Relación entre el Finnish Diabetes Risk Score, glucemia en ayunas y hemoglobina A1c / Relationship between the Finnish Diabetes Risk Score, fasting blood glucose and glycohemoglobin A1c

Introducción: el Finnish Diabetes Risk Score (FINDRISC) mostró alta sensibilidad y especificidad para la detección de personas que evolucionarían a diabetes mellitus (DM) en las poblaciones estudiadas, por lo cual se decidió utilizarlo entre quienes concurrieron por diferentes motivos a realizarse análisis de laboratorio en centros de la Asociación de Laboratorios de Alta Complejidad (ALAC), con el objeto de identificar personas con diferentes niveles de riesgo de presentar alteraciones de la glucemia en ayunas (GA) y de la HbA1c. Objetivos: explorar la asociación entre la puntuación del FINDRISC con GA y HbA1c, estableciendo el punto de corte de mayor sensibilidad y especificidad para encontrar una GA ≥100 mg/dL y una HbA1c ≥5,7% (38,8 mmol/mol), en una población que concurrió a centros de la ALAC. Materiales y métodos: se incluyeron 1.175 individuos de 45 laboratorios de la ALAC, procesamiento local de glucemia y centralizado de HbA1c (high performance liquid chromatography, HPLC). Análisis estadístico: chi-cuadrado, Odds Ratio, ANOVA, test de Tukey, regresión logística binomial y curvas ROC. Resultados: los puntajes totales del FINDRISC se asociaron de manera positiva y estadísticamente significativa, tanto con los valores de GA como con los niveles de HbA1c. Entre sus variables, una edad mayor o igual a 45 años, un perímetro abdominal de alto riesgo, un índice de masa corporal mayor o igual a 25 Kg/m., la presencia de antecedentes familiares de DM (padres, hermanos o hijos) y la existencia de antecedentes de medicación antihipertensiva se asociaron de manera significativa con valores de GA iguales o superiores a 100 mg/dL y/o niveles de HbA1c iguales o mayores a 5,7% (38,8 mmol/mol). No se halló asociación significativa con la realización de actividad física (al menos 30 minutos diarios) ni con el registro de ingesta diario de frutas y verduras. Los valores medios de GA y HbA1c en individuos con puntajes totales del FINDRISC menores o iguales a 11 fueron de 89,9 mg/dL y 5,2% (33,0 mmol/mol), respectivamente, elevándose hasta valores medios de 116,1 mg/dL y 6,1% (43,0 mmol/mol) en los individuos con puntajes iguales o superiores a 21, siguiendo una asociación del tipo "dosis/respuesta". Por curvas ROC, un FINDRISC de 13 presenta una sensibilidad del 81,89%, especificidad del 67,60% y 70,55% de diagnósticos correctos de HbA1c ≥5,7% (38,8 mmol/mol), y una sensibilidad del 72,50%, especificidad del 70,62% y 71,20% de diagnósticos correctos para encontrar personas con una GA ≥100 mg/dL. Conclusiones: el puntaje del FINDRISC se relacionó con niveles crecientes de GA y HbA1c, resultando útil para encontrar personas con GA ≥100 mg/dL y HbA1c ≥5,7% (38,8 mmol/mol) en la población estudiada.

Introduction: the Finnish Diabetes Risk Score (FINDRISC) has high sensitivity and specificity for the identification of people at risk of diabetes mellitus (DM) in various populations. Therefore, we aimed to use this index to identify individuals at risk of having alterations in fasting glycemia (FG) and HbA1c among those who underwent laboratory analysis at ALAC, Argentina. Objectives: to explore the relationships of the FINDRISC score with the fasting blood glucose (FG) concentration and glycated hemoglobin (HbA1c) level, and to establish appropriate cut-off scores to predict FG ≥100 mg/dL and HbA1c ≥5.7% (38.8 mmol/mol) in this population. Materials and methods: we recruited 1,175 individuals from 45 ALAC laboratories for whom FG and HbA1c had been measured. We analyzed the data using the chi square test, odds ratios, ANOVA plus Tukey's post-hoc test, binomial logistic regression, and receiver operating characteristic (ROC) curves. Results: total FINDRISC score significantly positively correlated with both FG and HbA1c. Of the constituent variables, age ≥45 years, a large waist circumference, a body mass index ≥25 kg/m., a close family history of DM, and the use of antihypertensive medication were significantly associated with FG ≥100 mg/dL and/or HbA1c ≥5.7% (38.8 mmol/mol). However, no significant association was found with physical activity or the daily consumption of fruit and vegetables. The mean FG and HbA1c for individuals with total FINDRISC scores ≤11 were 89.9 mg/dL and 5.2% (33.0 mmol/mol), respectively, which increased to 116.1 mg/dL and 6.1% (43.0 mmol/mol) for individuals with scores ≥21, with a dose/response-type relationship. ROC analysis showed that a FINDRISC of 13 was associated with a sensitivity of 81.89%, a specificity of 67.60%, and a correct diagnosis rate of 70.55% for HbA1c ≥5.7% (38.8 mmol/mol); and a sensitivity of 72.50%, a specificity of 70.62%, and a correct diagnosis rate of 71.20% for FG ≥100 mg/dL. Conclusions: FINDRISC score increases with increasing FG and HbA1c, and is a useful means of identifying people with FG ≥100 mg/dL and HbA1c ≥5.7% (38.8 mmol/mol).

