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microvascular complications of impaired glucose tolerance

Firouz Daneshgari, Guiming Liu, Ann T Hanna-Mitchell
Diabetes Mellitus (DM) is a prevalent chronic disease. Type 1 diabetes mellitus (T1DM) is a metabolic disorder that is characterized by hyperglycemia in the context of absolute lack of insulin; whereas type 2 diabetes mellitus (T2DM) is due to insulin resistance-related relative insulin deficiency. Obesity is an established risk factor for T2DM. In comparison with T1DM, T2DM is more complex. The natural history of T2DM in most patients typically involves a course of obesity to impaired glucose tolerance, to insulin resistance and hyperglycemia...
January 4, 2017: American Journal of Physiology. Renal Physiology
Andrew J Krentz, Marcus Hompesch
The clinical utility of diabetes biomarkers can be considered in terms of diagnosis, management and prediction of long-term vascular complications. Glucose satisfies all of these requirements. Thresholds of hyperglycemia diagnostic of diabetes reflect inflections that confer a risk of developing long-term microvascular complications. Degrees of hyperglycemia (impaired fasting glucose, impaired glucose tolerance) that lie below the diagnostic threshold for diabetes identify individuals at risk of progression to diabetes and/or development of atherothrombotic cardiovascular disease...
October 13, 2016: Biomarkers in Medicine
Muhammad Abdul-Ghani, Ralph A DeFronzo, Amin Jayyousi
PURPOSE OF REVIEW: The purpose of this review is to summarize the distinct metabolic and pathophysiologic phenotype of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) and the subsequent clinical implications with regard to future type 2 diabetes mellitus (T2DM) and cardiovascular risk. RECENT FINDINGS: Both IFG and IGT manifest the two core defects of T2DM, that is, insulin resistance and β-cell dysfunction. However, the site of insulin resistance and shape of β-cell dysfunction differ...
July 6, 2016: Current Opinion in Clinical Nutrition and Metabolic Care
Ben Brannick, Anne Wynn, Samuel Dagogo-Jack
Prediabetes is a state characterized by impaired fasting glucose or impaired glucose tolerance. Evidence is increasingly demonstrating that prediabetes is a toxic state, in addition to being a harbinger of future development of diabetes mellitus. This minireview discusses the pathophysiology and clinical significance of prediabetes, and approach to its management, in the context of the worldwide diabetes epidemic. The pathophysiologic defects underlying prediabetes include insulin resistance, β cell dysfunction, increased lipolysis, inflammation, suboptimal incretin effect, and possibly hepatic glucose overproduction...
June 2016: Experimental Biology and Medicine
Neil F Goodman, Rhoda H Cobin, Walter Futterweit, Jennifer S Glueck, Richard S Legro, Enrico Carmina
Polycystic ovary syndrome (PCOS) is recognized as the most common endocrine disorder of reproductive-aged women around the world. This document, produced by the collaboration of the American Association of Clinical Endocrinologists and the Androgen Excess Society aims to highlight the most important clinical issues confronting physicians and their patients with PCOS. It is a summary of current best practices in 2014. Insulin resistance is believed to play an intrinsic role in the pathogenesis of PCOS. The mechanism by which insulin resistance or insulin give rise to oligomenorrhea and hyperandrogenemia, however, is unclear...
December 2015: Endocrine Practice
D Scott Kehler, Andrew N Stammers, Shanel E Susser, Naomi C Hamm, Dustin E Kimber, Michael W Hlynsky, Todd A Duhamel
The prevalence of type 2 diabetes mellitus (T2DM) in youth has increased dramatically over the past decades. The literature also suggests that the progression from an impaired glucose tolerance state to established T2DM is more rapid in youth, compared to adults. The presence of significant cardiovascular complications in youth with T2DM, including cardiac, macrovascular, and microvascular remodeling, is another major issue in this younger cohort and poses a significant threat to the healthcare system. However, this issue is only now emerging as a major public health concern, with few data to support optimal treatment targets and strategies to reduce cardiovascular disease (CVD) risk in youth with T2DM...
October 2015: Biochemistry and Cell Biology, Biochimie et Biologie Cellulaire
Patricio López-Jaramillo, Carlos Velandia-Carrillo, Diego Gómez-Arbeláez, Martin Aldana-Campos
The diagnosis of diabetes mellitus type 2 (DM2) is based either on increased plasma glucose or Glycated hemoglobin levels. Since these measures are the only means for diagnosis of DM2, they must be well adapted to each population according to their metabolic characteristics, given that these may vary in each population. The World Health Organization (WHO) determined the cut-points of plasma glucose levels for the diagnosis of DM2 by associating hyperglycemia with the risk of a specific microvascular complication-retinopathy...
