Clinical utility of 30-min plasma glucose for prediction of type 2 diabetes among people with prediabetes: Ancillary analysis of the diabetes community lifestyle improvement program

Prediabetes and Cardiometabolic Risk: The Need for Improved Diagnostic Strategies and Treatment to Prevent Diabetes and Cardiovascular Disease

The progression from prediabetes to type-2 diabetes depends on multiple pathophysiological, clinical, and epidemiological factors that generally overlap. Both insulin resistance and decreased insulin secretion are considered to be the main causes. The diagnosis and approach to the prediabetic patient are heterogeneous. There is no agreement on the diagnostic criteria to identify prediabetic subjects or the approach to those with insufficient responses to treatment, with respect to regression to normal glycemic values or the prevention of complications. The stratification of prediabetic patients, considering the indicators of impaired fasting glucose, impaired glucose tolerance, or HbA1c, can help to identify the sub-phenotypes of subjects at risk for T2DM. However, considering other associated risk factors, such as impaired lipid profiles, or risk scores, such as the Finnish Diabetes Risk Score, may improve classification. Nevertheless, we still do not have enough information regarding cardiovascular risk reduction. The sub-phenotyping of subjects with prediabetes may provide an opportunity to improve the screening and management of cardiometabolic risk in subjects with prediabetes.

Functional Properties of Prickly Pear Cactus Fruit Peels Undergoing Supplemental Irrigation and Fruit Storage Conditions

Prickly pear cactus fruit peels have been seen as organic waste. This study explored the effect of supplemental irrigation during fruit growth of 'Roja Lisa' (Opuntia ficus-indica) prickly pear cactus on the antioxidant, hypoglycemic and hypolipidemic properties of peel extracts from fruits collected at harvest and after storage conditions. The treatments were non-irrigated and supplemental irrigation and the storage conditions were cold or room temperature, and freshly harvested fruit. After each fruit quality evaluation, peels from each treatment combination were pooled and the concentrations of phenolic compounds, inhibition of an in vitro digestive enzyme, antioxidant capacity, and in vivo hypoglycemic (- control = 268 mg/dL versus fruit peel extracts = 204 mg/dL at 30 min) and hypolipidemic (- control = 203 mg/dL versus fruit peel extracts = 148 mg/dL at 30 min) properties were determined. Therefore, fruit peels could potentially be harnessed for human health benefits, instead of treated as organic waste.

The Oral Glucose Tolerance Test: 100 Years Later

For over 100 years, the oral glucose tolerance test (OGTT) has been the cornerstone for detecting prediabetes and type 2 diabetes (T2DM). In recent decades, controversies have arisen identifying internationally acceptable cut points using fasting plasma glucose (FPG), 2-h post-load glucose (2-h PG), and/or HbA1c for defining intermediate hyperglycemia (prediabetes). Despite this, there has been a steadfast global consensus of the 2-h PG for defining dysglycemic states during the OGTT. This article reviews the history of the OGTT and recent advances in its application, including the glucose challenge test and mathematical modeling for determining the shape of the glucose curve. Pitfalls of the FPG, 2-h PG during the OGTT, and HbA1c are considered as well. Finally, the associations between the 30-minute and 1-hour plasma glucose (1-h PG) levels derived from the OGTT and incidence of diabetes and its complications will be reviewed. The considerable evidence base supports modifying current screening and diagnostic recommendations with the use of the 1-h PG. Measurement of the 1-h PG level could increase the likelihood of identifying high-risk individuals when the pancreatic ß-cell function is substantially more intact with the added practical advantage of potentially replacing the conventional 2-h OGTT making it more acceptable in the clinical setting.