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.

Prevalencia de diabetes mellitus y glucemia en ayuno alterada al momento del diagnóstico de cáncer de páncreas, en un grupo de pacientes asistidos en un centro de referencia gastroenterológico en Argentina / Prevalence of diabetes mellitus and altered fasting blood glucose at the time of pancreatic cancer diagnosis, in a group of patients assisted in a gastroenterological referral center in Argentina

Introducción: la diabetes mellitus (DM) se considera un factor de riesgo para el desarrollo de adenocarcinoma ductal de páncreas (ACDP). Objetivos: describir la prevalencia de DM y glucemia en ayuno alterada (GAA) al diagnóstico de ACDP en pacientes asistidos en un centro de referencia gastroenterológico; analizar las diferencias en las características personales y nutricionales en pacientes con ACDP y DM, ACDP y GAA, y ACDP sin DM ni GAA; establecer el tiempo transcurrido desde el diagnóstico de DM hasta diagnosticar ACDP. Materiales y métodos: de octubre de 2019 a marzo de 2020 se revisaron 465 historias clínicas de las Secciones Oncología y Nutrición de pacientes >18 años con diagnóstico de ACDP. Resultados: se registraron 171 historias clínicas (36,7%) con ACDP y DM, y 294 (63,2%) con ACDP sin DM. En el 45,1% de las primeras, el intervalo entre el diagnóstico de DM y el de ACDP fue <1 año, y en el 17,65%, 15,69% y 21,57% los lapsos correspondieron a 1 y 5 años, entre 5 y 10 años y >10 años respectivamente. Conclusiones: la prevalencia de DM en ACDP fue superior a la registrada en la población general (37% vs 12,7%), siendo del 45,10% cuando se presentó dentro del primer año del diagnóstico oncológico. Nuestros resultados concuerdan con la bibliografía internacional que relaciona la DM de reciente diagnóstico como factor asociado a la presencia de ACDP por factores de riesgo compartidos, variables fisiopatológicas de la DM o a consecuencia de la terapéutica farmacológica de la misma.

Introduction: diabetes mellitus (DM) is considered to be a risk factor for the development of pancreatic ductal adenocarcinoma (PDAC). Objectives: describe the prevalence of DM and of impaired fasting glucose (IFG) at the diagnosis of PDAC, among patients assisted in a gastroenterological reference center. Analyze differences in personal and nutritional characteristics in patients with both PDAC and DM; with both PDAC and IFG; and with PDAC but neither DM nor IFG. Determine the time lapse between the diagnosis of DM and the diagnosis of PDAC. Materials and methods: between October 2019 and March 2020, we analyzed 465 clinical records of PDAC-diagnosed patients over 18 years, from Oncology and Nutrition Sections. Results: 171 clinical records (36.7%) showed both PDAC and DM; 294 clinical records (63.2%) showed PDAC but not DM. In 45.1% of the former, the interval between the diagnosis of DM and that of PDAC was <1 year, and in 17.65%, 15.69% and 21.57%, the lapses corresponded to 1 and 5 years, between 5 and 10 years y >10 years, respectively. Conclusions: the prevalence of DM in PDAC patients (37%) is higher than that registered in the overall population (12.7%), reaching a 45.10% when detected during the first year of oncological diagnosis. Our results match the international literature relating recently-diagnosed DM with the presence of PDAC, as effect of shared risk factors between both diseases, or DM pathophysiology factors, or DM pharmacological therapeutic

