Unmasking the diabetic population in pre-diabetic subset of population
DOI:
https://doi.org/10.18203/2349-3933.ijam20202122Keywords:
Diabetes, Fasting plasma glucose, Oral glucose tolerance test, Pre-diabetes, Post prandial plasma glucoseAbstract
Background: Identification of individuals with a high risk of developing diabetes and early diagnosis of diabetes is essential in prevention and early treatment of diabetes. Effective lifestyle and pharmacologic interventions to delay development of diabetes in people with high risk have been established.
Methods: This Prospective non-randomized interventional study was conducted in 100 Pre diabetic patients who came in OPD of MGM Medical College and MY Hospitals, Indore, MP, from December, 2017 to February, 2019.
Results: OGTT after 1hour was more than160mg/dl and OGTT after 2 hour was more than140mg/dl was found in 40 patients that is 40% of patients. The mean OGTT at 1 hour at presentation was 189.60±28.89 mg/dl and after 6 weeks (first follow-up) was 150.90±14.29mg/dl. The difference was found to be statistically significant (p=0.001), showing a significantly lower OGTT at 1 hour after 6 weeks (first follow-up). The mean OGTT at 1 hour after 6 weeks (first follow-up) was 169.00±3.72 mg/dl and after 6 weeks (second follow-up) was 148.67±6.29 mg/dl. The difference was found to be statistically significant (p=0.001), showing a significantly lower OGTT at 1 hour after 6 weeks (second follow-up) in comparison to follow-up after 6 weeks (first follow-up).
Conclusions: Patients who were labelled as pre-diabetic on the basis of FPG and PPPG may have underlying diabetes which will remain unmasked due to less sensitivity of these tests individually.
References
Buchanan TA, Xiang AH, Peters RK, Kjos SL, Marroquin A, Goico J, et al. Preservation of pancreatic beta-cell function and prevention of type 2 diabetes by pharmacological treatment of insulin resistance in high-risk Hispanic women. Diabetes. 2002;51(9):2796-803.
Dunstan DW, Zimmet PZ, Welborn TA, De Courten MP, Cameron AJ, Sicree RA, et al. The rising prevalence of diabetes and impaired glucose tolerance: The Australian Diabetes, Obesity and Lifestyle Study. Diabetes Care. 2002;25(5):829-34.
Hamman RF, Wing RR, Edelstein SL, Lachin JM, Bray GA, Delahanty L, et al. Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care. 2006;29(9):2102-7.
Knowler WC, Barrett-Conner E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;7(3466):393-403.
Schwartz S. Is there a rationale for insulin therapy in pre-diabetic individuals? Treat Endocrinol. 2006;5 (6):385-93.
Manjhvar SK, Gupta H, Valame S. Prevalence of impaired glucose tolerance test in first degree relatives (>30yrs) of type II diabetes mellitus patients: Original Report. J Evolut Med Dent Sci. 2014;3:37.
Kim DL, Kim SD, Kim SK, Park S, Song KH. Is an oral glucose tolerance test still valid for diagnosing diabetes mellitus? Diab Metab J. 2016 Apr 1;40(2):118-28.
Saito T, Watanabe M, Nishida J, Izumi T, Omura M, Takagi T, et al. Lifestyle modification and prevention of type 2 diabetes in overweight Japanese with impaired fasting glucose levels: a randomized controlled trial. Arch Int Med. 2011 Aug 8;171(15):1352-60.
Matfin G, Pratley RE. Advances in the treatment of prediabetes. Therapeutic Adv Endocrinol Metab. 2010 Apr;1(1):5-14.
Kulkarni S, Xavier D, George B, Umesh S, Fathima S, Bantwal G. Effect of intensive lifestyle modification & metformin on cardiovascular risk in prediabetes: A pilot randomized control trial. Indian J Med Res. 2018 Dec;148(6):705.
