Comparative prognostic performance of definitions of prediabetes: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study

Warren, Bethany; Pankow, James S.; Matsushita, Kunihiro; Punjabi, Naresh M.; Daya, Natalie; Grams, Morgan E.; Woodward, Mark; Selvin, Elizabeth

doi:10.1016/s2213-8587(16)30321-7

Cited by 155 publications

(142 citation statements)

References 22 publications

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“…The definition of prediabetes is controversial given 5 different fasting glucose and HbA 1c criteria with differing sensitivities and specificities (Table ) resulting in differing prevalence and clinical outcomes . Warren et al recently compared these tests and threshold levels for identifying prediabetes extending previous observations demonstrating different and overlapping prevalence of prediabetes according to the definition used …”

Section: Introductionmentioning

confidence: 99%

Lessons learned from the 1‐hour post‐load glucose level during OGTT: Current screening recommendations for dysglycaemia should be revised

Bergman¹,

Jagannathan

Buysschaert

et al. 2018

Diabetes Metabolism Res

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This perspective covers a novel area of research describing the inadequacies of current approaches for diagnosing dysglycaemia and proposes that the 1-hour post-load glucose level during the 75-g oral glucose tolerance test may serve as a novel biomarker to detect dysglycaemia earlier than currently recommended screening criteria for glucose disorders. Considerable evidence suggests that a 1-hour post-load plasma glucose value ≥155 mg/dl (8.6 mmol/L) may identify individuals with reduced β-cell function prior to progressing to prediabetes and diabetes and is highly predictive of those likely to progress to diabetes more than the HbA or 2-hour post-load glucose values. An elevated 1-hour post-load glucose level was a better predictor of type 2 diabetes than isolated 2-hour post-load levels in Indian, Japanese, and Israeli and Nordic populations. Furthermore, epidemiological studies have shown that a 1-hour PG ≥155 mg/dl (8.6 mmol/L) predicted progression to diabetes as well as increased risk for microvascular disease and mortality when the 2-hour level was <140 mg/dl (7.8 mmol/L). The risk of myocardial infarction or fatal ischemic heart disease was also greater among subjects with elevated 1-hour glucose levels as were risks of retinopathy and peripheral vascular complications in a Swedish cohort. The authors believe that the considerable evidence base supports redefining current screening and diagnostic recommendations with the 1-hour post-load level. Measurement of the 1-hour PG level would increase the likelihood of identifying a larger, high-risk group with the additional practical advantage of potentially replacing the conventional 2-hour oral glucose tolerance test making it more acceptable in a clinical setting.

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Section: Introductionmentioning

confidence: 99%

Lessons learned from the 1‐hour post‐load glucose level during OGTT: Current screening recommendations for dysglycaemia should be revised

Bergman¹,

Jagannathan

Buysschaert

et al. 2018

Diabetes Metabolism Res

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“…The Sheffield group models (Gillett 2015, Breeze 2016) and the CDC/University of Michigan group models (Hoerger 2007, Herman 2005) reported that they explicitly based their diabetes models on previous T2D decision model(s). Three studies (Gillett 2015, Breeze 2016 and Herman 2005) developed new T2D model structures but reported these to be based on previous T2D models, such as Eastman 1997 . The remaining studies reported an apparently new model structure, with the aim of addressing their particular research question.…”

Section: Resultsmentioning

confidence: 99%

“…The variation seemed to be largely a function of the clinical studies used to inform the model and their inclusion criteria, as well as changes in the classification and diagnosis of (pre)diabetes over time. This is relevant, as disease progression will differ according to the definition of prediabetes . For example, IFG and IGT are considered distinct pathophysiological mechanisms and may lead to differing risks of developing diabetes or complications .…”

