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Esmaeilzadeh A, Mohammadi V, Elahi R, Rezakhani N. The role of heat shock proteins (HSPs) in type 2 diabetes mellitus pathophysiology. J Diabetes Complications 2023; 37:108564. [PMID: 37852076 DOI: 10.1016/j.jdiacomp.2023.108564] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/05/2023] [Accepted: 07/21/2023] [Indexed: 10/20/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by sustained hyperglycemia caused by impaired insulin signaling and secretion. Metabolic stress, caused by an inappropriate diet, is one of the major hallmarks provoking inflammation, endoplasmic reticulum (ER) stress, and mitochondrial dysfunction. Heat shock proteins (HSPs) are a group of highly conserved proteins that have a crucial role in chaperoning damaged and misfolded proteins to avoid disruption of cellular homeostasis under stress conditions. To do this, HSPs interact with diverse intra-and extracellular pathways among which are the insulin signaling, insulin secretion, and apoptosis pathways. Therefore, HSP dysfunction, e.g. HSP70, may lead to disruption of the pathways responsible for insulin secretion and uptake. Consistently, the altered expression of other HSPs and genetic polymorphisms in HSP-producing genes in diabetic subjects has made HSPs hot research in T2DM. This paper provides a comprehensive overview of the role of different HSPs in T2DM pathogenesis, affected cellular pathways, and the potential therapeutic strategies targeting HSPs in T2DM.
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Affiliation(s)
- Abdolreza Esmaeilzadeh
- Department of Immunology, Zanjan University of Medical Sciences, Zanjan, Iran; Cancer Gene Therapy Research Center (CGRC), Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Vahid Mohammadi
- School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Reza Elahi
- School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Negin Rezakhani
- School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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Simmons SS. Strikes and Gutters: Biomarkers and anthropometric measures for predicting diagnosed diabetes mellitus in adults in low- and middle-income countries. Heliyon 2023; 9:e19494. [PMID: 37810094 PMCID: PMC10558610 DOI: 10.1016/j.heliyon.2023.e19494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 10/10/2023] Open
Abstract
The management of diabetes necessitates the requirement of reliable health indices, specifically biomarkers and anthropometric measures, to detect the presence or absence of the disease. Nevertheless, limited robust empirical evidence exists regarding the optimal metrics for predicting diabetes in adults, particularly within low- and middle-income countries. This study investigates objective and subjective indices for screening diabetes in these countries. METHODS Data for this study was sourced from surveys conducted among adults (aged 18 years and above) in seventeen (17) countries. Self-reported diabetes status, fifty-four biomarkers, and twenty-six core and twenty-eight estimated anthropometric indices, including weight, waist circumference, body mass index, glycaemic triglycerides, and fasting blood glucose, were utilised to construct lasso regression models. RESULTS The study revealed variances in diabetes prediction outcomes across different countries. Central adiposity measures, fasting plasma glucose and glycaemic triglycerides demonstrated superior predictive capabilities for diabetes when compared to body mass index. Furthermore, fasting plasma or blood glucose, serving as a biomarker, emerged as the most accurate predictor of diabetes. CONCLUSIONS These findings offer critical insights into both general and context-specific tools for diabetes screening. The study proposes that fasting plasma glucose and central adiposity indices should be considered as routine screening tools for diabetes, both in policy interventions and clinical practice. By identifying adults with or at higher risk of developing diabetes and implementing appropriate interventions, these screening tools possess the potential to mitigate diabetes-related complications in low- and middle-income countries.
