Few studies have examined the associations between long-term exposure to ultrafine particles (UFP) and type 2 diabetes (T2DM). This study aimed to investigate the impact of long-term UFP exposure on diabetes prevalence and stages, as well as glycemic markers, using data from a large multi-center cohort collected from 2017 to 2021. The health outcomes assessed included diabetes prevalence and stages (normoglycemia, prediabetes, and diabetes), as well as glycemic markers, i.e., fasting blood glucose (FPG) and glycated hemoglobin (HbA1c). The three-year average UFP concentration prior to baseline was used as the long-term UFP exposure level. This cross-sectional study included 93,990 participants, with a diabetes prevalence of 10.97 %. An interquartile range increase in UFP was significantly associated with diabetes prevalence and stages, with ORs of 1.20 (95 % CI: 1.14, 1.26) and 1.11 (95 % CI: 1.07, 1.44), respectively. Specifically, for comparison between normoglycemia and prediabetes, and between prediabetes and diabetes, the corresponding ORs were 1.01 (95 % CI: 0.96, 1.04) and 1.24 (95 % CI: 1.17, 1.31), respectively. UFP exposure was also significantly associated with elevated levels of FPG and HbA1c. These findings suggest that long-term UFP exposure may be a potential risk factor for diabetes with larger risks in the prediabetes population.

The incidence of Type 2 Diabetes Mellitus (T2DM) continues to rise steadily, significantly impacting human health. Early prediction of pre-diabetic risks has emerged as a crucial public health concern in recent years. Machine learning methods have proven effective in enhancing prediction accuracy. However, existing approaches may lack interpretability regarding underlying mechanisms. Therefore, we aim to employ an interpretable machine learning approach utilizing nationwide cross-sectional data to predict pre-diabetic risk and quantify the impact of potential risks.

The LASSO regression algorithm was used to conduct feature selection from 30 factors, ultimately identifying nine non-zero coefficient features associated with pre-diabetes, including age, TG, TC, BMI, Apolipoprotein B, TP, leukocyte count, HDL-C, and hypertension. Various machine learning algorithms, including Extreme Gradient Boosting (XGBoost), Random Forest (RF), Support Vector Machine (SVM), Naive Bayes (NB), Artificial Neural Networks (ANNs), Decision Trees (DT), and Logistic Regression (LR), were employed to compare predictive performance. Employing an interpretable machine learning approach, we aimed to enhance the accuracy of pre-diabetes risk prediction and quantify the impact and significance of potential risks on pre-diabetes.

From the China Health and Nutrition Survey (CHNS) data, a cohort of 8,277 individuals was selected, exhibiting a disease prevalence of 7.13%. The XGBoost model demonstrated superior performance with an AUC value of 0.939, surpassing RF, SVM, DT, ANNs, Naive Bayes, and LR models. Additionally, Shapley Additive Explanation (SHAP) analysis indicated that age, BMI, TC, ApoB, TG, hypertension, TP, HDL-C, and WBC may serve as risk factors for pre-diabetes.

The constructed model comprises nine easily accessible predictive factors, which prove highly effective in forecasting the risk of pre-diabetes. Concurrently, we have quantified the specific impact of each predictive factor on the risk and ranked them based on their influence. This result may serve as a convenient tool for early identification of individuals at high risk of pre-diabetes, providing effective guidance for preventing the progression of pre-diabetes to T2DM.

With rising the prevalence of type 2 diabetes mellitus (T2DM) and prediabetes, the importance of 1-hour postload plasma glucose (1-h PG) for early hyperglycemia screening is emphasized.

This study investigates the utility of 1-h PG in predicting T2DM in adults with normal fasting plasma glucose levels.

A total of 7504 participants were categorized into 3 groups: normal glucose tolerance (NGT) with 1-h PG < 155 mg/dL, NGT with 1-h PG ≥ 155 mg/dL, and impaired glucose tolerance (IGT). Insulin sensitivity and secretion indices were compared between groups at baseline, and T2DM incidence was analyzed using Cox proportional hazards models. The predictive abilities of 1-h PG and 2-hour postload plasma glucose (2-h PG) were assessed with receiver operating characteristic analysis.

At baseline, the composite insulin sensitivity index in the NGT and 1-h PG ≥ 155 mg/dL group was similarly reduced as in the IGT group (P = .076). Over a mean follow-up of 7.4 years, T2DM developed in 960 patients (12.8%). The highest risk was in the IGT group (hazard ratio, 5.47), followed by the NGT and 1-h PG ≥ 155 mg/dL group (hazard ratio, 2.74), compared to the NGT and 1-h PG < 155 mg/dL group. The 1-h PG level had a higher area under the curve (0.772) than other glycemic parameters, including 2-h PG.

Even with normal fasting plasma glucose, a 1-h PG ≥ 155 mg/dL indicates lower insulin sensitivity similar to IGT and increased T2DM risk, making it a more effective early screening tool than 2-h PG.

The associations of vegetable and potato intakes with type 2 diabetes (T2D) appear to be nuanced, depending on vegetable types and preparation method, respectively.

We investigated the associations of total vegetable, vegetable subgroup, and potato intakes with (1) markers of T2D at baseline and (2) incident T2D cumulative over a 12-year follow-up period in Australian adults.

Using data from the Australian Diabetes, Obesity and Lifestyle Study, intakes of vegetables and potatoes were assessed via a food frequency questionnaire at baseline. Associations between vegetable intake and (1) fasting plasma glucose (FPG), 2-hour postload plasma glucose (PLG), updated homeostasis model assessment of β-cell function (HOMA2-%β), HOMA2 of insulin sensitivity (HOMA2-%S), and fasting insulin levels at baseline; and (2) cumulative incident T2D at the end of 12-year follow-up were examined using generalized linear and Cox proportional hazards models, respectively.

In total, 8009 participants were included having median age of 52 years, and vegetable intake of 132 g/day. Higher intake of total vegetable, green leafy, yellow/orange/red, and moderate intakes of cruciferous vegetables was associated with lower PLG. Additionally, higher green leafy vegetable intake was associated with lower HOMA2-%β and serum insulin. Conversely, higher potato fries/chips intakes were associated with higher FPG, HOMA2-%β, serum insulin, and lower HOMA2-%S. Participants with moderate cruciferous vegetables intake had a 25% lower risk of T2D at the end of 12 years of follow-up.

A higher intake of vegetables, particularly green leafy vegetables, may improve while consuming potato fries/chips, but not potatoes prepared in a healthy way, may worsen glucose tolerance and insulin sensitivity. Our findings suggest a nuanced relationship between vegetable subgroups and their impact on glucose tolerance.

The aqueous extraction of sesame oil is a traditional process that generates a large amount of melanoidins. However, little is known about the characteristics and bioactive functions of these melanoidins.

