The Prediabetic Period: Review of Clinical Aspects

Hyperglycemia that does not satisfy the diagnostic criteria for diabetes mellitus (DM) is generally called prediabetes (preDM). The global prevalence of preDM has been increasing progressively in the past few decades, and it has been established that preDM status is a strong risk factor for DM and cardiovascular disease. Currently, preDM status is classified into two subtypes: impaired fasting glucose and impaired glucose tolerance. Currently, preDM is not regarded as an independent clinical entity, but only as a risk factor for others. In this article, we review various clinical aspects of preDM in terms of the working definition, changes in criteria over the years, epidemiology, and pathophysiological characteristics, and its clinical significance in current medicine

Site-Specific GlcNAcylation of Human Erythrocyte Proteins: Potential Biomarker(s) for Diabetes

OBJECTIVE—O-linked N-acetylglucosamine (O-GlcNAc) is upregulated in diabetic tissues and plays a role in insulin resistance and glucose toxicity. Here, we investigated the extent of GlcNAcylation on human erythrocyte proteins and compared site-specific GlcNAcylation on erythrocyte proteins from diabetic and normal individuals

Type 2 Diabetes and the Risk of Renal Cell Cancer in Women

Objective: Type 2 diabetes is associated with increased risks of several types of cancer; however, its relationship to renal cell cancer remains unclear. Research Design and Methods: A total of 118,177 women aged 30 to 55 years at baseline (1976) were followed up through 2008 in the Nurses’ Health Study. Self-reports of physician-diagnosed diabetes were collected at baseline and updated biennially. Hazard ratios (HRs) were calculated using Cox proportional hazards models with adjustment for age, BMI, hypertension, smoking, and parity. Results: During 32 years of follow-up (3,531,170 person-years), 16,819 cases of type 2 diabetes and 330 cases of pathology-confirmed incident renal cell cancer were documented. After multivariate adjustment, type 2 diabetes was significantly associated with an increased risk of renal cell cancer (HR 1.60 [95% CI 1.19–2.17]). These associations were consistent across different strata of BMI, smoking, and hypertension ($P_{interaction} \geq 0.32$). The risk of renal cell cancer increased with an increasing number of comorbidities, including obesity, hypertension, and type 2 diabetes ($P_{trend} < 0.001$). When compared with women without any comorbidity, women who had all three conditions had a HR of 4.13 (2.76–6.18) for renal cell cancer. Conclusions: Type 2 diabetes is independently associated with an increased risk of renal cell cancer in women. In addition, comorbidity of obesity, hypertension, and type 2 diabetes substantially elevates the risk of renal cell cancer

Diagnostic criteria for diabetes revisited: making use of combined criteria

BACKGROUND: Existing cut-offs for fasting plasma glucose (FPG) and post-load glucose (2hPG) criteria are not equivalent in the diagnosis of diabetes and glucose intolerance. Adjusting cut-offs of single measurements have not helped so we undertook this project to see if they could be complementary. METHODS: We performed oral glucose tolerance tests and mean levels of hemoglobin A1c (HbA1c) measurements on 43 patients referred to a diabetes clinic for possible diabetes. Results of single and combined use of the FPG and 2hPG criteria were evaluated against the levels of HbA1c and results re-interpreted in the light of existing reports in the literature. RESULTS: Our results confirm that the FPG and the 2hPG, being specific and sensitive respectively for the presence of glucose intolerance or diabetes, are not equivalent. They are shown to be indeed complementary and a re-definition of diagnostic criteria based on their combined use is proposed. CONCLUSIONS: We conclude that altering single measurement cut-offs for the diagnosis of diabetes and altered glucose tolerance will not result in better outcomes. We present the case for a combined criteria in the diagnosis and definition of diabetes with a FPG≥7 mmol/L AND 2-hour glucose ≥7.8 mmol/L being used to define diabetes while a FPG<7 mmol/L AND 2-hour glucose <7.8 mmol/L being used to define normality. Discordant values will define impaired glucose tolerance (IGT). This proposal requires prospective evaluation in a large cohort

Etiological Approach to Characterization of Diabetes Type: The SEARCH for Diabetes in Youth Study

OBJECTIVE To describe an etiologic approach to classification of diabetes types in youth based on the 1997 American Diabetes Association (ADA) framework, using data from the SEARCH for Diabetes in Youth Study