasting to the improvement of body and metabolic composition, in order to provide information and to define the parameters that condition safe achievement of its benefits. IF dieting triggers adaptive cell responses that cause a decrease in lipid oxidative stress markers in individuals with obesity and prediabetes. Metabolic alterations have been found to go hand in hand with the alteration of circadian rhythms; if IF contributes to this effect, it may assist in treating and preventing obesity and associated diseases. However, there are also disadvantages, such as the loss of lean muscle mass by wasting, and increased hypoglycemia(AU)

La incidencia de obesidad y sobrepeso en el mundo ha ido en aumento en los últimos años debido a la mala alimentación y la falta de actividad física; Las personas que padecen obesidad y sobrepeso, relacionadas con la desnutrición por exceso, suelen recurrir a dietas de restricción calórica que suelen ser poco efectivas. En este contexto, el ayuno intermitente (AI) se ha popularizado debido a las posibilidades de pérdida de peso que ofrece. Esta dieta consiste en alternar períodos de ayuno con alimentación sin restricciones; sin embargo, su eficacia y consecuencias son desconocidas para la mayoría de los usuarios. Esta revisión narrativa analiza si el ayuno intermitente contribuye a la mejora de la composición corporal y metabólica. El objetivo de la revisión fue examinar los datos disponibles sobre la contribución del ayuno intermitente a la mejora de la composición corporal y metabólica, con el fin de aportar información y definir los parámetros que condicionan la consecución segura de sus beneficios. Se ha encontrado que las alteraciones metabólicas van de la mano con la alteración de los ritmos circadianos; si AI contribuye a este efecto, puede ayudar a tratar y prevenir la obesidad y las enfermedades asociadas. Sin embargo, también existen desventajas, como la pérdida de masa muscular magra por atrofia y el aumento de la hipoglucemia(AU)

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.

Opiniones y recomendaciones de la Sociedad Argentina de Diabetes. Hemoglobina A1c / Opinions and recommendations of the Argentine Diabetes Society. Hemoglobin A1c

La estandarización de la hemoglobina A1c (HbA1c) permitió en algunos países su uso para el diagnóstico de la diabetes mellitus (DM) y la prediabetes, además de su empleo en el seguimiento del paciente con DM. Es importante recordar que se trata de una medida indirecta del promedio glucémico durante el tiempo de vida media del eritrocito, pudiendo verse afectada por variables no glucémicas, como también por interferencias analíticas según la metodología empleada para su determinación. A continuación, se describen las recomendaciones y consideraciones a tener en cuenta para la determinación de la HbA1c cuando se emplea como criterio diagnóstico de la DM, teniendo en cuenta que al utilizarla para tal fin es necesario que la medida se realice con métodos certificados y estandarizados al ensayo utilizado en el Diabetes Control and Complications Trial (DCCT).

The standardization of hemoglobin A1c (HbA1c) allowed in some countries its use for the diagnosis of diabetes mellitus (DM) and prediabetes, in addition to its use in the follow-up of patients with DM. It is important to highlight that it is an indirect measurement of the glycemic average during the halflife of the erythrocyte, and may be affected by non-glycemic variables, as well as by analytical interferences depending on the methodology used for its determination. The recommendations and considerations to take into account for the determination of HbA1c when it is used as a diagnostic criterion for diabetes are described below. In addition, it is important to emphasize that it is essential that the HbA1c measurement be performed with certified and standardized methods to the Diabetes Control and Complications Trial (DCCT)results.

Opiniones y recomendaciones de la Sociedad Argentina de Diabetes. Glucemia en ayunas alterada: ¿es oportuno utilizar el punto de corte en 100 mg/dl en Argentina? / Opinions and recommendations of the Argentine Diabetes Society. Impaired fasting blood glucose: is it appropriate to use a cut-off point of 100 mg/dl in Argentina?