Electronic tongue, fluorescence emission spectroscopy, and Fourier transform infrared spectroscopy analyses indicated that melanoidins from sesame residues (MELs) are brown macromolecular compounds with protein skeletons and heteroaromatic ring structures, a bitter taste, and instability in strong oxidative and reductive environments. The MELs demonstrated inhibitory effects on α-glucosidase, α-amylase and pancreatic lipase in vitro. These MELs mitigated weight loss in mice with type 2 diabetes (T2DM), reduced their fasting blood glucose to 54.73% (500 mg kg-1 day-1) of the initial value, increased the glycogen levels in the liver and skeletal muscles, lowered blood lipid levels, and protected the liver. Western blot analysis revealed that MELs inhibited the activities of enzymes such as PEPCK, FBPase, and G6Pase through the IRS-1/PI3K/Akt and AMPK pathways, increased the activity of the enzymes hexokinase (HK) and pyruvate kinase (PK), enhanced liver glycolytic ability, and promoted liver glycogen synthesis, thereby reducing blood glucose levels in T2DM mice. Moreover, MELs reduced the ratio of Firmicutes to Bacteroides (F/B) in the intestines of T2DM mice, increased the relative abundance of beneficial bacteria such as Lactobacillus, Coprococcus, and Ruminococcus, and reduced the propionic acid content.

Melanoidins can regulate T2DM by activating the IRS-1/PI3K/Akt and AMPK-signaling pathways and ameliorating gut microbiota imbalances in T2DM mice. © 2024 Society of Chemical Industry.

Background: Diabetes mellitus is one of the greatest public health challenges worldwide and one of the major conditions contributing to a poorer quality of life. The main factors that may deteriorate quality of life among patients with diabetes include age, financial status, educational background, quality of healthcare services and presence of disease complications. This study aimed to assess the quality of life among patients with type 1 and type 2 diabetes and prediabetes in Poland using the example of the Podlaskie Province, taking into account selected sociodemographic variables. Methods: A total of 874 patients participated in the study, including 448 women (55.8%) and 386 men (44.2%). The study was conducted from July 2022 to July 2023 among participants of the "Zatrzymaj cukrzycę! Polski Rejestr Diabetologiczny PolReD" ("Stop Diabetes! Polish Diabetes Registry (PolRed)") project or those hospitalised in the Department of Endocrinology, Diabetology and Internal Medicine at the University Clinical Hospital in Bialystok. The study used a diagnostic survey method using a survey questionnaire developed by the authors and the 36-Item Short Form Survey (SF-36). Results: The overall study group had the highest level of quality of life assessment in the domains of social functioning (M = 69.48; SD ± 28.07), physical functioning (M = 64.54; SD ± 31.57) and role limitations due to emotional problems (M = 62.40; SD ± 45.21), and the lowest level of quality of life in the domain of general health perceptions (M = 42.21; SD ± 12.77). Age was found to be negatively correlated in all quality of life domains analysed (r = -0.438; p < 0.001)-quality of life decreased with age in all investigated domains. Men had a statistically significantly (p < 0.05) higher quality of life in each analysed domain (M = 43.52-74.08; SD ± 12.68-44.09) compared to women (M = 41.18-65.88; SD ± 12.76-46.08). Place of residence also exhibited a statistically significant (p < 0.05) differentiated quality of life in terms of physical functioning. Conclusions: The assessment of quality of life among patients with type 1 and type 2 diabetes and those diagnosed with prediabetes from the Podlaskie Province depends on the type of hyperglycaemic disorder. The assessment of quality of life among patients with type 1 and type 2 diabetes and prediabetes is determined by specific socio-demographic factors, including, above all, age and gender. Respondents with type 1 diabetes have a higher quality of life in terms of role limitations due to physical health, role limitations due to emotional problems, pain (bodily pain) and general health compared to respondents with type 2 diabetes.

Hyperglycemia can promote the development of prostate cancer (PCa). Differential expression levels of miRNAs between PCa patients and controls were also reported. Therefore, we examined the relationship between hyperglycemia and miRNA levels in PCa.

Relative expression of urinary miR-574-3p, miR-375, miR-205-5p, miR-200b-3p, miR-187-3p, miR-182-5p, and miR-100-5p were investigated in 105 PCa patients and 138 noncancer controls by Real-Time quantitative PCR. Fasting plasma glucose measurements were retrieved from clinical records. The differential miRNA expressions among groups were compared using non-parametric tests. Correlations with glucose and prostate-specific antigen (PSA) were tested using Pearson correlation coefficient.

When we analyzed miRNA expression according to glycemic state, significant down-regulations were found for miR-200b-3p, miR-187-3p, miR-182-5p, and miR-100-5p in noncancer controls with high glucose. The lowest down-regulations were observed for miR-187-3p, miR-182-5p, and miR-100-5p. Subsequently, when hyperglycemia was considered in PCa, significant dysregulations of selected miRNAs were found in hyperglycemic PCa patients than in controls with high glucose. In particular, miR-375 and miR-182-5p showed a 3-FC in hyperglycemic PCa patients than controls who left hyperglycemia untreated. Conversely, only a down-regulation of miR-574-3p was observed in PCa patients regardless of glycemic status and only modest down-regulation of miR-574-3p, miR-200b-3p, miR-187-3p and miR-182-5p were found in normoglycemic PCa patients. Next, significant correlations between miRNAs and glucose (miR-200b-3p, miR-100-5p) and PSA (miR-205-5p and miR-187-3p) were detected in controls. Similarly, miR-205-5p and miR-187-3p were correlated with glucose in PCa patients, while miR-574-3p and miR-375 showed inverse relationships.

miRNA dysregulations can occur in hyperglycemic PCa patients as compared to noncancer controls who left hyperglycemia untreated. Hyperglycemia can consistently promote the expression of miR-375 and miR-182-5p. Uncontrolled hyperglycemic state could contribute to the creation of a suitable microenvironment for later PCa development by promoting gene expression.

Data regarding the risk of incident type 2 diabetes (T2D) and prediabetes among patients with hepatitis C virus (HCV) achieving direct-acting antivirals (DAAs)-induced sustained virologic response (SVR12) remains limited.

A total of 1079 patients, including 589 with normoglycemia and 490 with prediabetes, who underwent biannual fasting glucose and glycosylated haemoglobin (HbA1c) assessment for a median post-SVR12 follow-up of 5.5 years, were enrolled. We reported the crude (cIRs) and age-standardised incidence rates (ASIRs) of T2D and prediabetes. Factors associated with incident T2D and prediabetes were assessed using the Cox proportional hazards models.

