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A window of opportunity against diabetes: frequency of microvascular and macrovascular complications in prediabetes

Yıl 2023, Cilt: 9 Sayı: 1, 116 - 123, 04.01.2023
https://doi.org/10.18621/eurj.880152

Öz

Objectives: To determine the chronic complications of diabetes mellitus (DM) in patients with prediabetes, and to compare prediabetics with normoglycemic group participants in terms of the presence of the complications of DM.


Methods:
An observational study was conducted between December 2018 to April 2019. The patients aged 18-65 years were recruited from an internal medicine outpatient clinic of a tertiary care hospital. A total of 106 prediabetic patients and 54 normoglycemic subjects were included to the study. OGTT-0th, OGTT-2nd and HbA1c levels, lipid parameters, blood pressure, the homeostasis model assessment of insulin resistan (HOMA-IR), body mass index (BMI) were estimated. Nephropathy (urine protein/urine creatinine ratio, serum creatinine [sCre], Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI] equation-- creatinine clearance), retinopathy by dilated fundus examination and neuropathy (10-g monofilament testing and electroneuromyography [ENMG]) were assessed.


Results:
Age, gender, BMI, HOMA-IR, smoking status, lipid parameters, systolic blood pressure were similar in both groups. The values of oral glucose tolerance test (OGTT)-0th, OGTT-2nd and glycated hemoglobin (HbA1c) were higher in prediabetics. Although not statistically significant, proteinuria was slightly more occurred in the prediabetics than the controls. sCre was significantly higher, and CKD-EPI equation was significantly lower in prediabetics than in controls (p = 0.012, p = 0.001, respectively). We did not detected diabetic retinopathy in any participants. Neuropathy was slightly more occured in prediabetics, but it was not significantly different (p = 0.309). There were no correlation between sCre, CKD-EPI, proteinuria and age, BMI, HOMA-IR, OGTT-0th, OGTT-2nd, and HbA1c.


Conclusions:
Managing the prediabetes by early diagnosis is very meaningful in terms of prevention from DM and its complications. So, prediabetes may be a window of opportunity for diabetes associated morbidity.