Establecer el punto de corte entre la glucemia en ayunas normal y la alterada resulta de suma importancia a los efectos de considerar a un paciente en riesgo, tanto de progresar a estdos más avanzados de la enfermedad como de sufrir complicaciones micro y macroangiopáticas. Desde 2006 la Sociedad Argentina de Diabetes (SAD), sobre la base de la evidencia considerada en ese momento, estableció el límite inferior de la glucemia alterada en ayunas (GAA) en 110 mg/dl; posteriormente, durante 2022, la Comisión Directiva de la SAD convocó a un grupo de expertos con el objeto de evaluar si esta recomendación debía mantenerse o, al igual que otras sociedades científicas de prestigio, adoptar a tal efecto 100 mg/dl. En este documento de Opiniones y Recomendaciones se encuentran los fundamentos por los cuales la SAD adoptará, de ahora en más, 100 mg/dl como límite inferior de la GAA, en base a las nuevas evidencias científicas que muestran que desde este punto de corte se produce un aumento en la progresión a la diabetes mellitus y de las complicaciones tanto macro como microangiopáticas.

To establish the cut-off point between normal and impaired fasting glycemia (IFG) is extremely important for the purposes of considering a patient at risk both of progressing to more advanced stages of the disease and of suffering micro- and macroangiopathic complications. Since 2006, the Argentine Diabetes Society (ADS), based on the evidence considered at that time, established the lower limit of IFG at 110 mg/d, laterduring the year 2022, The Board of Directors of the ADS vened a group of experts in order to assess whether this recommendation should be maintained or, like other prestigious scientific societies, adopt 100 mg/dl for this purpose. This Opinions and Recommendations document contains therationale for which the SAD will adopt, from now on, 100 mg/dlas the lower limit of the IFG, based on the new scientific edence that shows that from this cut-off point it produces increase in progression to diabetes and both macro and microangiopathic complications.

Mechanism of Huangjing Qianshi Decoction in treatment of prediabetic mice based on transcriptome sequencing / 中国中药杂志

Based on transcriptome sequencing technology, the mouse model of prediabetes treated with Huangjing Qianshi Decoction was sequenced to explore the possible mechanism of treating prediabetes. First of all, transcriptome sequencing was performed on the normal BKS-DB mouse group, the prediabetic model group, and the Huangjing Qianshi Decoction treatment group(treatment group) to obtain differentially expressed genes in the skeletal muscle samples of mice. The serum biochemical indexes were detected in each group to screen out the core genes of Huangjing Qianshi Decoction in prediabetes. Gene Ontology(GO) database and Kyoto Encyclopedia of Genes and Genomes(KEGG) database were used to conduct signaling pathway enrichment analysis of differentially expressed genes, and real-time quantitative polymerase chain reaction(RT-qPCR) was used to verify them. The results showed that the levels of fasting blood glucose(FBG), fasting insulin(FINS), insulin resistance index(HOMA-IR), total cholesterol(TC), triglycerides(TG), and low-density lipoprotein cholesterol(LDL-C) in the mouse model were significantly decreased after treatment with Huangjing Qianshi Decoction. In the results of differential gene screening, there were 1 666 differentially expressed genes in the model group as compared with the normal group, and there were 971 differentially expressed genes in the treatment group as compared with the model group. Among them, interleukin-6(IL-6) and NR3C2 genes, which were closely related to the regulation of insulin resis-tance function, were significantly up-regulated between the model group and the normal group, and vascular endothelial growth factor A(VEGFA) genes were significantly down-regulated between the model group and the normal group. However, the expression results of IL-6, NR3C2, and VEGFA genes were adverse between the treatment group and the model group. GO functional enrichment analysis found that the biological process annotation mainly focused on cell synthesis, cycle, and metabolism; cell component annotation mainly focused on organelles and internal components; and molecular function annotation mainly focused on binding molecular functions. KEGG pathway enrichment analysis found that it involved the protein tyrosine kinase 6(PTK6) pathway, CD28-dependent phosphoinositide 3-kinase/protein kinase B(PI3K/AKT) pathway, p53 pathway, etc. Therefore, Huangjing Qianshi Decoction can improve the state of prediabetes, and the mechanism may be related to cell cycle and apoptosis, PI3K/AKT pathway, p53 pathway, and other biological pathways regulated by IL-6, NR3C2, and VEGFA.