The cIRs of T2D and prediabetes were 1.18 and 8.99 per 100 person-years of follow-up (PYFU), respectively. Additionally, the ASIRs of T2D and prediabetes were 1.09 (95% CI: 0.76-1.53) and 8.47 (95% CI: 7.23-9.90) per 100 PYFU. Prediabetes (adjusted hazard ratio [aHR]: 4.71; 95% confidence interval (CI): 2.55-8.70, p < 0.001), body mass index (BMI) per kg/m2 increase (aHR: 1.17; 95% CI: 1.09-1.26, p < 0.001) and liver stiffness measurement (LSM) per kPa increase (aHR: 1.05; 95% CI: 1.02-1.09, p = 0.001) were associated with a higher risk of incident T2D. Age per year increase (aHR: 1.02; 95% CI: 1.01-1.03, p < 0.001) was associated with a higher risk of incident prediabetes.

The incidence rates of T2D and prediabetes remain substantial among patients after HCV eradication. Lifestyle modification, drug therapy and regular monitoring of glycemic status are crucial for patients at risk of developing T2D and prediabetes following HCV clearance.

The global burden of diabetes is rising sharply, with a significant proportion of cases emerging in low- and middle-income countries (LMICs). Prediabetes, a condition characterized by elevated blood glucose levels that do not yet meet the threshold for diabetes, serves as a crucial stage for intervention and prevention. Despite its importance, comprehensive data on prediabetes prevalence in LMICs are sparse. Thus, we conducted a systematic review and meta-analysis to ascertain the prevalence of prediabetes in LMICs. We systematically reviewed studies on prediabetes in Low- and Middle-Income Countries (LMICs) from 1st January 2003 and 31st July 2024 using PubMed, Scopus, and Web of Science databases. The NIH study quality assessment tool assessed bias, and pooled prevalence was determined via a random-effects model. We examined publication bias through funnel plot analysis and Begg's and Egger's tests. The prevalence of prediabetes estimated from 164 studies conducted in LMICs was 13.1% (95% CI: 11.7%, 14.5%) based on the World Health Organization (WHO) criteria, and 27.0% (95% CI: 24.5%, 29.5%) based on the American Diabetes Association (ADA) criteria. The pooled prevalence did not significantly differ between males and females for both diagnostic criterias and by study design. The analysis indicated a noteworthy degree of heterogeneity in the pooled estimates (I2 > 70%; p < 0.05). The findings from this study indicated a higher burden of prediabetes within LMICs with regional variations.

The atherogenic index of plasma (AIP) is a recent biomarker linked to atherosclerosis that has been validated as a novel indicator for myocardial infarction (MI). However, the relationship between AIP and the severity of coronary artery disease (CAD) in MI patients is still ambiguous, particularly among individuals with different glucose metabolic conditions. A total of 741 participants who were immediately assessed with coronary angiography upon admission and diagnosed with acute MI were recruited. The severity of CAD was assessed based on the number of narrowed vessels. AIP tertiles were used to divide the patients into three groups (T1: AIP < 0.030; T2: 0.030 ≤ AIP ≤ 0.316; T3: AIP > 0.316). The American Diabetes Association's guidelines define three types of glucose metabolic state: diabetes mellitus (DM), prediabetes (Pre-DM), and normal glucose regulation (NGR). Logistic regression analysis was utilized to confirm an association between AIP and CAD severity in MI patients. ROC curves were employed to evaluate the diagnostic utility of AIP for CAD severity in MI patients. In MI patients, a statistically significant correlation was found between AIP and the severity of CAD, with logistic regression analysis revealing a strong association (OR: 2.055; 95% CI: 1.189-3.550; P = 0.009). Following adjustments for risk factors in the logistic regression model, AIP remained an independent predictor of multi-vessel CAD (OR: 2.902;95% CI: 1.555-5.521 ; P < 0.001). Moreover, compared with the T1 group, the odds ratios for multi-vessel CAD in the T2 and T3 groups were 2.039 (95% CI: 1.321-3.175; P = 0.001) and 2.087 (95% CI: 1.317-3.340; P = 0.001), respectively. The area under the curve for predicting CAD severity with AIP was 0.568 (95% CI: 0.520-0.616; p = 0.006). In addition, a significant association was observed between AIP and an increased risk of multi-vessel CAD in the Pre-DM group. In MI patients, AIP is closely associated with the risk of multi-vessel CAD and the prediction of the severity of CAD. In Pre-DM patients, AIP is clearly associated with the severity of CAD, whereas this association is absent in the NGR and DM groups.

Prediabetes is a highly prevalent and increasingly common condition affecting a significant proportion of the global population. The heterogeneous nature of prediabetes presents a challenge in identifying individuals who particularly benefit from lifestyle or other therapeutic interventions aiming at preventing type 2 diabetes (T2D) and associated comorbidities. The phenotypic characteristics of individuals at risk for diabetes are associated with both specific risk profiles for progression and a differential potential to facilitate prediabetes remission and reduce the risk of future T2D. This review examines the current definition and global prevalence of prediabetes and evaluates the potential of prediabetes remission to reduce the alarming increase in the global burden of T2D.

The impact of hepatic lipid accumulation on hyperuricemia presents an intriguing research avenue, particularly in light of existing studies linking obesity with hyperuricemia. Nevertheless, there remains a scarcity of quantitative investigations into the correlation between liver fat content (LFC) and hyperuricemia among prediabetic cohorts, notably within the Chinese demographic.

This cross-sectional study was conducted at the Health Management Center of Henan Provincial People's Hospital between January 2019 and December 2023, involving 2,950 pre-diabetic participants. Participants were categorized into groups based on diagnostic criteria for hyperuricemia. LFC was assessed using computed tomography. Statistical analyses included multivariate logistic regression, limited cubic spline regression models, and subgroup analyses to explore the association between LFC and hyperuricemia among individuals with pre-diabetes.

The prevalence of hyperuricemia among the 2,950 prediabetic individuals was observed to be 22.20%. Prediabetic individuals with hyperuricemia exhibited higher levels of LFC compared to those without hyperuricemia. This association persisted even after adjusting for other variables, indicating a heightened risk of hyperuricemia among prediabetic individuals with elevated LFC [Q4 vs Q1: odds ratio (OR 2.70), 95% confidence interval (CI) 1.93-3.79, P < 0.001; P for trend < 0.001]. Importantly, a nonlinear relationship between LFC and hyperuricemia risk was identified in the prediabetic individuals, showing a significant increase in hyperuricemia risk when LFC exceeded 8.4% (OR per standard deviation = 1.05, 95% CI: 1.02-1.08, P < 0.001).

In individuals with prediabetes, a higher LFC is associated with an elevated risk of hyperuricemia, especially when LFC exceeds 8.4%.

Prediabetes is disproportionately prevalent in Hispanic men in the United States. Weight management, such as through lifestyle interventions, effectively reduces diabetes risk. However, Hispanic men remain underrepresented in existing lifestyle interventions, and their preferences for engaging in preventative behaviors remain unexplored. We aimed to explore the experiences of Hispanic men being diagnosed with prediabetes and the perceived influences on engaging in preventative behaviors and lifestyle change.