Teşekkür

Dr. Kemal Erol

Kaynakça

  • 1. American Diabetes Association. Standards of medical care in diabetes-2017. Diabetes Care 2017;40:S11-24.
  • 2. Gao HX, Regier EE, Close KL. Prevalence of and trends in diabetes among adults in the United States, 1988-2012. J Diabetes 2016;8:8-9.
  • 3. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al.; TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28:169-80.
  • 4. Price HI, Agnew MD, Gamble JM. Comparative cardiovascular morbidity and mortality in patients taking different insulin regimens for type 2 diabetes: a systematic review. BMJ Open 2015;5:e006341.
  • 5. Chuah LL, Papamargaritis D, Pillai D, Krishnamoorthy A, le Roux CW. Morbidity and mortality of diabetes with surgery. Nutr Hosp 2013;28 Suppl 2:47-52.
  • 6. Kong LN, Hu P, Yang L, Cui D. The effectiveness of peer support on self-efficacy and quality of life in adults with type 2 diabetes: A systematic review and meta-analysis. J Adv Nurs 2019;75:711-22.
  • 7. Stefan N, Fritsche A, Schick F, Haring HU. Phenotypes of prediabetes and stratification of cardiometabolic risk. Lancet Diabetes Endocrinol 2016;4:789-98.
  • 8. Abdul-Ghani M, DeFronzo RA, Jayyousi A. Prediabetes and risk of diabetes and associated complications: impaired fasting glucose versus impaired glucose tolerance: does it matter? Curr Opin Clin Nutr Metab Care 2016;19:394-9.
  • 9. Huang D, Refaat M, Mohammedi K, Jayyousi A, Al Suwaidi J, Khalil CA. Macrovascular complications in patients with diabetes and prediabetes. Biomed Res Int 2017;2017:7839101.
  • 10. Gerstein HC, Pogue J, Mann JF, Lonn E, Dagenais GR, McQueen M, et al.; HOPE investigators. The relationship between dysglycaemia and cardiovascular and renal risk in diabetic and non-diabetic participants in the HOPE study: a prospective epidemiological analysis. Diabetologia 2005;48:1749-55.
  • 11. Unwin N, Shaw J, Zimmet P, Alberti KGMM. Impaired glucose tolerance and impaired fasting glycaemia: the current status on definition and intervention. Diabet Med 2002;19:708-23.
  • 12. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000;894: i–xii, 1-253.
  • 13. Haffner SM, Miettinen H, Stern MP. The homeostasis model in the San Antonio Heart Study. Diabetes Care 1997;20:1087-92.
  • 14. Levey AS, Stevens LA, Schmid CH, Zhang Y, Castro AF, Feldman HI. A new equation to estimate glomerular filtration rate. Ann Intern Med 2009;150:604-12.
  • 15. American Diabetes Association. Standards of medical care in diabetes-2017. Diabetes Care 2017;40:S88-99.
  • 16. England JD, Gronseth GS, Franklin G, Miller RG, Asbury AK, Carter GT, et al.; American Academy of Neurology; American Association of Electrodiagnostic Medicine; American Academy of Physical Medicine and Rehabilitation. Distal symmetric polyneuropathy: a definition for clinical research: report of the American Academy of Neurology, the American Association of Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology 2005;64:199-207.
  • 17. DECODE Study Group, European Diabetes Epidemiology Group. Is the current definition for diabetes relevant to mortality risk from all causes and cardiovascular and noncardiovascular diseases? Diabetes Care 2003;26:688-96.
  • 18. Erman O, Erman A, Vodonos A, Gafter U, van Dijk DJ. A new cutoff for abnormal proteinuria in diabetes mellitus patients: relationship to albuminuria. Isr Med Assoc J 2016;18:418-21.
  • 19. Culleton BF, Larson MG, Parfrey PS, Kannel WB, Levy D. Proteinuria as a risk factor for cardiovascular disease and mortality in older people: a prospective study. Am J Med 2000;109:1-8.
