Diagnosis and Classification of Diabetes Mellitus

Basevi, Vittorio

doi:10.2337/dc11-s062

Cited by 2,751 publications

(711 citation statements)

References 15 publications

(4 reference statements)

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“…At least 60% of patients who develop diabetes have either impaired glucose tolerance or impaired fasting glucose concentration identified in the previous 5 years. Patients with impaired glucose tolerance become diabetic at a rate of 5–10% per year, with approximately one‐third becoming diabetic within 2–5 years 8. In our study, 38% of cats with impaired glucose tolerance and 75% with impaired fasting glucose concentration relapsed within a year of testing, suggesting that diabetic cats in remission with abnormal glucose test results also should be considered prediabetic.…”

Section: Discussionmentioning

confidence: 49%

“…Humans with impaired glucose tolerance and impaired fasting glucose concentration are considered prediabetic and are at increased risk of diabetes 8. At least 60% of patients who develop diabetes have either impaired glucose tolerance or impaired fasting glucose concentration identified in the previous 5 years.…”

Section: Discussionmentioning

confidence: 99%

“…Factors predisposing to diabetic relapse are currently unknown, and it is unclear if the majority of cats in remission have persistent abnormalities of glucose metabolism or have normal glucose tolerance. Human patients with impaired glucose tolerance or impaired fasting glucose concentration (blood glucose concentration above normal but below diabetic range, resulting from an inability to maintain normal blood glucose concentration) are classified as prediabetic and are at greatly increased risk of becoming diabetic 8. Structured lifestyle intervention, aimed at increasing physical activity and producing 5–10% loss of body weight, and certain pharmacological agents, prevent or delay the development of diabetes in people with impaired glucose tolerance 8.…”

mentioning

confidence: 99%

“…Human patients with impaired glucose tolerance or impaired fasting glucose concentration (blood glucose concentration above normal but below diabetic range, resulting from an inability to maintain normal blood glucose concentration) are classified as prediabetic and are at greatly increased risk of becoming diabetic 8. Structured lifestyle intervention, aimed at increasing physical activity and producing 5–10% loss of body weight, and certain pharmacological agents, prevent or delay the development of diabetes in people with impaired glucose tolerance 8. Knowledge of the glucose tolerance status of cats in remission may be important to guide treatment to decrease or delay diabetic relapse, and for predicting relapse.…”

mentioning

confidence: 99%

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Glycemic Status and Predictors of Relapse for Diabetic Cats in Remission

Gottlieb¹,

Rand

Marshall³

et al. 2014

Veterinary Internal Medicne

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BackgroundIt is unknown if diabetic cats in remission have persistent abnormalities of glucose metabolism and should be considered prediabetic, or have normal glucose tolerance.ObjectiveTo characterize glycemic status of diabetic cats in remission and to determine predictors of relapse.AnimalsA total of 21 cats in diabetic remission and 28 healthy control cats.MethodsAt a median of 107 days after remission, screening blood glucose concentration was measured on entry to the clinic. After a 24‐hour fast in hospital, fasting blood glucose, fructosamine and feline pancreatic lipase concentrations were measured, and 3 hours later, a simplified IV glucose tolerance test (1 g glucose/kg) performed. Twenty cats were monitored for relapse for at least 9 months.ResultsOf the 21 cats in remission, 19% (4/21) had impaired fasting glucose concentration and 76% (16/21) had impaired glucose tolerance. Of cats followed up for 9 months after testing, 30% (6/20) had relapsed and required insulin treatment. Fasting blood glucose concentration ≥7.5 mmol/L (≥135 mg/dL) (odds ratio [OR] = 12.8) and severely impaired glucose tolerance (≥5 hours to return to <6.5 mmol/L or <117 mg/dL; OR = 15.2) were significantly associated with relapse. Blood glucose concentration >14 mmol/L; 252 mg/dL at 3 hours was significantly associated with relapse (OR = 10.1).Conclusion and Clinical ImportanceMost cats in diabetic remission have impaired glucose tolerance and a minority have impaired fasting glucose concentration and should be considered prediabetic. More severe glucose intolerance and impaired fasting glucose concentration are predictors of relapse. Ongoing glucose monitoring of diabetic cats in remission is recommended.