This qualitative study conveniently sampled Hispanic men with prediabetes (n = 15) from a Federally Qualified Health Center in New York City. Private semi-structured interviews were audio recorded and explored prediabetes beliefs and perceived influences on engaging in preventative lifestyle change. Transcripts were double-coded using a deductive thematic approach, which revealed 5 major themes consistent with the Health Belief Model.

(1) Perceived Susceptibility and Severity: Despite fearing diabetes, Hispanic men are unsure about their personal risk for developing it. (2) Cues to Action: Receiving a clinical diagnosis and recognizing its potential impact on family members heightens concerns about diabetes risk. (3) Benefits of Lifestyle Change: Small, practical changes in dieting and exercising can make preventing diabetes manageable. (4) Barriers to Lifestyle Change: Restrictive environments and schedules, coupled with some cultural habits, can lead to unhealthy lifestyle choices. (5) Self-Efficacy: Lifestyle change is a matter of personal agency, but additional information can support the right changes.

Influences potentially unique to Hispanic men in this setting included references to unhealthy foods environments, overwhelming working conditions, carbohydrate-rich cultural staples, and the threat of diabetes to self-perceptions of being head-of-family. These findings provide insight into Hispanic men's perceived barriers to engaging in preventative behaviors and motivators that can potentially facilitate their engagement in diabetes prevention.

Prediabetes is a serious metabolic disorder that is often overlooked and 70% of individuals with prediabetes would eventually develop type 2 diabetes. The diabetogenic effects of pesticides have been reported in toxicological studies but their association with prediabetes is rarely investigated. We aimed to evaluate the association between pesticide exposure and impaired glucose regulation (IGR), including prediabetes (defined as impaired fasting glucose [IFG] and/or impaired glucose tolerance [IGT]) and insulin resistance, in a general U.S. non-diabetic population. Three classes of urinary pesticides, including organophosphorus pesticides (OPs), pyrethroid, and herbicides were measured. Generalized linear regression, restricted cubic spline, and Bayesian kernel machine regression (BKMR) models were combined to evaluate their associations. 3,5,6-trichloropyridinol (TCPY) was positively associated with prediabetes and IGT (highest vs lowest TCPY quartile: prediabetes: OR: 1.97, 95% CI: 1.18, 3.31; IGT: OR: 2.03, 95% CI: 1.14, 3.66) in a linear dose-response manner (P for nonlinear<0.05). Another two metabolites of OPs, malathion dicarboxylic acid (MDCA) diacid and para-nitrophenol (PNP), were found to increase the odds ratio of insulin resistance (PNP: OR: 1.22, 95% CI: 1.05, 1.42; MDCA: OR: 1.36, 95% CI: 1.08, 1.70) with linear dose-response curves (P for nonlinear<0.05). Considering mutual exposure to multiple pesticides, TCPY, MDCA, and PNP made the most contributions in the mixture exposure and IGR. No obvious interactions among pesticides were found in the multiple exposure settings. The odds ratio of TCPY exposure and prediabetes was increased with advancing age but not related to body mass index (BMI). The results remained robust in sensitivity analysis with restricted participants without abnormal urinary creatinine and unsteady glucose or insulin levels. Our findings suggested the close relationship between OPs and impaired glucose regulation, especially in older adults, which provides insights into the prevention of diabetes at the earlier stage.

The interest in creating new products to decrease the risk of developing non-communicable chronic diseases such as type 2 diabetes (T2D) is increasing. These products include traditional food sources used as part of diverse cultures around the world, such as dragon fruit. The aim of this study was to investigate the effects of a frozen red dragon fruit (FRDF) beverage on blood pressure, glycaemic response (GR) and insulinaemic response (IR), lipid profile (LP), total antioxidant status (TAS), and C-reactive protein (CRP) levels in healthy subjects and individuals at risk of T2D.

A parallel design trial (UREC registration number 211527; ClinicalTrials.gov registration number NCT05199636/19 January 2022) lasting four weeks and involving three testing sessions was conducted; participants were randomly assigned to one of two treatments (following general health guidance or consuming FRDF beverage). Systolic and diastolic blood pressures were taken; venous blood samples were collected to determine the LP and CRP levels; and capillary blood samples were taken before and after consuming a standard glucose drink to evaluate GR and IR at 15 min intervals (first hour) and 30 min intervals (second hour).

Eighteen participants completed this study, nine healthy (28.44 ± 5.20 years) and nine at risk (31.78 ± 12.11 years). The daily consumption of an FRDF-based beverage for four weeks by individuals at risk of T2D resulted in a reduction in blood pressure and IR-incremental area under the curve. The LP showed a downward trend, and a significant difference between treatments (p = 0.009) was found for CRP levels.

Beverages based on FRDF may have the potential to decrease the risk of T2D.

Background and Objectives: Prediabetes is a medical disease characterized by elevated blood sugar levels that exceed normal levels but do not meet the criteria for a diagnosis of diabetes mellitus. This study aimed to assess the impact of structured exercise manual interventions on the biochemical markers of sedentary prediabetic patients over sixteen weeks. Materials and Methods: A sixteen-weeks randomized controlled trial was conducted to assess the impact of an exercise-based manual program on biochemical markers, such as HbA1c, insulin sensitivity measures, and lipid profiles, in sedentary individuals with prediabetes. The Riphah Rehabilitation Center in Lahore, Pakistan, was the site of the trial. In this investigation, 126 individuals with prediabetes were randomly assigned to three groups: control, unsupervised, and supervised. The RCT was completed by 36 participants in each group after a 16-weeks intervention in the supervised and unsupervised groups, as well as a follow-up in the control group. An activity-based exercise manual that included dietary guidelines, educational materials, and an exercise routine was followed by both the supervised and unsupervised groups. The exercise interventions included both aerobic and resistance components. Results: The results indicated that the supervised group exhibited a substantial increase in insulin sensitivity, lipid profiles, and glycemic control when contrasted with the unsupervised and control groups. Significant improvements were observed in key biochemical parameters, including fasting blood levels (supervised as compared to unsupervised and control, respectively, the mean difference was 12.82 mg/dL vs. 11.36 mg/dL vs. 0.09 mg/dL p > 0.001), HbA1c (supervised as compared to unsupervised and control groups, respectively, the mean difference was 0.67% vs. 0.69% vs. 0.13% p < 0.001), and lipid profile (triglycerides (mean difference 0.25 mmol/L, 0.08 mmol/L, 0.11 mmol/L p < 0.001); LDL (mean difference 19.31 mg/dL, 10.51 mg/dL, 2.49 mg/dL p < 0.001); HDL (mean difference -12.68 mg/dL, -8.03 mg/dL, -1.48 mg/dL p < 0.001)). In comparison to the unsupervised and control groups, the insulin sensitivity parameters also demonstrated a modest improvement in the supervised group. The supervised group exhibited the greatest benefits from exercise among the groups that received exercise interventions. Conclusions: The present investigation demonstrated the significance of including structured physical activity into the regular routine of individuals with prediabetes, to decelerate the advancement of prediabetes to type 2 diabetes mellitus (T2DM). The current study emphasizes the essential role of structured exercise routines in the control of prediabetes and suggests that monitoring enhances the adherence and effectiveness of lifestyle interventions.