  • 20. Bahar A, Makhlough A, Yousefi A, Kashi Z, Abediankenari S. Correlation between prediabetes conditions and microalbuminuria. Nephrourol Mon 2013;5:741-4.
  • 21. Meigs JB, D'Agostino RB, Sr, Nathan DM, Rifai N, Wilson PWF, Framingham Offspring Study. Longitudinal association of glycemia and microalbuminuria: the Framingham Offspring Study. Diabetes Care 2002;25:977-83.
  • 22. Sato Y, Yano Y, Fujimoto S, Konta T, Iseki K, Moriyama T, et al. Glycohemoglobin not as predictive as fasting glucose as a measure of prediabetes in predicting proteinuria. Nephrol Dial Transplant 2012;27:3862-68.
  • 23. Okada R, Yasuda Y, Tsushita K, Waka K, Hamajima N, Matsuo S. Trace proteinuria by dipstick screening is associated with metabolic syndrome, hypertension, and diabetes. Clin Exp Nephrol 2018;22:1387-94.
  • 24. Abdul-Ghani MA, Tripathy D, DeFronzo RA. Contributions of betacell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose. Diabetes Care 2006;29:1130-9.
  • 25. Echouffo-Tcheugui JB, Narayan KM, Weisman D, Golden SH, aar BG. Association between prediabetes and risk of chronic kidney disease: a systematic review and meta-analysis. Diabet Med 2016;33:1615-24.
  • 26. Ritz E, Koleganova N, Piecha G. Is there an obesity-metabolic syndrome related glomerulopathy? Curr Opin Nephrol Hypertens 2011;20:44-9.
  • 27. Fox CS, Larson MG, Leip EP, Meigs JB, Wilson PWF, Levy D. Glycemic status and development of kidney disease: the Framingham Heart Study. Diabetes Care 2005;28:2436-40.
  • 28. Selvin E, Ning Y, Steffes MW, Bash LD, Klein R, Wong TY, et al. Glycated hemoglobin and the risk of kidney disease and retinopathy in adults with and without diabetes. Diabetes 2011;60:298-305.
  • 29. Sun F, Tao Q, Zhan S. Metabolic syndrome and the development of chronic kidney disease among 118 924 non-diabetic Taiwanese in a retrospective cohort. Nephrology (Carlton) 2010;15:84-92.
  • 30. Kawata I, Koshi T, Hirabayashi K, Koike H, Sato Y, Yamashita K, et al. Prediabetes defined by the International Expert Committee as a risk for development of glomerular hyperfiltration. Acta Diabetol 2019;56:525-9.
  • 31. Melsom T, Schei J, Stefansson VTN, Solbu MD, Jensen TG, Mathisen UD, et al. Prediabetes and risk of glomerular hyperfiltration and albuminuria in the general nondiabetic population: a prospective cohort study. Am J Kidney Dis 2016;67:841-50.
  • 32. Zaleska-Żmijewska A, Piątkiewicz P, Śmigielska B, Sokolowska-Oracz A, Wawrzyniak ZM, Romaniuk D, et al. Retinal photoreceptors and microvascular changes in prediabetes measured with adaptive optics (rtx1™): a case-control study. J Diabetes Res 2017;2017:4174292.
  • 33. Franklin GM, Kahn LB, Baxter J, Marshall JA, Hamman RF. Sensory neuropathy in non-insulin-dependent diabetes mellitus. The San Luis Valley Diabetes Study. Am J Epidemiol 1990;131:633-43.
  • 34. Dyck PJ, Clark VM, Overland CJ, Davies JL, Pach JM, Dyck PJB, et al. Impaired glycemia and diabetic polyneuropathy: the OC IG Survey. Diabetes Care 2012;35:584-91.
  • 35. Ziegler D, Rathmann W, Dickhaus T, Meisinger C, Mielck A.; KORA Study Group. Neuropathic pain in diabetes, prediabetes and normal glucose tolerance: the MONICA/KORA Augsburg Surveys S2 and S3. Pain Med 2009;10:393-400.
  • 36. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. JAMA 1999;282:153-8.
  • 37. Aroori S, Spence RA. Carpal tunnel syndrome. Ulster Medical J 2008;77:6-17.
Yıl 2023, Cilt: 9 Sayı: 1, 116 - 123, 04.01.2023
https://doi.org/10.18621/eurj.880152