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Affiliation(s)
- Sally Sonia Simmons
- Department of Social Policy, London School of Economics and Political Science, London, WC2A 2AE, United Kingdom
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3
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Gottwald-Hostalek U, Gwilt M. Vascular complications in prediabetes and type 2 diabetes: a continuous process arising from a common pathology. Curr Med Res Opin 2022; 38:1841-1851. [PMID: 35833523 DOI: 10.1080/03007995.2022.2101805] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The term, "prediabetes", describes a state of hyperglycaemia that is intermediate between true normoglycaemia and the diagnostic cut-offs for indices of glycaemia that are used to diagnose type 2 diabetes. The presence of prediabetes markedly increases the risk of developing type 2 diabetes. Numerous randomized, controlled evaluations of various agents have demonstrated significant prevention or delay of the onset of type 2 diabetes in subjects with prediabetes. Intensive lifestyle interventions and metformin have been studied most widely, with the lifestyle intervention being more effective in the majority of subjects. The application of therapeutic interventions at the time of prediabetes to preserve long-term outcomes has been controversial, however, due to a lack of evidence relating to the pathogenic effects of prediabetes and the effectiveness of interventions to produce a long-term clinical benefit. Recent studies have confirmed that prediabetes, however defined, is associated with a significantly increased risk of macrovascular and microvascular complications essentially identical to those of diabetes, and also with subclinical derangements of the function of microvasculature and neurons that likely signify increased risk of compilations in future. Normoglycaemia, prediabetes and type 2 diabetes appear to be part of a continuum of increased risk of adverse outcomes. Long-term (25-30 years) post-trial follow up of two major diabetes prevention trials have shown that short-term interventions to prevent diabetes lead to long-term reductions in the risk of complications. These findings support the concept of therapeutic intervention to preserve long-term health in people with prediabetes before type 2 diabetes becomes established.
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López-Jaramillo P, Barbosa E, Molina DI, Sanchez R, Diaz M, Camacho PA, Lanas F, Pasquel M, Accini JL, Ponte-Negretti CI, Alcocer L, Cobos L, Wyss F, Sebba-Barroso W, Coca A, Zanchetti A. Latin American Consensus on the management of hypertension in the patient with diabetes and the metabolic syndrome. J Hypertens 2020; 37:1126-1147. [PMID: 30882601 DOI: 10.1097/hjh.0000000000002072] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
: The prevalence of hypertension, type 2 diabetes mellitus (DM2) and the metabolic syndrome continues to increase in Latin America, while the rates of diagnosis, treatment and control of these disorders remain low. The frequency of the risk factors that constitute the metabolic syndrome and are associated with an increased risk of cardiovascular disease has not diminished since the publication of the previous consensus. This document discusses the socioeconomic, demographic, environmental and cultural characteristics of most associated Latin American countries and partially explains the lack of better results in improving clinical and public health actions that allow high morbidity and mortality rates caused by cardiovascular diseases and DM2 to be reduced through programs aligned with the so-called precision medicine, which should be predictive, preventive, personalized and participatory. The Consensus ratifies the diagnostic criteria expressed in the previous consensus to define hypertension and DM2 but, for the metabolic syndrome, and in the absence of evidence, the recommendation is to implement a cohort study that determines the abdominal perimeter value associated with hard outcomes, such as DM2 and CVD. Meanwhile, we recommend modifying the criterion to more than 94 cm in men and more than 84 cm in women according to WHO recommendations. We also recommend the carrying out of a study that identifies the situation of hypertension and DM2 in people of African ancestry who, in Latin America, exceed 75 million and whose epidemiology does not include solid studies. With respect to the proposed therapeutic targets, we recommended maintaining those defined in the previous consensus, but insisting that early pharmacological management of prediabetes with metformin should be introduced, as should the treatment of diabetic hypertensive patients with a combination therapy of two fixed-dose antihypertensive drugs and management with statins. To increase adherence, the use of different drugs combined in a single pill (polypill) is recommended. The simplification of the therapeutic regimen is accompanied by greater control of cardiovascular risk factors, both in primary and secondary prevention, and has been shown to be cost-effective. The consensus recommends the use of the currently available polypill combining an angiotensin-converting enzyme inhibitor, a statin and aspirin for secondary cardiovascular prevention and in patients with a high cardiovascular risk, such as hypertension patients with DM2.