Fasting plasma glucose (FPG), glycated hemoglobin A1C (HbA1C), and 2-hour postload plasma glucose (2h PG) are all currently used to define prediabetes. We aimed to determine whether a higher number of prediabetes defects correspond to an increased all-cause and cardiovascular disease (CVD) mortality.

Individuals with prediabetes and available information on FPG, HbA1C, 2h PG, and mortality data were derived from the 2005-2016 National Health and Nutrition Examination Survey. Kaplan-Meier survival curves, Cox proportional hazards regression analysis, and stratified analysis were used to compare all-cause and CVD mortality among participants with one, two, and all three defects.

Among the 4511 individuals included, 76.31%, 30.89%, and 41.65% met the FPG-, 2h PG-, and HbA1C-defined criteria for prediabetes, respectively. There were 2609 (60.78%), 1420 (29.60%), and 482 (9.62%) adults meeting one, two, and all three criteria for prediabetes, respectively. During a median follow-up of 100 months, a total of 534 (180 CVD-related) deaths occurred. The multivariable-adjusted hazard ratios and 95% confidence intervals in those meeting two and three criteria were 1.341 (1.042-1.727) and 1.369 (1.027-1.824), respectively, for all-cause mortality (P for trend = 0.006), and 1.836 (1.228-2.744) and 2.037 (1.092-3.801), respectively, for CVD mortality (P for trend = 0.002), with those meeting only one criterion as the reference. In subgroup analysis, the association between the number of diagnostic criteria for prediabetes and CVD mortality was observed only in men.

A higher number of diagnostic criteria for prediabetes was associated with increased all-cause and CVD mortality.

The optimal definition and risk stratification approach to identify high-risk patients with prediabetes and stable coronary heart disease has not been well studied to date. The objective of the current study is to compare the prognostic value of different definitions of prediabetes, and to explore the role of "very-high-risk" (VHR) criteria according to the 2018 American Heart Association/American College of Cardiology cholesterol guideline in the risk stratification of patients with prediabetes and stable coronary heart disease.

This prospective large-cohort study enrolled a total of 7930 patients with stable coronary heart disease. Prediabetes was defined according to various guidelines and further classified on the basis of the VHR criteria according to the 2018 American Heart Association/American College of Cardiology guideline. The primary end point was major adverse cardiovascular events (MACEs), which was defined as the composite end point of cardiac death, nonfatal acute myocardial infarction, and stroke. During a median of 3 years' follow-up, a total of 256 MACEs occurred. Prediabetes defined according to the World Health Organization/International Expert Committee criteria was associated with significant increased MACE risk compared with normoglycemia (adjusted hazard ratio [HR], 1.484 [95% CI, 1.139-1.935]; P=0.0035). The VHR group was associated with increased MACE risk compared with the non-VHR group (adjusted HR, 1.783 [95% CI, 1.344-2.366], P<0.0001). The VHR criteria played an important role in risk stratification, and prediabetes combined with VHR criteria was associated with higher MACE risk regardless of the prediabetes definition.

Our findings suggested the potential use of the World Health Organization/International Expert Committee definition and VHR criteria in risk stratification of patients with prediabetes and stable coronary heart disease.

Prediabetes is characterized by impaired fasting glucose or impaired glucose tolerance (IGT), which can lead to cardiovascular complications. This study aims to determine the effects of lifestyle modification on glycemic outcomes in prediabetic individuals.

This quasi-experimental trial was conducted at the Department of Adult Cardiology, Phoenix Hospital, Abu Dhabi. Participants aged ≥18 years, of either gender, diagnosed with prediabetes as defined by hemoglobin A1c (HbA1c) levels between 5.7% and 6.4% were included in the study. Participants underwent a three-month lifestyle modification, adapted from cardiac rehabilitation principles, which included glycemic control, nutritional counseling, physical activity counseling, and exercise training. The primary outcome was the change in HbA1c levels following the intervention. Data analysis was performed using RStudio (Posit Software, Boston, MA).

A total number of 101 participants were enrolled, and 96 people completed the study. The average age of the participants was 44.80 ± 8.27 years. Most individuals were males, 85 (88.5%), and 11 females accounted for 11.5%. Postintervention, 25 participants (26%) reverted to normoglycemia, while 67 (69.8%) remained prediabetic, and 4 (4.2%) progressed to diabetes. Significant reductions in HbA1c levels were observed (p < 0.05). Subgroup analysis revealed no significant differences in outcomes based on age, gender, or clinical characteristics. The program demonstrated strong adherence, with a retention rate of 95%.

Lifestyle modification effectively improved glycemic control and reduced the progression of diabetes in prediabetic individuals. The findings support the integration of lifestyle interventions for managing prediabetes.

The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

This study aimed to identify low- and high-risk diabetes groups within prediabetes populations using data from the Taiwan Biobank (TWB) and UK Biobank (UKB) through a clustering-based Unsupervised Learning (UL) approach, to inform targeted type 2 diabetes (T2D) interventions.

Data from TWB and UKB, comprising clinical and genetic information, were analyzed. Prediabetes was defined by glucose thresholds, and incident T2D was identified through follow-up data. K-means clustering was performed on prediabetes participants using significant features determined through logistic regression and LASSO. Cluster stability was assessed using mean Jaccard similarity, silhouette score, and the elbow method.

We identified two stable clusters representing high- and low-risk diabetes groups in both biobanks. The high-risk clusters showed higher diabetes incidence, with 15.7% in TWB and 13.0% in UKB, compared to 7.3% and 9.1% in the low-risk clusters, respectively. Notably, males were predominant in the high-risk groups, constituting 76.6% in TWB and 52.7% in UKB. In TWB, the high-risk group also exhibited significantly higher BMI, fasting glucose, and triglycerides, while UKB showed marginal significance in BMI and other metabolic indicators. Current smoking was significantly associated with increased diabetes risk in the TWB high-risk group (P < 0.001). Kaplan-Meier curves indicated significant differences in diabetes complication incidences between clusters.

UL effectively identified risk-specific groups within prediabetes populations, with high-risk groups strongly associated male gender, higher BMI, smoking, and metabolic markers. Tailored preventive strategies, particularly for young males in Taiwan, are crucial to reducing T2D risk.