Concordance of self-reporting of diabetes compared with medical records: A comparative study using polyclinic data in Singapore

INTRODUCTION@#Studies of concordance between patients' self-report of diseases and a criterion standard (e.g. chart review) are usually conducted in epidemiological studies to evaluate the agreement of self-reported data for use in public health research. To our knowledge, there are no published studies on concordance for highly prevalent chronic diseases such as diabetes and pre-diabetes. The aims of this study were to evaluate the concordance between patients' self-report and their medical records of diabetes and pre-diabetes diagnoses, and to identify factors associated with diabetes concordance.@*METHOD@#A cross-sectional, interviewer-administered survey was conducted on patients with chronic diseases after obtaining written consent to assess their medical notes. Interviewers were blinded to the participants' profiles. Concordance was evaluated using Cohen's kappa (κ). A multivariable logistic regression model was used to identify factors associated with diabetes concordance.@*RESULTS@#There was substantial agreement between self-reported and medical records of diabetes diagnoses (κ=0.76) and fair agreement for pre-diabetes diagnoses (κ=0.36). The logistic regression model suggested that non-Chinese patients had higher odds of diabetes concordance than Chinese patients (odds ratio [OR]=4.10, 95% confidence interval [CI] 1.19-14.13, P=0.03). Patients with 3 or more chronic diseases (i.e. multimorbidity) had lower odds of diabetes concordance than patients without multimorbidity (OR=0.21, 95% CI 0.09-0.48, P<0.001).@*CONCLUSION@#Diabetes concordance was substantial, supporting the use of self-report of diabetes by patients with chronic diseases in the primary care setting for future research. Pre-diabetes concordance was fair and may have important clinical implications. Further studies to explore and improve health literacy and patient-physician communication are needed.

Relationship between hemoglobin and serum uric acid in adults with various glucose metabolism status / 中华预防医学杂志

Objective: To investigate the relationship between hemoglobin and serum uric acid in adults with various glucose metabolism status. Methods: The demographic data and biochemical indicators of the adult population who had received physical examination in the Second Medical Center of the PLA General Hospital from January 2018 to December 2021 were collected. The subjects were divided into two groups according to the level of serum uric acid: the normal uric acid group and the hyperuricemia group. The relationship between hemoglobin (stratified into four levels of Q1 to Q4 by the quartile) and serum uric acid was quantified by using Pearson correlation and logistic regression analysis. The effects of age and glucose metabolism status on the relationship between hemoglobin and serum uric acid were analyzed. Results: A total of 33 183 adults were enrolled with age (50.6±10.0) years. The level of hemoglobin in the normal uric acid group (142.61±14.24) g/L was significantly lower than that in the hyperuricemia group [(151.79±11.24) g/L, P<0.001]. Univariate Pearson correlation analysis showed that hemoglobin was positively associated with serum uric acid (r=0.444, P<0.001). After adjusting for related confounding factors, multivariate logistic regression analysis showed that hemoglobin was associated with serum uric acid, and the OR values (95%CI) of hemoglobin Q2 to Q4 group were 1.29 (1.13-1.48), 1.42 (1.24-1.62) and 1.51 (1.32-1.72), respectively (Ptrend<0.001) when compared with hemoglobin Q1 group. Subgroup analysis and hierarchical interaction analysis suggested that with the increase of hemoglobin, the serum uric acid in the age<60 years subgroup, normal glucose subgroup and prediabetes subgroup increased gradually (Ptrend<0.05 and Pinteraction<0.001). Conclusion: The association between hemoglobin and serum uric acid in adults is affected by age and glucose metabolism status.