Öz

Kaynakça

  • 1. American Diabetes Association. Standards of medical care in diabetes-2017. Diabetes Care 2017;40:S11-24.
  • 2. Gao HX, Regier EE, Close KL. Prevalence of and trends in diabetes among adults in the United States, 1988-2012. J Diabetes 2016;8:8-9.
  • 3. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al.; TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28:169-80.
  • 4. Price HI, Agnew MD, Gamble JM. Comparative cardiovascular morbidity and mortality in patients taking different insulin regimens for type 2 diabetes: a systematic review. BMJ Open 2015;5:e006341.
  • 5. Chuah LL, Papamargaritis D, Pillai D, Krishnamoorthy A, le Roux CW. Morbidity and mortality of diabetes with surgery. Nutr Hosp 2013;28 Suppl 2:47-52.
  • 6. Kong LN, Hu P, Yang L, Cui D. The effectiveness of peer support on self-efficacy and quality of life in adults with type 2 diabetes: A systematic review and meta-analysis. J Adv Nurs 2019;75:711-22.
  • 7. Stefan N, Fritsche A, Schick F, Haring HU. Phenotypes of prediabetes and stratification of cardiometabolic risk. Lancet Diabetes Endocrinol 2016;4:789-98.
  • 8. Abdul-Ghani M, DeFronzo RA, Jayyousi A. Prediabetes and risk of diabetes and associated complications: impaired fasting glucose versus impaired glucose tolerance: does it matter? Curr Opin Clin Nutr Metab Care 2016;19:394-9.
  • 9. Huang D, Refaat M, Mohammedi K, Jayyousi A, Al Suwaidi J, Khalil CA. Macrovascular complications in patients with diabetes and prediabetes. Biomed Res Int 2017;2017:7839101.
  • 10. Gerstein HC, Pogue J, Mann JF, Lonn E, Dagenais GR, McQueen M, et al.; HOPE investigators. The relationship between dysglycaemia and cardiovascular and renal risk in diabetic and non-diabetic participants in the HOPE study: a prospective epidemiological analysis. Diabetologia 2005;48:1749-55.
  • 11. Unwin N, Shaw J, Zimmet P, Alberti KGMM. Impaired glucose tolerance and impaired fasting glycaemia: the current status on definition and intervention. Diabet Med 2002;19:708-23.
  • 12. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000;894: i–xii, 1-253.
  • 13. Haffner SM, Miettinen H, Stern MP. The homeostasis model in the San Antonio Heart Study. Diabetes Care 1997;20:1087-92.
  • 14. Levey AS, Stevens LA, Schmid CH, Zhang Y, Castro AF, Feldman HI. A new equation to estimate glomerular filtration rate. Ann Intern Med 2009;150:604-12.
  • 15. American Diabetes Association. Standards of medical care in diabetes-2017. Diabetes Care 2017;40:S88-99.
  • 16. England JD, Gronseth GS, Franklin G, Miller RG, Asbury AK, Carter GT, et al.; American Academy of Neurology; American Association of Electrodiagnostic Medicine; American Academy of Physical Medicine and Rehabilitation. Distal symmetric polyneuropathy: a definition for clinical research: report of the American Academy of Neurology, the American Association of Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology 2005;64:199-207.
  • 17. DECODE Study Group, European Diabetes Epidemiology Group. Is the current definition for diabetes relevant to mortality risk from all causes and cardiovascular and noncardiovascular diseases? Diabetes Care 2003;26:688-96.
  • 18. Erman O, Erman A, Vodonos A, Gafter U, van Dijk DJ. A new cutoff for abnormal proteinuria in diabetes mellitus patients: relationship to albuminuria. Isr Med Assoc J 2016;18:418-21.
  • 19. Culleton BF, Larson MG, Parfrey PS, Kannel WB, Levy D. Proteinuria as a risk factor for cardiovascular disease and mortality in older people: a prospective study. Am J Med 2000;109:1-8.
  • 20. Bahar A, Makhlough A, Yousefi A, Kashi Z, Abediankenari S. Correlation between prediabetes conditions and microalbuminuria. Nephrourol Mon 2013;5:741-4.
  • 21. Meigs JB, D'Agostino RB, Sr, Nathan DM, Rifai N, Wilson PWF, Framingham Offspring Study. Longitudinal association of glycemia and microalbuminuria: the Framingham Offspring Study. Diabetes Care 2002;25:977-83.