Prevalence of impaired fasting blood glucose and its relationship with health check-ups in medical staff in Beijing, 2009-2015 / 中华健康管理学杂志

Objective To explore the fasting blood glucose (FBG) variation trends and the prevalence of impaired fasting blood glucose(IFG)among medical staff in Beijing, 2009-2015.Methods A prospective cohort study, using seven years of follow-up data, was conducted in a large-scale tertiary hospital in Beijing.A total of 1 284 medical staff aged 35 to 60 years were recruited.We divided them into 4 groups according to age and occupational categories,and the level of FBG was tested at the same time each year. Results The number of medical staff who completed all 7 annual FBG tests was 403. There was a stepwise increase in the levels of FBG (4.92 mmol/L, 5.26 mmol/L, and 5.60 mmol/L in the years 2009, 2012,and 2015,respectively;F=100.643,P<0.001).An increasing trend in the prevalence of IFG was also evident (3.7%, 7.7%, and 13.4% in the years 2009, 2012, and 2015, respectively; χ2=39.099, P<0.001). Compared with baseline levels(in 2009),the average levels of FBG and the prevalence of IFG in men and women, as well as in all occupational classes (doctors, nurses, technicians, and other medical employees), were significantly elevated by the year 2015 (all P<0.05). The levels of FBG in male medical staff were higher than that in female medical staff,in both 2009 and 2015(both P<0.001).Conclusion The trend of increasing FBG levels and IFG cases in medical staff,especially in men,has been a problem for hospitals. Health policy action is urgently needed to deflate the IFG bubbles.

Clinical Observation of Compound Huanglian Jiangtang Powder for Patients with Impaired Fasting Blood Glucose / 中国药房

OBJECTIVE:To observe clinical efficacy and safety of Compound huanglian jiangtang powder for patients with im-paired fasting blood glucose(FBG). METHODS:122 patients with impaired FBG were selected and randomly divided into control group and trial group with 61 cases in each group. Two groups was given healthy education and diet guidance;trial group was giv-en Compound huanglian jiangtang powder 2.5 g orally,qd. Both groups were treated for 4 months. Clinical efficacy of 2 groups was observed and FBG,TC,TG,LDL-C,HbA1c,SOD,MDA and GSH-PX levels and BMI were observed before and after treat-ment. The occurrence of ADR was recorded. RESULTS:Total effective rate of trial group was 77.0%,which was significantly higher than that of control group(24.6%),with statistical significance(P0.05);after treat-ment,above indexes of 2 groups were improved significantly,the trial group was significantly better than the control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Compound huanglian jiangtang pow-der is effective improvement of laboratory indexes and safe for impaired FBG.

Risk Factors of Impaired Fasting Glucose and Type 2 Diabetes Mellitus: Using Datamining / 한국역학회지

PURPOSE: This study aimed to contribute to overall public health by examining the prevalence rates of impaired fasting blood glucose and type 2 diabetes mellitus and developing a model to predict high risk factors for impaired fasting blood glucose and type 2 diabetes mellitus. METHODS: The 1998 Public Health Nutrition Survey data was used for this study. Subjects were 7,702 adult at the age of 20 or over. The frequency analysis, chisquared test was performed. A decision tree was utilized to define a model designed to predict high risk factors for impaired fasting glucose and type 2 diabetes mellitus. RESULTS: The prevalence rates of impaired fasting blood glucose was 10.8% and prevalence rates of type 2 diabetes mellitus was 9.4%. The decision tree analysis exhibited that age was strong factors for impaired fasting blood glucose. HDL cholesterol and kind of economic activities were high risk factors for impaired fasting blood glucose and type 2 diabetes mellitus on those in 20s. BMI, total cholesterol level, marriage status, sex for impaired fasting blood glucose and type 2 diabetes mellitus on those in 30s. The total cholesterol level, drinking and waist size were identified as risk factors on those in 40s. BMI, education level and hypertension seemed to have an impact on those in 50s. The waist size, sex and income had an impact on those in 60s. CONCLUSIONS: This study underscores the need for the public health infrastructure to improve various health promotion programs for those who have risk factors for impaired fasting blood glucose and type 2 diabetes mellius. The implementation of effective nutrition, workout and anti-drinking programs will boost public health.