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

Glucemia en ayunas entre 100 y 109 mg/dL versus prediabetes según hemoglobina glicosilada / Fasting blood glucose between 100 and 109 mg/dL versus prediabetes according to glycosylated hemoglobin

Introducción: algunos estudios han señalado que valores de glucemia en ayunas entre 100 y 109 mg/dL se asocian con frecuencias elevadas de prediabetes cuando el criterio de clasificación son los valores de HbA1c. La Sociedad Argentina de Diabetes (SAD) sostiene a 110 mg/dL como valor a partir del cual se clasifica a un paciente como portador de glucemia en ayunas alterada; la frecuencia de individuos posiblemente clasificados en forma incorrecta, según este criterio, aún no se conoce en la población argentina. Objetivos: establecer la frecuencia con que se presenta prediabetes según HbA1c en una población sin diagnóstico de diabetes mellitus (DM) con glucemias en ayunas entre 100 y 109 mg/dL; correlacionar las dos variables y cuantificar la probabilidad de que esto ocurra respecto de otros con glucemias en ayunas <100 mg/dL. Materiales y métodos: se incluyeron 1.002 muestras de igual número de sujetos desde 45 laboratorios de análisis clínicos de la Asociación de Laboratorios de Alta Complejidad (ALAC), con procesamiento local de glucemia y centralizado de HbA1c por high performance liquid chromatography (HPLC). Análisis estadístico: chi cuadrado, odds ratio, coeficiente de correlación y determinación de Pearson, y correlación serial de Durbin-Watson. Resultados: frecuencia de HbA1c ≥5,7% en la población estudiada con glucemias de ayunas entre 100 y 109 mg/dL=29,7%; test de chi cuadrado: p<0,001; odds ratio de tener HbA1c ≥5,7% entre la población con glucemias en ayunas de 100 a 109 mg/dL vs aquella con valores <100 mg/dL=4,328 (IC 95% 2,922-6,411); r=0,852, r2 = 0,727, Durbin-Watson=1,152. Conclusiones: la prediabetes diagnosticada por HbA1c resultó cuatro veces más frecuente en la población estudiada con glucemias en ayunas entre 100 y 109 mg/dL, que en aquella con valores por debajo de 100 mg/dL.

Introduction: some studies have shown that fasting blood glucose values between 100 and 109 mg/dL are associated with high rates of prediabetes when the classification criteria are HbA1c values. The Argentine Diabetes Society still maintains 110 mg/dL as the value from which a patient is classified as having impaired fasting blood glucose; the frequency of individuals possibly incorrectly classified, according to this criterion, is not yet known in any Argentine population. Objectives: to establish the frequency in a population without a diagnosis of diabetes mellitus with fasting blood glucose levels between 100 and 109 mg/dL in which prediabetes occurs according to HbA1c, to correlate both variables and to quantify the probability that this predicts with respect to others with fasting blood glucose levels <100 mg/dL. Materials and methods: 1.002 samples from the same number of subjects from 45 clinical laboratories belonging to ALAC, with local processing of blood glucose and centralized processing of HbA1c by high performance liquid chromatography (HPLC). Statistical analysis: chi square, odds ratio, Pearson correlation coefficient, coefficient of determination and Durbin-Watson serial correlation. Results: frequency of HbA1c ≥5.7% in the studied population with fasting blood glucose levels between 100 and 109 mg/ dL = 29.7%, chi square test: p<0.001; odds ratio of having HbA1c ≥5.7% between the population with fasting blood glucose levels of 100 to 109 mg/dL vs that one with values <100 mg/dL=4.328 (95% CI 2.922-6.411); r=0.852, r2 =0.727, DurbinWatson=1.152. Conclusions: prediabetes diagnosed by HbA1c was four times more frequent in the studied population with fasting glucose values between 100 and 109 mg/dL than in that one with values below 100 mg/dL.