  • 22. Sato Y, Yano Y, Fujimoto S, Konta T, Iseki K, Moriyama T, et al. Glycohemoglobin not as predictive as fasting glucose as a measure of prediabetes in predicting proteinuria. Nephrol Dial Transplant 2012;27:3862-68.
  • 23. Okada R, Yasuda Y, Tsushita K, Waka K, Hamajima N, Matsuo S. Trace proteinuria by dipstick screening is associated with metabolic syndrome, hypertension, and diabetes. Clin Exp Nephrol 2018;22:1387-94.
  • 24. Abdul-Ghani MA, Tripathy D, DeFronzo RA. Contributions of betacell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose. Diabetes Care 2006;29:1130-9.
  • 25. Echouffo-Tcheugui JB, Narayan KM, Weisman D, Golden SH, aar BG. Association between prediabetes and risk of chronic kidney disease: a systematic review and meta-analysis. Diabet Med 2016;33:1615-24.
  • 26. Ritz E, Koleganova N, Piecha G. Is there an obesity-metabolic syndrome related glomerulopathy? Curr Opin Nephrol Hypertens 2011;20:44-9.
  • 27. Fox CS, Larson MG, Leip EP, Meigs JB, Wilson PWF, Levy D. Glycemic status and development of kidney disease: the Framingham Heart Study. Diabetes Care 2005;28:2436-40.
  • 28. Selvin E, Ning Y, Steffes MW, Bash LD, Klein R, Wong TY, et al. Glycated hemoglobin and the risk of kidney disease and retinopathy in adults with and without diabetes. Diabetes 2011;60:298-305.
  • 29. Sun F, Tao Q, Zhan S. Metabolic syndrome and the development of chronic kidney disease among 118 924 non-diabetic Taiwanese in a retrospective cohort. Nephrology (Carlton) 2010;15:84-92.
  • 30. Kawata I, Koshi T, Hirabayashi K, Koike H, Sato Y, Yamashita K, et al. Prediabetes defined by the International Expert Committee as a risk for development of glomerular hyperfiltration. Acta Diabetol 2019;56:525-9.
  • 31. Melsom T, Schei J, Stefansson VTN, Solbu MD, Jensen TG, Mathisen UD, et al. Prediabetes and risk of glomerular hyperfiltration and albuminuria in the general nondiabetic population: a prospective cohort study. Am J Kidney Dis 2016;67:841-50.
  • 32. Zaleska-Żmijewska A, Piątkiewicz P, Śmigielska B, Sokolowska-Oracz A, Wawrzyniak ZM, Romaniuk D, et al. Retinal photoreceptors and microvascular changes in prediabetes measured with adaptive optics (rtx1™): a case-control study. J Diabetes Res 2017;2017:4174292.
  • 33. Franklin GM, Kahn LB, Baxter J, Marshall JA, Hamman RF. Sensory neuropathy in non-insulin-dependent diabetes mellitus. The San Luis Valley Diabetes Study. Am J Epidemiol 1990;131:633-43.
  • 34. Dyck PJ, Clark VM, Overland CJ, Davies JL, Pach JM, Dyck PJB, et al. Impaired glycemia and diabetic polyneuropathy: the OC IG Survey. Diabetes Care 2012;35:584-91.
  • 35. Ziegler D, Rathmann W, Dickhaus T, Meisinger C, Mielck A.; KORA Study Group. Neuropathic pain in diabetes, prediabetes and normal glucose tolerance: the MONICA/KORA Augsburg Surveys S2 and S3. Pain Med 2009;10:393-400.
  • 36. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. JAMA 1999;282:153-8.
  • 37. Aroori S, Spence RA. Carpal tunnel syndrome. Ulster Medical J 2008;77:6-17.
Toplam 37 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Endokrinoloji, İç Hastalıkları
Bölüm Original Article
Yazarlar

Ulaş Serkan Topaloğlu 0000-0001-6625-7763

Mehmet Fatih Göl 0000-0001-7773-641X

Ender Sırakaya 0000-0003-2013-6338

Fatih Tanrıverdi 0000-0001-8277-6774

Yayımlanma Tarihi 4 Ocak 2023
Gönderilme Tarihi 14 Şubat 2021
Kabul Tarihi 17 Mayıs 2021
Yayımlandığı Sayı Yıl 2023 Cilt: 9 Sayı: 1

Kaynak Göster

AMA Topaloğlu US, Göl MF, Sırakaya E, Tanrıverdi F. A window of opportunity against diabetes: frequency of microvascular and macrovascular complications in prediabetes. Eur Res J. Ocak 2023;9(1):116-123. doi:10.18621/eurj.880152

e-ISSN: 2149-3189 


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