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Pre-diabetes and progression towards diabetes

by Rimke Vos and Huberta Hart

Diabetes and the Heart
Risk Factors and Prevention


The case

  • A 54-year-old caucasian man
  • Manager
  • BMI 29 kg/m2
  • Health check offered by his employer
  • Result: 2h OGTT 10.3 mmol/ L 

He was referred to his general practitioner for further follow up.

Test your knowledge

 

Note: The views and opinions expressed on this page are those of the author and may not be accepted by others. While every attempt is made to keep the information up to date, there is always going to be a lag in updating information. The reader is encouraged to read this in conjunction with appropriate ESC Guidelines. The material on this page is for educational purposes and is not for use as a definitive management strategy in the care of patients. Quiz material in the site are only examples and do not guarantee outcomes from formal examinations.

References

Question 1:

Faerch K, Vistisen D, Johansen NB, et al. Cardiovascular risk stratification and management in pre-diabetes. Curr Diab Rep 2014; 14: 493.
Barry E, Roberts S, Oke J, et al. Efficacy and effectiveness of screen and treat policies in prevention of type 2 diabetes: systematic review and meta-analysis of screening tests and interventions. BMJ 2017; 356: i6538.

Question 2:

Yudkin JS and Montori VM. The epidemic of prediabetes: the medicine and the politics. BMJ 2014; 349: g4485.
DeJesus RS, Breitkopf CR, Rutten LJ, et al. Incidence rate of prediabetes progression to diabetes: modeling an optimum target group for intervention. Popul Health Manag 2017; 20: 216–223.

Ligthart S, van Herpt TT, Leening MJ, et al. Lifetime risk of developing impaired glucose metabolism and eventual progression from prediabetes to type 2 diabetes: a prospective cohort study. Lancet Diabetes Endocrinol 2016; 4: 44–51.

Morris DH, Khunti K, Achana F, et al. Progression rates from HbA1c 6.0–6.4% and other prediabetes definitions to type 2 diabetes: a meta-analysis. Diabetologia 2013; 56: 1489–1493.

Bertram MY and Vos T. Quantifying the duration of prediabetes. Aust N Z J Public Health 2010; 34: 311–314.
Du T, Fernandez C, Barshop R, et al. Sex differences in cardiovascular risk profile from childhood to midlife between individuals who did and did not develop diabetes at follow-up: The Bogalusa Heart Study. Diabetes Care 2019; 42: 635–643.

Question 3:

Barry E, Roberts S, Oke J, et al. Efficacy and effectiveness of screen and treat policies in prevention of type 2 diabetes: systematic review and meta-analysis of screening tests and interventions. BMJ 2017; 356: i6538.
Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393–403.

Ramachandran A, Snehalatha C, Mary S, et al. The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia 2006; 49: 289–297.

Saito T, Watanabe M, Nishida J, et al. Lifestyle modification and prevention of type 2 diabetes in overweight Japanese with impaired fasting glucose levels: a randomized controlled trial. Arch Intern Med 2011; 171: 1352–1360.

Tuomilehto J, Lindstrom J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343–1350.

Aroda VR, Knowler WC, Crandall JP, et al. Metformin for diabetes prevention: insights gained from the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study. Diabetologia 2017; 60: 1601–1611.

Notes to editor

Author information:

Vos, Rimke C, PhD, Leiden University Medical Centre – Campus The Hague, The Hague
Hart, Huberta E. MD, PhD, Utrecht University Medical Centre & Leidsche Rijn Julius Health Centers, Utrecht