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.

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.

Year Risk of Developing Type 2 Diabetes Mellitus ­ A Survey of Rural Communities in Southern Nigeria

BACKGROUND: The exponential rise in the prevalence of Type 2 Diabetes (T2DM) necessitates the introduction of strategies for early diagnosis to reduce the burden of the disease. This study assessed the prevalence of prediabetes and also determined the 10-year risk of developing T2DM in Southern Nigerian rural communities by adopting the validated Finnish Diabetes Risk Score (FINDRISC) tool. METHODS: 273 participants from 3 Southern rural communities aged 18 years and older were recruited in this cross-sectional study.Data in the FINDRISC stratification tool and Random Blood Glucose (RBG) variables were obtained for the participants. IBM SPSS version 21 was used to analyze the data with a level of significance put at p< 0.05. RESULTS: The participants' mean age was 54.20±16.61 years. The prevalence of prediabetes among the study participants based on RBG was 4.8% (3.8% of males and 6.6% of females, respectively).Most of the study participants (41%) had a low risk of developing T2DM which meant that 1 in 100 participants would become diabetic in a 10-year period, based on the FINDRISC scale. Amongst the male participants, the Total Diabetes Risk Score (TDRS) showed significant positive correlation with the RBG (r=0.315, p=0.001); similarly, a weak positive correlation between TDRS and RBG was noted among female participants. CONCLUSION: The propensity of developing T2DM in 10 years was indisputably low amongst rural dwellers in the Southern Nigerian rural communities studied. Further studies to compare the risk of developing T2DM between rural and urban communities would be required

Prevalence of diabetes mellitus among Uygur children in Hotan Prefecture of Xinjiang, China / 中国当代儿科杂志

OBJECTIVES@#To investigate the prevalence of diabetes mellitus (DM) among Uygur children in Hotan Prefecture of Xinjiang, China, as well as the factors influencing the development of DM.@*METHODS@#The cluster random sampling method was used to select 5 308 children, aged 4-18 years, from the middle and primary schools and kindergartens in Hotan Prefecture of Xinjiang. The survey methods included questionnaire survey and the measurement of height and weight. All subjects were tested for fasting fingertip blood glucose to investigate the prevalence of DM and impaired fasting glucose (IFG).@*RESULTS@#A total of 5 184 valid questionnaires were collected. Fourteen children (0.27%) were found to have DM, among whom 8 had type 1 DM, 2 had type 2 DM, and 4 had unclassified DM. Twenty-nine children (0.56%) were found to have IFG. There was no significant difference in the prevalence rate of DM and IFG between boys and girls (P>0.05). The prevalence rate of DM was 0.18% in the 4-<10 years group, 0.47% in the 10-<15 years group, and 0.07% in the 15-18 years group (P=0.072).The prevalence rate of IFG in the above three age groups was 0.18%, 0.94%, and 0.42%, respectively, with a significant difference among groups (P=0.007). The proportion of family history of DM and the proportion of overweight/obesity in children with DM were significantly higher than those in children without DM (P<0.05), while the proportion of children with DM who preferred coarse grains was significantly lower than that in children without DM (P<0.05).@*CONCLUSIONS@#The prevalence of DM and IFG in Uyghur children in Hotan Prefecture of Xinjiang is relatively low. There is no significant difference in the prevalence of DM among children of different genders or age groups, but the prevalence of IFG in children of different age groups is different. A family history of DM, overweight or obesity, and low intake of coarse grains might be associated with the development of DM.