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Glycemic Status and Predictors of Relapse for Diabetic Cats in Remission

Gottlieb¹,

Rand

Marshall³

et al. 2014

Veterinary Internal Medicne

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“…In 2008, the Hyperglycemia and Adverse Pregnancy Outcome study found an association of maternal plasma glucose during 2‐h, 75‐g OGTT and adverse pregnancy outcomes 12. Based on the findings, the International Association of the Diabetes and Pregnancy Study Group (IADPSG) proposed a new diagnostic strategy using 75‐g OGTT13, which was adopted by the ADA in 201114. The 50‐g GCT is not included in the IADPSG strategy.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of more gestational diabetes lead to better pregnancy outcomes: Comparing the International Association of the Diabetes and Pregnancy Study Group criteria, and the Carpenter and Coustan criteria

Nien

Kuo

et al. 2015

J of Diabetes Invest

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Aims/IntroductionThe International Association of the Diabetes and Pregnancy Study Group (IADPSG) criteria for gestational diabetes are associated with increased prevalence. However, it remains unknown if intervention for more women with gestational diabetes mellitus by the IADPSG criteria results in better pregnancy outcomes than adopting the Carpenter and Coustan (C&C) criteria in Asian populations.Materials and MethodsThis was a retrospective cohort study. A total of 1,840 women, 952 subjects by the IADPSG criteria and 888 subjects by the C&C criteria, who delivered singletons in 2011 in a single tertiary center, were included in the study. The same therapeutic interventions were offered to women with gestational diabetes mellitus by the two criteria. Maternal and neonatal outcomes were evaluated.ResultsAdopting the IADPSG criteria increased the prevalence of gestational diabetes mellitus diagnosis to 13.44%, compared with 2.59% by the C&C criteria. The diagnosis was made 3 weeks earlier by the IADPSG criteria (27 vs 30.5 weeks, P < 0.0001). Adopting the IADPSG criteria was associated with reduced risk of primary cesarean section (adjusted odds ratio 0.79, 95% confidence interval 0.63–0.998, P < 0.05) and having any one of the adverse fetal outcomes (adjusted odds ratio 0.79, 95% confidence interval 0.64–0.998, P < 0.05), including birthweight >90th percentile, jaundice, admission to neonatal intensive care unit, birth trauma, neonatal hypoglycemia and fetal death.ConclusionsAdopting the IADPSG criteria is associated with improved pregnancy outcomes, at the expense of increased prevalence of gestational diabetes mellitus diagnosis.

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Dysfunctional Adiposity and the Risk of Prediabetes and Type 2 Diabetes in Obese Adults

Neeland¹,

Turer²,

Ayers³

et al. 2012

JAMA

546

430

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MARKED INCREASE IN THEprevalence of overweight and obesity 1 has contributed to a doubling in type 2 diabetes mellitus incidence over the past 3 decades. 2 Increasing rates of diabetes among obese individuals has counterbalanced reductions in other cardiovascular disease (CVD) risk factors and is the primary factor contributing to a slowed decline in CVD event rates in the general population. 3 Prediabetes, an intermediate hyperglycemia phenotype and risk factor for diabetes, 4 is also associated with obesity and carries an excess risk for CVD and death. 5 Although increased body mass index (BMI) is associated with diabetes at the population level, 6 it does not adequately discriminate diabetes risk among obese individuals. 7 Indeed, many obese persons appear resistant to the development of metabolic disease. 8 Because the metabolic disease risks associated with obesity are heterogeneous, there remains an unmet clinical need for tools that differentiate obese persons who will ultimately develop prediabetes and diabetes from those who will remain metabolically healthy.Adipose tissue dysfunction is characterized by ectopic fat deposition in the abdominal viscera and liver, inflammatory and adipokine dysregulation, and insulin resistance and may be a more important mediator of diabetes devel-CME available online at www.jamaarchivescme.com and questions on p 1165.

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Diagnosis and Classification of Diabetes Mellitus

Cited by 2,751 publications

References 15 publications

Glycemic Status and Predictors of Relapse for Diabetic Cats in Remission

Glycemic Status and Predictors of Relapse for Diabetic Cats in Remission

Diagnosis of more gestational diabetes lead to better pregnancy outcomes: Comparing the International Association of the Diabetes and Pregnancy Study Group criteria, and the Carpenter and Coustan criteria

Dysfunctional Adiposity and the Risk of Prediabetes and Type 2 Diabetes in Obese Adults

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