To investigate insulin resistance and pancreatic β-cell function in overweight or obese people under the same glucose tolerance conditions. The subjects were categorized based on the results of the oral glucose tolerance test (OGTT) and the BMI classification criteria. Basal and postprandial glucose concentrations, insulin concentrations, pancreatic β-cell function (HOMA-β), the insulin resistance index (HOMA-IR), and the insulin early secretion index (ΔI30/ΔG30) were compared between the different weight groups. Among individuals with similar glucose tolerances, those in the obese group presented higher HOMA-β, HOMA-IR, and ΔI30/ΔG30 values than did those in the normal weight and overweight groups. Additionally, in individuals with normal glucose tolerance and early diabetes, OGTT 1-h plasma glucose concentrations demonstrated a stronger correlation with early insulin secretion across different body weights. When the same glucose-tolerant population was grouped by weight, OGTTs were significantly less different than IRTs. Therefore, integrating both tests is the optimal approach. In individuals with preobesity, there is an increase in pancreatic β-cell function to maintain normal blood glucose levels. As the disease progresses, obesity substantially increases insulin resistance, which acts as a disease-promoting factor. Furthermore, OGTT 1-h plasma glucose concentrations are strongly correlated with insulin secretion in normal or early diabetic populations.

The impact of serum uric acid (SUA) levels on metabolic disorders, particularly concerning the development or reversal of prediabetes, is not well understood. While high uric acid is recognized for its association with metabolic disturbances, its specific influence on prediabetes progression and regression has been insufficiently explored. This study investigates how SUA levels correlate with the natural course of prediabetes, shedding light on its management.

A cohort of 3659 individuals diagnosed with prediabetes at Nanjing First Hospital was tracked over three years. Follow-up assessments included fasting plasma glucose and hemoglobin A1c (HbA1c) measurements. Serum uric acid was measured initially and categorized into quartiles (Q1 through Q4). To assess the impact of uric acid levels on shifting prediabetes status, methods such as restricted cubic spline, segmented regression, stratified analysis, and receiver operating characteristic curves were utilized in a multinomial logistic regression framework.

At baseline, all 3659 participants had prediabetes; by the three-year mark, 2626 remained in this category, 523 reverted to normal fasting glucose (NFG), and 510 advanced to diabetes. After adjustment for potential confounders, a positive correlation was found between higher SUA levels and progression to diabetes (Odds ratio [OR] 1.182, 95% confidence interval [CI]: 1.095-1.276), with no significant link to reversion to NFG (OR: 0.987, 95% CI: 0.909-1.073).

Elevated SUA levels are linked with a higher likelihood of progressing from prediabetes to diabetes but do not significantly forecast a regression to NFG.

To investigate the association between estimated glucose disposal rate (eGDR) and kidney function decline among populations with different glucose tolerance statuses including normal glucose tolerance (NGT), prediabetes, and diabetes.

The present study analyzed 5,069 participants from a cohort study. The association between eGDR and kidney function decline was assessed using binary logistic regression. Restricted cubic splines (RCS) analyses were also performed to investigate the dose-dependent associations.

During up to 5 years of follow-up, 116 (2.30%) individuals experienced kidney function decline. Binary logistic regression showed that an increased level of eGDR was associated with decreased risk of kidney function decline after full adjustment, in all participants (Q4 vs. Q1 HR 0.13, 95% CI 0.05-0.30, p = 0.001), prediabetes (Q4 vs. Q1HR 0.11, 95% CI 0.01-0.44, p = 0.007), and diabetes (Q4 vs. Q1 HR 0.06, 95% CI 0.00-0.37, p = 0.012), but not in those with NGT. RCS analyses suggested dose-dependent relationships of eGDR with the risk of kidney function decline in all participants (L-shaped curve) and those with prediabetes (inverted U-shaped curve) and diabetes (L-shaped curve).

The association between elevated baseline eGDR and reduced risk of kidney function decline was significant in participants with prediabetes and diabetes, but not in those with NGT. These dose-dependent associations may have important implications for the assessment of high-risk patients by healthcare professionals and may lead to the development of more tailored and effective prevention strategies.

Prediabetes is the first stage of a continuum that extends through the diagnosis of clinical type 2 diabetes towards long-standing diabetes with multiple comorbidities. The diagnosis of prediabetes provides an opportunity to interrupt the diabetes continuum at an early stage to ensure long-term optimization of clinical outcomes. All people with prediabetes should receive intervention to improve their lifestyles (quality of diet and level of physical activity), as this has been proven beyond doubt to reduce substantially the risk of conversion to diabetes. Additionally, a large base of clinical evidence supports the use of metformin in preventing or delaying the transition from prediabetes to clinical type 2 diabetes, for some people with prediabetes. For many years, guidelines for the management of type 2 diabetes focused on lowering blood glucose, with metformin prescribed first for those without contraindications. More recently, guidelines have shifted towards prevention of diabetes complications as the primary goal, with increased use of GLP-1 receptor agonists (or multi-agonist incretin peptides) or SGLT-2 inhibitors for patients with existing atherosclerotic cardiovascular disease, heart failure or chronic kidney disease. Access to these medications often remains challenging. Metformin remains a suitable option for initial pharmacologic intervention to manage glycemia for many people with prediabetes or type 2 diabetes along with other therapy to maintain control of blood glucose or to address specific comorbidities as the patient progresses along the diabetes continuum.

To determine prevalence, trends, and subsequent outcomes of prediabetes defined by American Diabetes Association (ADA), World Health Organization (WHO), and International Expert Committee (IEC) criteria in the United States between 1999 and 2018.

Ten cycles of cross-sectional National Health and Nutrition Examination Survey data were included. Prediabetes was defined by ADA, WHO, and IEC criteria. Unadjusted or covariate adjusted prevalence and trends of prediabetes were estimated. Cox proportional regression model was performed to evaluate the association between prediabetes and all-cause, cardiovascular, or diabetes-related mortality.

Among the 59 369 participants included (weighted mean age, 41.1 years; 48.7% male), the prevalence of prediabetes was 29.4% in ADA criteria, 16.3% in WHO criteria, and 5.0% in IEC criteria. The covariate adjusted prevalence of prediabetes defined by ADA criteria increased significantly in at least twofolds from 15.6% in 1999-2002 to 37.3% in 2015-2018 (P < .001). Similar significant increased trends were observed in WHO and IEC criteria (P < .001). Compared with normal glycemia, prediabetes participants had higher adjusted risk of diabetes-related mortality irrespective of the criteria used (ADA: hazard ratio [HR] 9.11 [95% CI, 5.83-14.22]; WHO: HR 5.35 [95% CI, 3.01-9.51]; IEC: HR 9.64 [95% CI, 5.92-15.71]). No significant associations between prediabetes and all-cause or cardiovascular mortality were observed in the adjusted models.