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Affiliation(s)
- Patricio López-Jaramillo
- Clinica de Síndrome Metabolico, Prediabetes y Diabetes, Direccion de Investigaciones FOSCAL y Facultad de Salud, Universidad de Santander (UDES), Bucaramanga, Colombia
| | | | - Dora I Molina
- Universidad de Caldas e IPS Médicos Internistas de Caldas, Manizales, Colombia
| | - Ramiro Sanchez
- Hospital Universitario Fundacion Favaloro, Buenos Aires, Argentina
| | | | - Paul A Camacho
- Direccion de Investigaciones FOSCAL y Facultad de Salud, Universidad Autonoma de Bucaramanga (UNAB), Bucaramanga, Colombia
| | | | | | - José L Accini
- Fundacion Hospital Universidad del Norte y Universidad Libre, Barranquilla, Colombia
| | | | - Luis Alcocer
- Instituto Mexicano de Salud Cardiovascular, Ciudad de Mexico, Mexico
| | - Leonardo Cobos
- Unidad de Cardiologia, Hospital El Pino, Santiago, Chile
| | - Fernando Wyss
- Servicios y Tecnologica Cardiovascular de Gautemala, S.A., Guatemala
| | | | - Antonio Coca
- Hospital Clínico, Universidad de Barcelona, Spain
| | - Alberto Zanchetti
- Istituto Auxologico Italiano, IRCCS, and Università degli Studi of Milan, Italy
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McCurley JL, Penedo F, Roesch SC, Isasi CR, Carnethon M, Sotres-Alvarez D, Schneiderman N, Gonzalez P, Chirinos DA, Camacho A, Teng Y, Gallo LC. Psychosocial Factors in the Relationship between Socioeconomic Status and Cardiometabolic Risk: the HCHS/SOL Sociocultural Ancillary Study. Ann Behav Med 2018; 51:477-488. [PMID: 28130624 DOI: 10.1007/s12160-016-9871-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND U.S. Hispanics/Latinos display a high prevalence of metabolic syndrome (MetSyn), a group of co-occurring cardiometabolic risk factors (abdominal obesity, impaired fasting glucose, dyslipidemia, elevated blood pressure) associated with higher cardiovascular disease and mortality risk. Low socioeconomic status (SES) is associated with higher risk for MetSyn in Hispanics/Latinos, and psychosocial factors may play a role in this relationship. PURPOSE This cross-sectional study examined psychosocial factors in the association of SES and MetSyn components in 4,996 Hispanic/Latino adults from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. METHODS MetSyn components were measured at the baseline examination. Participants completed interviews to determine psychosocial risks (e.g., depression) and resources (e.g., social support) within 9 months of baseline (< 4 months in 72.6% of participants). Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were used to identify latent constructs and examine associations. RESULTS Participant mean age was 41.7 years (SE = 0.4) and 62.7% were female. CFA identified single latent factors for SES and psychosocial indicators, and three factors for MetSyn [blood pressure, lipids, metabolic factors]. SEMs showed that lower SES was related to MetSyn factors indirectly through higher psychosocial risk/lower resources (Y-Bχ2 (df = 420) = 4412.90, p < .05, RMSEA = .042, SRMR = .051). A statistically significant effect consistent with mediation was found from lower SES to higher metabolic risk (glucose/waist circumference) via psychosocial risk/resource variables (Mackinnon's 95% asymmetric CI = -0.13 to -0.02). CONCLUSIONS SES is related to metabolic variables indirectly through psychosocial factors in U.S. Hispanics/Latinos of diverse ancestries.
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Affiliation(s)
- Jessica L McCurley
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Frank Penedo
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Scott C Roesch
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Carmen R Isasi
- Deptartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mercedes Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Patricia Gonzalez
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Diana A Chirinos
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Alvaro Camacho
- Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, San Diego, CA, USA
| | - Yanping Teng
- Department of Biostatistics, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA. .,South Bay Latino Research Center, 450 4th Ave, Suite 304, Chula Vista, CA, 91910, USA.
