Impaired fasting glucose and impaired glucose tolerance: implications for care.
David M. Nathan,Mayer B. Davidson,Ralph A. DeFronzo,Robert J. Heine,Robert R. Henry,Richard E. Pratley,Bernard Zinman +6 more
TLDR
With the development of diabetes, there is a large increase in risk for CVD, as well as for long-term complications affecting the eyes, kidneys, and nervous system, and the risk of a CVD event is modestly increased.Abstract:
Type 2 diabetes is now epidemic. In the U.S., there has been a 61% increase in incidence between 1990 and 2001 (1). There are currently 1.5 million new cases per year, and the prevalence in 2005 was almost 21 million (2). The epidemic has affected developed and developing countries alike, and the worldwide prevalence of diabetes is projected to increase dramatically by 2025 (3). The increase in type 2 diabetes is related to lifestyle changes that have resulted in overweight, obesity, and decreased physical activity levels. These environmental changes, superimposed on genetic predisposition, increase insulin resistance, which, in concert with progressive β-cell failure, results in rising glycemia in the nondiabetic range. In addition to the risk for diabetes, insulin resistance and impaired insulin secretion are accompanied by a host of major cardiovascular disease (CVD) risk factors including hypertension and dyslipidemia. Further reduction in insulin secretion over time results in increasing glycemia and the development of diabetes, which in turn is associated with the development of microvascular and cardiovascular complications.
The transition from the early metabolic abnormalities that precede diabetes, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), to diabetes may take many years; however, current estimates indicate that most individuals (perhaps up to 70%) with these pre-diabetic states eventually develop diabetes (4–10). During the pre-diabetic state, the risk of a CVD event is modestly increased (11–22). With the development of diabetes, however, there is a large increase in risk for CVD, as well as for long-term complications affecting the eyes, kidneys, and nervous system. The complications of diabetes, which are the cause of major morbidity and mortality, are related to its duration, chronic level of glycemia, and other risk factors.
Although clinical trials have demonstrated the effectiveness of intensive glycemic and blood pressure control to …read more
Citations
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Journal ArticleDOI
Standards of Medical Care in Diabetes—2012
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payers, and other interested individuals with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care.
Journal ArticleDOI
Standards of Medical Care in Diabetes—2010
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care.
Journal ArticleDOI
Comment on: American Diabetes Association. Standards of Medical Care in Diabetes—2011. Diabetes Care 2011;34(Suppl. 1):S11–S61
TL;DR: The new standards set by the American Diabetes Association in 2011 recommend universal screening at 24–28 weeks of gestation and an oral glucose tolerance test with a diagnostic fasting plasma glucose of ≥92 mg/dL (4.5 mmol/L) (much lower than the World Health Organization criteria).
Journal ArticleDOI
Standards of Medical Care in Diabetes—2011
TL;DR: I. Screening and management of chronic complications in children and adolescents with type 1 diabetes i.e., screenings for type 2 diabetes and risk of future diabetes in adults, and strategy for improving diabetes care in the hospital, are outlined.
References
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William C. Knowler,Elizabeth Barrett-Connor,Sarah E. Fowler,Richard F. Hamman,John M. Lachin,Elizabeth A. Walker,David M. Nathan +6 more
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TL;DR: Overweight and obesity were significantly associated with diabetes, high blood pressure, high cholesterol, asthma, arthritis, and poor health status, and increases in obesity and diabetes continue in both sexes, all ages, all races, all educational levels, and all smoking levels.
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Effects of Diet and Exercise in Preventing NIDDM in People With Impaired Glucose Tolerance: The Da Qing IGT and Diabetes Study
Xiao Ren Pan,Guang Wei Li,Ying Hua Hu,Ji Xing Wang,Wenying Yang,Zuo Xin An,Ze Xi Hu,Juan Lin,Jian Zhong Xiao,Hui Bi Cao,Ping An Liu,Xi Gui Jiang,Ya Yan Jiang,Jin Ping Wang,Hui Zheng,Hui Zhang,Peter H. Bennett,Barbara V. Howard +17 more
TL;DR: Diet and/or exercise interventions led to a significant decrease in the incidence of diabetes over a 6-year period among those with IGT, and thereby reduce the overall incidence of diabetic complications.
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Saul Genuth,K. G. M. M. Alberti,Peter H. Bennett,John B. Buse,Ralph A. DeFronzo,Richard Kahn,John L. Kitzmiller,William C. Knowler,Harold E. Lebovitz,Åke Lernmark,David M. Nathan,Jerry P. Palmer,Robbert Rizza,Christopher D Saudek,Jonathan E. Shaw,Michael W. Steffes,Michael P. Stern,Jaakko Tuomilehto,Paul Zimmet +18 more