In the United States, approximately 1 in 3 individuals have prediabetes according to ADA criteria. The prevalence of prediabetes has shown a significant and more than twofold increase over the past 2 decades, posing an elevated risk of diabetes-related mortality, regardless of the criteria applied.

To compare the 1-hour postload glucose (1h-PG) value of an oral glucose tolerance test (OGTT) with the metabolic syndrome (MetS) and the Finish Diabetes Risk Score (FINDRISC) in patients with impaired fasting glucose (IFG) to predict type 2 diabetes mellitus (T2DM).

A cohort study was conducted in patients at a general hospital in Lima, Perú. An OGTT was performed in subjects with IFG who were followed-up for 7 years for T2DM development. The exposure variables were 1h-PG ≥ 155 mg/dL, MetS, and a FINDRISC ≥ 13 points, and the outcome was the presence of T2DM. The relative risk, confidence interval, and area under the curve (AUROC) were also estimated.

Among 324 subjects with IFG, 218 completed the 7-year follow-up. The mean age was 56.2 ± 11.5 years, 64.0% were woman, and 63.8% were overweight/obese. Of these, 36.8% had 1h-PG ≥ 155 mg/dL and normal glucose tolerance, 66.8% had MetS, and 64.5% had FINDRISC ≥ 13 points. After 7 years, 21.1% of participants developed T2DM, with 68.8% of them who had 1h-PG ≥ 155 mg/dL (P < .001), 62.2% had MetS (P = .013), and 67.9% had FINDRISC ≥ 13 (P = .68). After adjusting by age, sex, and body mass index, the relative risk was 3.52 (1.64-7.54; 95% CI), 1.81 (0.96-3.38; 95% CI), and 1.17 (0.51-2.70; 95% CI) for each exposure variable, respectively. Also, the AUROC was 0.72 (0.60-0.83), 0.63 (0.51-0.75), and 0.51 (0.38-0.63) (P = .01), respectively.

By performing an OGTT in patients with IFG, an 1h-PG ≥ 155 mg/dL value may be helpful to predict T2DM at 7 years better than the use of MetS or the FINDRISC.

Dietary fiber (DF) can be separated from food and convenient to take, and has an important role in diabetes prevention, but long-term intervention data are lacking. This study evaluated the long-term benefits of DF supplementation on body composition, glucose-lipid metabolism, and clinical regression in middle-aged and elderly patients with prediabetes.

A randomized, controlled, open clinical study was conducted. Participants were randomized into a control group receiving health education and an intervention group consuming DF supplements daily before meals (15 g of mixed fiber per serving) for 6 consecutive months based on health education. Follow-up was 1 year with a 6-month cycle. Blood and anthropometric parameters were assessed at baseline and 6 months and 12 months of follow-up.

Fifty-four participants were included in the study, 27 in each group. After 6 months, waist circumference, waist-to-hip ratio, fasting plasma glucose (FPG), 2 hour plasma glucose (2h PG), and postprandial insulin levels were significantly lower in the intervention group compared to baseline. FPG, 2h PG, glycosylated hemoglobin, triglyceride/high-density lipoprotein cholesterol values and diabetes incidence were lower than in the control group. After 12 months, blood glucose and diabetes incidence remained lower in the intervention group.

DF supplementation can reduce the degree of central obesity, the levels of FPG and 2h PG, and the incidence of diabetes in middle-aged and older patients with prediabetes.

Prediabetes is prevalent in Saudi Arabia and globally. It is associated with adverse health outcomes and complications. Consequently, this study aimed to determine the risk factors associated with developing prediabetes in Saudi Arabia.

This is a case-control study conducted at the Family and Community Medicine Department at Prince Sultan Military Medical City, Riyadh, Saudi Arabia. The cases included individuals with prediabetes (prediabetes group), and the control group included individuals with normal HbA1c levels who were not diagnosed with prediabetes or diabetes. The data collected included sociodemographic data, clinical parameters, laboratory tests, and medical conditions.

The study included 46,201 patients (16,029 patients with prediabetes and 30,173 in the control group). The age of the patients (mean ± SD) with prediabetes was significantly higher than that of the control group (47.22 ± 14.04 versus 36.12 ± 11.83, p < 0.0001). A higher proportion of men was noted in the prediabetes group compared to the control group (36.32% versus 26.54%, p < 0.0001). The body mass index (mean ± SD) was higher in the prediabetes group compared to the control group (33.76 ± 6.75 versus 30.16 ± 7.26, p < 0.0001). The multiple logistic regression analysis showed six independent risk factors associated with prediabetes. These included age (aOR [95% CI] = 1.067 [1.065-1.069]) and gender, with women at a lower risk compared to men (aOR [95% CI] = 0.695 [0.664-0.728]). Other independent risk factors included polycystic ovarian syndrome (aOR [95% CI] = 58.102 (35.731-94.479]), obesity (aOR [95% CI] = 1.265 [1.075-1.487]), cardiac conditions (aOR [95% CI] = 4.870 [1.024-23.154]), and hypertension (aOR [95% CI] = 1.133 [1.031-1.245]).

The study showed that several risk factors are associated with the development of prediabetes in the Saudi population. Addressing these factors can help prevent prediabetes, and consequently, its burden and further progression to diabetes.

Obesity is chronic disease and causal precursor to myriad other conditions, including type 2 diabetes. In an earlier analysis of the SURMOUNT-1 trial, tirzepatide was shown to provide substantial and sustained reductions in body weight in persons with obesity over a 72-week period. Here, we report the 3-year safety outcomes with tirzepatide and its efficacy in reducing weight and delaying progression to type 2 diabetes in persons with both obesity and prediabetes.

We performed a phase 3, double-blind, randomized, controlled trial in which 2539 participants with obesity, of whom 1032 also had prediabetes, were assigned in a 1:1:1:1 ratio to receive tirzepatide at a once-weekly dose of 5 mg, 10 mg, or 15 mg or placebo. The current analysis involved the participants with both obesity and prediabetes, who received their assigned dose of tirzepatide or placebo for a total of 176 weeks, followed by a 17-week off-treatment period. The three key secondary end points, which were controlled for type I error, were the percent change in body weight from baseline to week 176 and onset of type 2 diabetes during the 176-week and 193-week periods.

At 176 weeks, the mean percent change in body weight among the participants who received tirzepatide was -12.3% with the 5-mg dose, -18.7% with the 10-mg dose, and -19.7% with the 15-mg dose, as compared with -1.3% among those who received placebo (P<0.001 for all comparisons with placebo). Fewer participants received a diagnosis of type 2 diabetes in the tirzepatide groups than in the placebo group (1.3% vs. 13.3%; hazard ratio, 0.07; 95% confidence interval [CI], 0.0 to 0.1; P<0.001). After 17 weeks off treatment or placebo, 2.4% of the participants who received tirzepatide and 13.7% of those who received placebo had type 2 diabetes (hazard ratio, 0.12; 95% CI, 0.1 to 0.2; P<0.001). Other than coronavirus disease 2019, the most common adverse events were gastrointestinal, most of which were mild to moderate in severity and occurred primarily during the dose-escalation period in the first 20 weeks of the trial. No new safety signals were identified.