December 15, 2014: World Journal of Diabetes
W El-Hammady, A Shawky, A El-Annany
BACKGROUND: Epidemiologic evidence suggests that the complications of diabetes begin early in the progression from normal glucose tolerance to frank diabetes. Prediabetes is defined as people with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), some of whom in fact already have the characteristic microvascular changes resulting from diabetes itself. METHODS AND RESULTS: This study was conducted on 108 patients presenting to Ain Shams University Catheterization Laboratory for elective percutaneous coronary intervention using bare metal stents (48 diabetic patients, 30 pre-diabetic patients and 30 non-diabetic patients)...
April 2013: Journal of the Saudi Heart Association
Richard E Gilbert, Johannes F E Mann, Markolf Hanefeld, Giatgen Spinas, Jackie Bosch, Salim Yusuf, Hertzel C Gerstein
AIMS/HYPOTHESIS: As glycaemia and the incidence of microvascular diabetes complications follow a log-linear relationship, it becomes increasingly difficult to demonstrate a microvascular benefit of glucose-lowering when the HbA1c level is close to normal. METHODS: The Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial randomised 12,537 people with diabetes, impaired glucose tolerance or impaired fasting glucose to receive standard glycaemic care or standard care with the addition of basal insulin glargine (A21Gly,B31Arg,B32Arg human insulin), targeting a fasting plasma glucose level ≤5...
July 2014: Diabetologia
Abhijit Shiny, Yesodha S Bibin, Coimbatore Subramanian Shanthirani, Bhaskaran S Regin, Ranjit Mohan Anjana, Muthuswamy Balasubramanyam, Saravanan Jebarani, Viswanathan Mohan
BACKGROUND: The neutrophil-lymphocyte ratio (NLR) has been demonstrated to be a better risk factor than total white blood cell count in the prediction of adverse outcomes in various medical conditions. This study analyzed the association of NLR with different grades of glucose tolerance and insulin resistance in Asian Indians. SUBJECTS AND METHODS: Study subjects were recruited from Phase 3 of the Chennai Urban Rural Epidemiology Study (CURES). For this cross-sectional analysis, subjects with normal glucose tolerance (NGT) (n=237), impaired glucose tolerance (IGT) (n=63), and type 2 diabetes mellitus (DM) (n=286) were selected...
August 2014: Diabetes Technology & Therapeutics
D Smith-Marsh
Type 2 diabetes is an increasingly prevalent disease in the United States, and is associated with microvascular and macrovascular complications. Prediabetes, which is defined as impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), increases the risk of development of type 2 diabetes. Lifestyle improvements, including weight loss and increased physical activity are effective in reducing the conversion of IGT to type 2 diabetes by 58%. However, lifestyle interventions alone may be difficult to maintain...
August 2013: Drugs of Today
Claire K Mulvey, Ann M McNeill, Cynthia J Girman, Timothy W Churchill, Karen Terembula, Jane F Ferguson, Rachana Shah, Nehal N Mehta, Atif N Qasim, Michael R Rickels, Muredach P Reilly
OBJECTIVE We evaluated relationships of oral glucose tolerance testing (OGTT)-derived measures of insulin sensitivity and pancreatic β-cell function with indices of diabetes complications in a cross-sectional study of patients with type 2 diabetes who are free of overt cardiovascular or renal disease. RESEARCH DESIGN AND METHODS A subset of participants from the Penn Diabetes Heart Study (n = 672; mean age 59 ± 8 years; 67% male; 60% Caucasian) underwent a standard 2-h, 75-g OGTT. Insulin sensitivity was estimated using the Matsuda Insulin Sensitivity Index (ISI), and β-cell function was estimated using the Insulinogenic Index...
2014: Diabetes Care
Adele Bahar, Atieh Makhlough, Atefe Yousefi, Zahra Kashi, Saeid Abediankenari
BACKGROUND: Impaired fasting glucose (IFG), and impaired glucose tolerance (IGT) are two prediabetes conditions which have some correlation with macrovascular disorders. The risk of microvascular complications in these groups is not clear. OBJECTIVES: The prevalence of albuminuria in subjects with IFG and IGT was evaluated in the present study. PATIENTS AND METHODS: In this study three groups of subjects were entered (45 subjects in each group): IFG, IGT, and normal glucose tolerance as control...