Mechanism of Huangjing Qianshi Decoction in treatment of prediabetes based on network pharmacology and molecular docking / 中国中药杂志

This study analyzed the molecular mechanism of Huangjing Qianshi Decoction(HQD) in the treatment of prediabetes based on network pharmacology and molecular docking. The active components of HQD were identified and screened based on Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP, http://Lsp.nwu.edu.cn/tcmsp.php) and then the targets of the components and the genes related to prediabetes were retrieved, followed by identifying the common targets of the decoction and the disease. The medicinal component-target network was constructed by Cytoscape to screen key components. The protein-protein interaction(PPI) network was established by STRING and hub genes were identified by Cytoscape-CytoNCA, followed by Gene Ontology(GO) term enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG) of the hub genes with R-clusterProfi-ler. Thereby, the possible signaling pathways were predicted and the molecular mechanism was deduced. A total of 79 active components of HQD and 785 diabetes-related targets of the components were screened out. The hub genes mainly involved the GO terms of tricarboxylic acid cycle, peptide binding, amide binding, hydrolase activity, and kinase activity regulation, and the KEGG pathways of AGE-RAGE signaling pathway, TNF signaling pathway, AMPK signaling pathway, IL-17 signaling pathway, and insulin signaling pathway. Western blot result showed that HQD-containing serum significantly reduced the expression of AKT1, AGE, and RAGE proteins in insulin resistance model cells. HQD's treatment of prediabetes is characterized by multiple pathways, multiple targets, and multiple levels. The main mechanism is that the components zhonghualiaoine, baicalein, kaempferol, and luteolin act on AKT1 and inhibit the AGE-RAGE axis.

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.

Señales aterogénicas tempranas y aterosclerosis subclínica en niños y adolescentes con diagnóstico reciente de prediabetes / Early atherogenic signs and atherosclerosis subclinical in childrenand adolescents with a recent diagnosis of prediabetes

Introducción: el inicio de la prediabetes en edades pediá-tricas se ha convertido en un problema cada vez más frecuente, donde la obesidad juega un papel relevante. Los pacientes con prediabetes en la infancia presentan una alta prevalencia de señales aterogénicas tempranas (SAT), las cuales constituyen factores de riesgo para enfermedad cardiovascular, esto conduce a una alteración precoz de la función endotelial. Objetivo: determinar la asociación entre las SAT detectadas y la aterosclerosis subclínica en niños y adolescentes con diagnóstico reciente de prediabetes. Método: se realizó un estudio descriptivo y transversal con 31 niños y adolescentes entre 5 y 18 años de edad con diagnóstico reciente de prediabetes, atendidos en el Instituto de Endocrinología de Cuba, durante noviembre 2015 a noviembre 2016. Las principales variables estudiadas fueron: edad, sexo, antecedentes patológicos familiares y personales, presencia de obesidad abdominal, tensión arterial, lipidograma, resistencia a la insulina, disfunción endo-telial (DE) y grosor íntima media carotideo (GIMC). Resultados: predominaron los adolescentes, el sexo masculino, los antecedentes familiares de diabetes mellitus tipo 2 y personales de obesidad. La obesidad abdominal, tensión arterial normal, lipidograma normal y resistencia insulínica caracterizaron a los pacientes. Se detectó DE en el 19,3 % de los pacientes y GIMC aumentado en el 58 %. En los pacientes con DE y GIMC aumentado, predominó la obesidad abdominal y la resistencia a la insulina. Conclusiones: desde el momento del diagnóstico de la prediabetes puede existir aterosclerosis subclínica en niños y adolescentes que presentan varias SAT asociadas. (AU)