Three years of treatment with tirzepatide in persons with obesity and prediabetes resulted in substantial and sustained weight reduction and a markedly lower risk of progression to type 2 diabetes than that with placebo. (Funded by Eli Lilly; SURMOUNT-1 ClinicalTrials.gov number, NCT04184622.).

Digital health lifestyle interventions (DHLI) may offer scalable solutions to manage prediabetes in clinical practice; however, their effectiveness on people with prediabetes has not been systematically investigated and reviewed. Hence, in this systematic review, meta-analysis, and meta-regression the effectiveness of DHLI on prediabetes-related outcomes was investigated.

Four databases were searched to identify randomized controlled trials investigating the effectiveness of DHLI on adults with prediabetes published before 23 February 2024. The primary outcome was the change in body weight, with secondary outcomes including, among others, glycemic status, body composition, and feasibility outcomes. Meta-analyses were conducted to provide overall effect estimates of outcomes. In addition, meta-regressions on the primary outcome were conducted. The study quality was assessed using the Cochrane Risk of Bias tool, and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

A total of 33 studies were included (n = 14 398). The study duration ranged from 3 to 60 months. The digital interventions varied from in-person meetings combined with pedometers and telephone calls to fully digital interventions. The overall estimated treatment difference in change in body weight favored the intervention (mean difference: -1.74 kg; 95% confidence interval: -2.37, -1.11; P < .01) with moderate certainty. Statistically significant overall effect estimates favoring the intervention were also found for secondary outcomes with very low to moderate certainty.

Digital health lifestyle interventions can result in statistically significant change in body weight and other secondary outcomes among people with prediabetes.

To identify the proportion of patients with prediabetes who have prescribed metformin and factors related to doing so as a preventive measure for diabetes in primary care at a Family Medicine Unit in northeastern Mexico.

This retrospective observational study included 372 adults who met the criteria for prediabetes diagnosis according to the American Diabetes Association. Data was collected from medical records from January 2020 to December 2021. Possible associations between the variables of interest and the prescription of metformin were tested via hypothesis tests, furthermore, binary logistic regression was performed.

Nearly 85% of the patients met at least one criterion for receiving metformin according to ADA recommendations, but only 60% of them were prescribed this medication. Patients with metformin prescriptions differed from those without in aspects such as having a documented diagnosis of prediabetes in their medical records, a higher BMI, and higher glucose levels.

Almost one out of two patients with a high risk of type 2 diabetes are not treated with metformin as a preventive measure. Factors associated with metformin prescription included a high BMI, elevated baseline glucose levels, and a prediabetes diagnosis in the medical record. These findings suggest the need for studies to evaluate physicians' reasons for different treatments and implementation of recommendations for type 2 diabetes prevention in patients with prediabetes in primary health care.

There is an increasing trend of pre-diabetes and diabetes mellitus (DM) among adolescents, and sub-Saharan Africa is no exception. However, few published data on pre-diabetes among adolescents in Sudan exist. We aimed to investigate the prevalence of and factors associated with pre-diabetes among adolescents in Eastern Sudan.

A community-based cross-sectional study was conducted from August to October 2023.

This community-based study was conducted in Gadarif city, the capital of Gadarif state, Eastern Sudan.

Adolescents (within the ages of 10-19 years).

A questionnaire was used to collect socio-demographic information. Anthropometric and glycated haemoglobin (HbA1c) measurements were performed in accordance with standard procedures. Multivariate logistic regression analysis was performed.

Of the 387 enrolled adolescents, 207 (53.5%) were female and 180 (46.5%) were male. The median (IQR) age was 14.0 (12.0-16.0) years. 39.5% of the participants' fathers were employed. The median (IQR) HbA1c was 5.5% (5.2%-5.8%). One-third (32.6%) of the adolescents had pre-diabetes or DM. Of the participants, 67.4%, 30.0% and 2.6% had no DM, pre-diabetes or type 2 DM, respectively. In the univariate analysis, the father's employment (OR=1.60, 95% CI=1.03 to 2.50) was associated with increased odds of pre-diabetes; age, sex, parents' education, the mother's occupation, body mass index z-score, cigarette smoking and a family history of DM were not associated with pre-diabetes. In the multivariate analysis, the father's employment (adjusted OR=1.70, 95% CI=1.03 to 2.50) was associated with increased odds of pre-diabetes.

Pre-diabetes is a significant public health problem among adolescents in Eastern Sudan. The introduction of early screening programmes for pre-diabetes at the community level is recommended to halt the progression of pre-diabetes to DM and to deal with existing DM among adolescents.

Myocardial layer-specific strain is a sensitive tool for detecting myocardial dysfunction. The objective of this study was to assess changes in the left ventricle (LV) function using myocardial layer-specific strain and its association with 10-year atherosclerotic cardiovascular disease risk (10Y-ASCVDR) in individuals with hypertension (HP).

The parameters of LV structure, including layer-specific global longitudinal strain (GLSww, GLSendo, GLSmid, GLSepi) and layer-specific global circumferential strain (GCSww, GCSendo, GCSmid, GCSepi), were analyzed by two-dimensional speckle-tracking echocardiography in 239 hypertensive patients and 124 control subjects. In addition, participants were divided into low-risk (LR) and high-risk (HR) subgroups according to 10Y-ASCVDR scores . The correlation between myocardial layer-specific strain and 10Y-ASCVDR was further analyzed by the restricted cubic spline (RCS) function.

The values of GLSww, GLSepi, GLSmid, and GLSendo were significantly lower in HP patients with HR than in HP patients with LR and controls (p < 0.05). However, no significant differences in layer-specific GCS were observed between the groups (p > 0.05). RCS analysis revealed that 10Y-ASCVDR exhibited a significant J-shaped relationship with layer-specific GLS and GCS. After adjusting for confounding factors, GLSww (β = 0.156, p = 0.042), GLSmid (β = 0.161, p = 0.032), GCSendo (β = 0.163, p = 0.024), and GCSmid (β = -0.175, p = 0.030) were identified as independent influencing factors for high 10Y-ASCVDR.

In hypertensive patients, myocardial layer-specific strain, especially GLS, sensitively detected LV dysfunction and showed a significant J-shaped relationship with 10Y-ASCVDR. GCSmid may have a compensatory effect on myocardial impairment. LV myocardial layer-specific strain may help to understand the early compensatory mechanisms of the myocardium in hypertension.