[Progression toward type-2 diabetes mellitus among Mexican pre-diabetics. Assessment of a cohort]. / Progresión de prediabetes a diabetes mellitus tipo 2 en mexicanos. Evaluación en una cohorte.

BACKGROUND: Pre-diabetic Latino subjects have shown higher incidence of type 2 diabetes mellitus (DM2) compared with other populations. The incidence is unknown in the Mexican population. Our aim was to identify the annual incidence of DM2 among a Mexican pre-diabetic population. METHODS: An inception cohort of healthy Mexican patients was followed from 2001 to 2006. Those who fulfilled diagnosis of DM2 (ADA criteria) were registered at one and 2 years of follow-up among pre-diabetic and normoglucemic individuals. We compared relevant variables between both groups, those who developed diabetes and those who did not. RESULTS: 656 subjects were included; at one year, 14 patients were diagnosed with DM2, 11 among pre-diabetics, incidence of 4.5 %; 3 among normoglucemic subjects, incidence of 0.72 %. The relative risk for the development of DM2 in the pre-diabetic group was 7.7 (IC95 % 2.1-27.9), and among the normoglucemic group of 1.04 (IC95 % 1.02-1.08). At the 2nd year, DM2 incidence was 7.6 % in pre-diabetics, and 0.6 % in normoglucemics. Risk factors associated were higher fast glucose and greater BMI. CONCLUSIONS: We found a constant annual incidence of DM2 among prediabetics of 6 cases per 100 patient/year in follow-up. Higher fast glucose determinations and greater BMI are the main determinants for DM2 development.

[Factors associated with microalbuminuria in non-hypertensive type-2 diabetes patients]. / Factores asociados con microalbuminuria en pacientes diabéticos tipo 2 no hipertensos.

INTRODUCTION: Microalbuminuria is a well known risk factor for renal damage and for cardiovascular disease in type-2 diabetic patients. OBJECTIVE: To evaluate anthropometric, laboratory, and diet factors related to the presence of microalbuminuria in non-hypertensive type 2 diabetic subjects. MATERIAL AND METHODS: We carry-out an assessment of a group of non-hypertensive diabetic patients with or without microalbuminuria. Some anthropometric measures, physical fitness, tobacco and alcohol consumption, creatinine clearance, HbA1c, lipid profile, the mean fast serum glucose levels in last two years, 24 h urine protein, and caloric intake were all measured. RESULTS: From 86 included patients, 19 had microalbuminuria; it was related with the length of diabetes mellitus duration (114 +/- 55 vs. 84 +/- 67 months; p = 0.03), higher HbA1c level (8.9 vs. 7.1%; p = 0.001), and lower HDL-cholesterol levels (37.7 +/- 11 vs. 42.9 +/- 12 mg/dL; p = 0.03). In the multivariate analysis HbA1c level, and mean fast glucose remained significant. CONCLUSIONS: In non-hypertensive diabetic subjects, poor glucose control, and longer disease duration were both related with microalbuminuria. Moreover, caloric intake, exercise, tobacco or alcohol consumption, or BMI did not show association with microalbuminuria.