Section: Discussionmentioning

confidence: 99%

Decision models of prediabetes populations: A systematic review

Leal

Morrow

Khurshid

et al. 2019

Diabetes Obesity Metabolism

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Aims With evidence supporting the use of preventive interventions for prediabetes populations and the use of novel biomarkers to stratify the risk of progression, there is a need to evaluate their cost‐effectiveness across jurisdictions. Our aim is to summarize and assess the quality and validity of decision models and model‐based economic evaluations of populations with prediabetes, to evaluate their potential use for the assessment of novel prevention strategies and to discuss the knowledge gaps, challenges and opportunities. Materials and methods We searched Medline, Embase, EconLit and NHS EED between 2000 and 2018 for studies reporting computer simulation models of the natural history of individuals with prediabetes and/or we used decision models to evaluate the impact of treatment strategies on these populations. Data were extracted following PRISMA guidelines and assessed using modelling checklists. Two reviewers independently assessed 50% of the titles and abstracts to determine whether a full text review was needed. Of these, 10% was assessed by each reviewer to cross‐reference the decision to proceed to full review. Using a standardized form and double extraction, each of four reviewers extracted 50% of the identified studies. Results A total of 29 published decision models that simulate prediabetes populations were identified. Studies showed large variations in the definition of prediabetes and model structure. The inclusion of complications in prediabetes (n = 8) and type 2 diabetes (n = 17) health states also varied. A minority of studies simulated annual changes in risk factors (glycaemia, HbA1c, blood pressure, BMI, lipids) as individuals progressed in the models (n = 7) and accounted for heterogeneity among individuals with prediabetes (n = 7). Conclusions Current prediabetes decision models have considerable limitations in terms of their quality and validity and do not allow evaluation of stratified strategies using novel biomarkers, highlighting a clear need for more comprehensive prediabetes decision models.

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“…GPC-2015-51, recognizes the terms increased risk of diabetes or prediabetes, recommending that people with a score equal to or greater than 12 on the Findrisk scale but do not meet diagnostic criteria for DM2, should establish the presence of increased risk categories of diabetes for inclusion in DM2 prevention programs Table 3 1 . [56][57][58][59][60][61] . A study in Colombia showed that hyperglycaemia was associated with a greater number of adverse outcomes in 439 individuals who survived a first acute myocardial infarction (AMI).…”

Section: What Do the Guidelines Say About Prediabetes?mentioning

confidence: 99%

Prediabetes in Colombia: Expert Consensus

et al. 2017

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The prevalence of Prediabetes in Colombia is high, and despite being recognized and categorized in the main Medical Guidelines and included in the International Classification of Diseases in Colombia, knowledge and awareness of it is limited amongst healthcare professionals and in the community. Our expert group recommends that educational programs emphasize a global approach to risk which includes a recognition of the importance of prediabetes and its evaluation along with and other risk factors such as a family history of DM2, overweight and obesity, dislipidemia and hypertension. Studies conducted in Colombia demonstrate the value of the FINDRIS questionnaire as a tool to identify subjects at risk of prediabetes and DM2, and we recommend that it should be systematic applied throughout the country as part of government policy.Prediabetes progresses to DM2 at an annual rate of 10%, but it has also been shown that prediabetes is an independent risk factor for cardiovascular outcomes. On this basis, the Committee recommends that once prediabetes is detected and diagnosed, immediate management of the disease begins through lifestyle changes, with follow up assessments performed at 3 and 6 months. If the patient does not respond with a weight loss of at least 5% and if the HbA1C values are not normalized, pharmacological management should be initiated with a metformin dose of 500 mg / day, increasing up to 1,500 -1,700 mg / day, according to tolerance. Article history:Received Estudios realizados en Colombia demuestran la utilidad de la encuesta FINDRIS para identificar sujetos en riesgo de prediabetes y DM2 por lo que se recomienda que la aplicación del FINDRIS debe ser una política gubernamental y aplicada en todo el país.La Prediabetes progresa hacia DM2 a una tasa anual del 10% y se ha demostrado que independientemente de esto la Prediabetes es un factor de riesgo para desenlaces cardiovasculares por lo que el Comité recomienda que una vez detectada y diagnosticada, se inicie el manejo inmediato a través de cambios en el estilo de vida y realizar valoración a los 3 y 6 meses. Si el paciente no responde con una pérdida de peso de al menos el 5% y si no se normalizan los valores de HbA1C, iniciar manejo farmacológico con una dosis de 500 mg/día de metformina, escalando hasta 1,500 -1,700 mg/día, según tolerancia.

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Comparative prognostic performance of definitions of prediabetes: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study

Cited by 155 publications

References 22 publications

Lessons learned from the 1‐hour post‐load glucose level during OGTT: Current screening recommendations for dysglycaemia should be revised

Lessons learned from the 1‐hour post‐load glucose level during OGTT: Current screening recommendations for dysglycaemia should be revised

Decision models of prediabetes populations: A systematic review

Prediabetes in Colombia: Expert Consensus

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