Introduction: The onset of prediabetes at pediatric ages has become in a frequent problem, where obesity plays a relevant role. Patients with prediabetes in childhood have a high prevalence of early atherogenic signs, wich are risk factors for cardiovascular disease and endothelial dysfunction. Objective: To determine the association between the early atherogenic signs and subclinical atherosclerosis in children and adolescents with a recent diagnosis of prediabetes. Method: A descriptive and cross-sectional study was conducted with 31 children and adolescents between 5 and 18 years of age with recent diagnosis (up to 3 months) of prediabetes, attended at the National Institute of Endocrinology of Cuba from November 2015 to November 2016. The mains variables studied were age, sex, family and personal pathological history, presence of abdominal obesity, blood pressure, lipidograma, insulin resistance, endothelial dysfunction (ED) and carotid intima-media thickness (CIMT). Results: The male adolescents, family history of type 2 diabetes and personal of obesity prevailed. Abdominal obesity, normal blood pressure, normal lipidograma and insulin resistance characterized the patients. ED was detected in 19, 3% of the patients and CIMT increased in 58%. Abdominal obesity and insulin resistance predominated in patients with ED and CIMT increased. Conclusions: From the time of diagnosis of prediabetes there may be subclinical atherosclerosis in children and adolescents with several early atherogenic signs associated.

Riesgo estimado de padecer diabetes mellitus tipo 2 en pacientes hipertensos con tratamiento farmacológico / Estimate Risk of Presenting Type 2 Diabetes Mellitus in Hypertensive Patients under Pharmacological Treatment

Introducción: La diabetes mellitus es un reto para los sistemas de salud pública de todas las naciones. Objetivo: Identificar el riesgo de padecer diabetes mellitus tipo 2 en pacientes que debutaron con hipertensión arterial que tienen tratamiento farmacológico. Métodos: Se realizó un estudio observacional, descriptivo de tipo serie de casos. El universo estuvo constituido por los 74 pacientes pertenecientes al área de salud del Policlínico Docente Universitario Alex Urquiola Marrero que debutaron con hipertensión arterial, en el año 2019; se estudió todo el universo. Las variables estudiadas fueron: edad, sexo, factores de riesgo asociados a la diabetes mellitus, antecedentes familiares de diabetes mellitus y riesgo de padecer diabetes mellitus. Luego de recolectar la información, esta fue digitalizada para su posterior procesamiento. La base de datos y su procesamiento se realizó utilizando el paquete de programas estadísticos SPSS. Se utilizó la escala Finnish Diabetes Risk Score para calcular el riesgo de padecer diabetes mellitus tipo 2. Resultados: 40 pacientes pertenecían al sexo masculino; 29,7 por ciento estaban entre 55 y 64 años; obesidad, sedentarismo y hábitos alimentarios inadecuados estuvieron presentes en más del 50 por ciento de los pacientes; 59,5 por ciento tenían antecedentes familiares de diabetes mellitus de 2do grado; 52,7 por ciento presentaron riesgo de padecer diabetes mellitus tipo 2 alto o muy alto. Conclusiones: En pacientes con hipertensión arterial de debut el riesgo de padecer diabetes mellitus tipo 2 es predominantemente alto y muy alto(AU)

Introduction: Diabetes mellitus is a challenge for the public health systems of all nations. Objective: To identify the risk of suffering type 2 diabetes mellitus in patients who debuted with arterial hypertension under pharmacological treatment. Methods: An observational, descriptive study pf case series was carried out. The universe was made up of the 74 patients belonging to the health area of Alex Urquiola Marrero University Teaching Polyclinic who debuted with arterial hypertension in 2019. The entire universe was studied. The variables studied were age, sex, risk factors associated with diabetes mellitus, family history of diabetes mellitus, and risk of suffering from diabetes mellitus. After collecting the information, it was entered into computer software for further processing. The database was processed using the SPSS statistical software package. The Finnish Diabetes Risk Score was used to calculate the risk of suffering from type 2 diabetes mellitus. Results: Of the total of patients, 40 belonged to the male sex. 29.7 percent were aged 55-64 years. Obesity, sedentary lifestyle and inadequate eating habits were present in more than 50 percent of the patients. 59.5 percent had a family history of diabetes mellitus, through a second-degree relative. 52.7 percent had a high or very high risk of suffering from type 2 diabetes mellitus. Conclusions: In patients who debuted with hypertension, the risk of suffering from type 2 diabetes mellitus is predominantly high or very high(AU)

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.