2013: Nephro-urology Monthly
Melinda Maggard-Gibbons, Margaret Maglione, Masha Livhits, Brett Ewing, Alicia Ruelaz Maher, Jianhui Hu, Zhaoping Li, Paul G Shekelle
IMPORTANCE: Bariatric surgery is beneficial in persons with a body mass index (BMI) of 35 or greater with obesity-related comorbidities. There is interest in using these procedures in persons with lower BMI and diabetes. OBJECTIVE: To assess the association between bariatric surgery vs nonsurgical treatments and weight loss and glycemic control among patients with diabetes or impaired glucose tolerance and BMI of 30 to 35. EVIDENCE REVIEW: PubMed, EMBASE, and Cochrane Library databases were searched from January 1985 through September 2012...
June 5, 2013: JAMA: the Journal of the American Medical Association
Ghassan Jarred, R Lee Kennedy
There are extensive data confirming involvement of the renin-angiotensin system in microvascular and macrovascular complications of diabetes. Blockade of the system with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) is regarded as the first-line approach to managing hypertension and end-organ protection in patients with diabetes. ACE inhibitors are still the preferred agents for most patients. Dose should be lower with renal impairment unless an agent which is not excreted by the kidneys is chosen...
February 2010: Therapeutic Advances in Endocrinology and Metabolism
Sergey Lupachyk, Pierre Watcho, Alexander A Obrosov, Roman Stavniichuk, Irina G Obrosova
Growing evidence suggests that prediabetes and metabolic syndrome are associated with increased risk for the development of microvascular complications including retinopathy, nephropathy, and, most commonly, peripheral painful neuropathy and/or autonomic neuropathy. The etiology of these disabling neuropathies is unclear, and several clinical and experimental studies implicated obesity, impaired fasting glycemia/impaired glucose tolerance, elevated triglyceride and non-esterified fatty acids, as well as oxidative-nitrative stress...
September 2013: Experimental Neurology
Camila Furtado de Souza, Jorge Luiz Gross, Fernando Gerchman, Cristiane Bauermann Leitão
Type 2 diabetes mellitus accounts for 90% of diabetes cases and is associated with macro- and microvascular complications of high morbidity and mortality. Individuals with increased risk for type 2 diabetes include those with impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and especially those with combined IFG and IGT. These individuals are part of a group known as prediabetes patients. Approximately 25% of individuals with prediabetes will develop type 2 diabetes in three to five years. Hyperglycemia, in the absence of diabetes, is also associated with increased risk of cardiovascular disease...
July 2012: Arquivos Brasileiros de Endocrinologia e Metabologia
Claude Jaffiol
W.H.O. predicts that there will be some 438 million diabetic patients in 2030, most of them living in developing countries. The IFD estimates that the prevalence of diabetes will rise by 98% in Africa during the next 20 years, with dramatic implications for public health and national budgets of the poorest countries. Type 2 diabetes is the most common form in Africa; type 1 is rarer than in western countries and tends to occur later. Two other forms seem specific to black Africans: ketosis-prone atypical diabetes, and tropical malnutrition-related diabetes...
June 2011: Bulletin de L'Académie Nationale de Médecine
Elisavet Moutzouri, Vasilis Tsimihodimos, Evangelos Rizos, Moses Elisaf
The incidence of diabetes is continuously increasing worldwide. Pre-diabetes (defined as impaired glucose tolerance, impaired fasting glucose or both) represents an intermediate state, which often progresses to overt diabetes within a few years. In addition, pre-diabetes may be associated with increased risk of microvascular and macrovascular complications. Thus, reverting a pre-diabetic state as well as preventing the development of diabetes represents enormous challenge for the clinician. Lifestyle modification in pre-diabetic individuals was found particularly effective in the prevention of diabetes...
December 15, 2011: European Journal of Pharmacology
P Suryanarayana, Madhoosudan A Patil, G Bhanuprakash Reddy
Cataract, the leading cause of blindness worldwide, is associated with many risk factors including diabetes. Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) states are associated with pre-diabetes and insulin resistance. This condition subsequently leads to the development of type-2 diabetes. Epidemiological studies indicated that not only diabetes but IGT/IFG will also lead to the development of microvascular disorders and cataract. However, there are no studies on the mechanism of insulin resistance induced changes in the eye lens...
October 2011: Indian Journal of Experimental Biology
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