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Lopez-Lopez J, Garay J, Wandurraga E, Camacho PA, Higuera-Escalante F, Cohen D, Lopez-Jaramillo P. The simultaneous assessment of glycosylated hemoglobin, fasting plasma glucose and oral glucose tolerance test does not improve the detection of type 2 diabetes mellitus in Colombian adults. PLoS One 2018; 13:e0194446. [PMID: 29652881 PMCID: PMC5898701 DOI: 10.1371/journal.pone.0194446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 03/02/2018] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Guidelines recommend early detection of type 2 diabetes mellitus (DM2). The objective of the present study was to evaluate the capacity to identify DM2 in subjects that were screened for DM2 simultaneously with all three of the tests recommended-fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c) and a 2-hour post 75-g oral glucose tolerance test (OGTT). METHODS AND RESULTS The present analysis of an anonymous database of 1113 adults from a reference clinical laboratory in Bucaramanga, Colombia, was an observational, descriptive, cross-sectional secondary source study. 259 individuals met at least one of the criteria for DM2: FPG ≥ 126mg/dL (7.0mmol/L), HbA1c ≥ 6.5% (48mmol/mol) and OGTT ≥ 200mg/dL (11.1mmol/L). 30 subjects (2.7%) were diabetic according to FPG, 56 subjects (5.0%) by HbA1c and 250 subjects (22.5%) by OGTT. In total 259 subjects (23.3% [IC 95%: 20.7%- 25.8%] were diabetic either by FPG, OGTT or HbA1c. DISCUSSION The largest number of patients were identified as diabetic with the OGTT. The combination of two or three tests did not increase the detection of new cases of DM2. Our findings suggest that routinely requesting FPG, OGTT and HbA1c at the same time may be inappropriate in at risk individuals, as this approach does not significantly improve the diagnostic capacity compared to using FPG+OGTT and substantially increases the financial burden on the health system, insurers or individual.
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Affiliation(s)
- Jose Lopez-Lopez
- Internal Medicine Residence Program, Universidad Autonoma de Bucaramanga (UNAB), Bucaramanga, Colombia
| | - Jennifer Garay
- Internal Medicine Residence Program, Universidad Autonoma de Bucaramanga (UNAB), Bucaramanga, Colombia
| | - Edwin Wandurraga
- Endocrinology Service, Fundación Oftalmológica de Santander—Clínica Carlos Ardila Lulle (FOSCAL), Floridablanca, Colombia
| | - Paul A. Camacho
- Research Department, Fundacion Oftalmologica de Santander (FOSCAL), Floridablanca, Colombia
- Facultad de ciencias de la Salud, Universidad Autonoma de Bucaramanga (UNAB), Bucaramanga, Colombia
| | | | - Daniel Cohen
- Research Department, Fundacion Oftalmologica de Santander (FOSCAL), Floridablanca, Colombia
- MASIRA Institute, Facultad de Salud, Universidad de Santander (UDES), Bucaramanga, Colombia
| | - Patricio Lopez-Jaramillo
- Research Department, Fundacion Oftalmologica de Santander (FOSCAL), Floridablanca, Colombia
- MASIRA Institute, Facultad de Salud, Universidad de Santander (UDES), Bucaramanga, Colombia
- Facultad de ciencias de la Salud, Universidad Autonoma de Bucaramanga (UNAB), Bucaramanga, Colombia
- Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, Ecuador
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NAVARRO-MEZA M, GARCIA-CAMACHO KA, SANTOYOTELLES F, LÓPEZ-ESPINOZA A, ARROYO-HELGUERA O. Dietary Behaviors and Biochemical Serum Indicators in Adults with Type 2 Diabetes Mellitus from a Rural Region of Jalisco, Mexico. IRANIAN JOURNAL OF PUBLIC HEALTH 2018; 47:610-612. [PMID: 29900150 PMCID: PMC5996326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Monica NAVARRO-MEZA
- Molecular Biology Chronic Illness Research Center, South University Center, University of Guadalajara, Guadalajara, Jalisco, Mexico, Nutrition and Nutritional Behavior Research Center, South University Center, University of Guadalajara, Guadalajara, Jalisco, Mexico,Corresponding Author:
| | - Karina Anai GARCIA-CAMACHO
- Nutrition and Nutritional Behavior Research Center, South University Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Felipe SANTOYOTELLES
- South University Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Antonio LÓPEZ-ESPINOZA
- Nutrition and Nutritional Behavior Research Center, South University Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Omar ARROYO-HELGUERA
- Ecology and Health Laboratory, Institute of Public Health, Universidad Veracruzana, Veracruz, México
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López-Jaramillo P, Calderón C, Castillo J, Escobar ID, Melgarejo E, Parra GA. Prediabetes in Colombia: Expert Consensus. Colomb Med (Cali) 2017; 48:191-203. [PMID: 29662261 PMCID: PMC5896726 DOI: 10.25100/cm.v43i4.3662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
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.
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Affiliation(s)
- Patricio López-Jaramillo
- Director de Investigación, Desarrollo e Innovación Tecnológica, Clínica de Síndrome Metabólico, Prediabetes y Diabetes, Bucaramanga, Colombia ,Fundación Oftalmológica de Santander (FOSCAL), Bucaramanga, Colombia
| | - Carlos Calderón
- Presidente de la Federación Diabetológica Colombiana (FDC), Bogotá, Colombia,Director de la Fundación Santandereana de Diabetes (FUSANDE), Bucaramanga, Colombia
| | - Jorge Castillo
- Presidente de la Sociedad Colombiana de Sarcopenia (SCS), Bogotá, Colombia., Vicepresidente de la Federación Diabetológica Colombiana (FDC), Bogota, Colombia
| | - Iván Darío Escobar
- Ex Presidente de la Fundación Colombiana de Obesidad (FUNCOBES), Bogotá, Colombia., Delegado de la Asociación Colombiana de Endocrinología (ACE), Bogota, Colombia
| | - Enrique Melgarejo
- Presidente de la Sociedad Colombiana de Cardiología y Cirugía Cardiovascular (SCC), Bogotá, Colombia.,Presidente Honorario del Colegio Panamericano del Endotelio (CPE), Bogotá, Colombia
| | - Gustavo Adolfo Parra
- Presidente de la Asociación Colombiana de Medicina Interna (ACMI), Bogotá, Colombia.,12 Universidad Autonoma de Bucaramanga (UNAB), Bucaramanga, Colombia
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López-Jaramillo P, Nieto-Martínez RE, Aure-Fariñez G, Mendivil CO, Lahsen RA, Silva-Filho RL, Andreotti LA, Manrique ME, Pasquel-Andrade MA, Rangel I, Vidrio M, Castañeda R, Restrepo M, Pinto ME. Identification and management of prediabetes: results of the Latin America Strategic Prediabetes Meeting. Rev Panam Salud Publica 2017; 41:e172. [PMID: 31410086 PMCID: PMC6664235 DOI: 10.26633/rpsp.2017.172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 05/31/2017] [Indexed: 12/14/2022] Open
Abstract
To understand the status of prediabetes diagnosis and treatment in Latin America and to evaluate the use of metformin for diabetes prevention in this context. A panel of 15 diabetes experts from seven countries in Latin America met on 14 – 15 August 2014 in Lima, Peru, to review the available literature, discuss the role of prediabetes in type 2 diabetes mellitus and cardiovascular disease, analyze collected information, and make conclusions for prediabetes diagnosis and treatment in Latin America. Prediabetes diagnosis, screening, and treatment, including lifestyle changes, pharmacological treatment, and cost-effectiveness were discussed. Five resulting statements were issued for Latin America: prediabetes is a clinical and public health problem; health care systems do not currently diagnose/treat prediabetes; use of prediabetes risk detection tools are needed region-wide; treatment includes lifestyle changes, multidisciplinary education, and metformin; and registries of patient records and further studies should be supported. The expert panel concluded that in Latin America, preventive treatment through lifestyle changes and metformin are cost-effective interventions. It is important to improve prediabetes identification and management at the primary care level.
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Affiliation(s)
- Patricio López-Jaramillo
- Metabolic Syndrome and Diabetes Clinic Fundación Oftalmológica de Santander Bucaramanga Colombia Metabolic Syndrome and Diabetes Clinic, Fundación Oftalmológica de Santander, Bucaramanga, Santander, Colombia
| | - Ramfis E Nieto-Martínez
- Human Physiology Universidad Centro-Occidental Lisandro Alvarado Barquisimeto Venezuela Human Physiology, Universidad Centro-Occidental Lisandro Alvarado, Barquisimeto, Venezuela
| | - Gestne Aure-Fariñez
- Centro Medico Docente la Trinidad Centro Medico Docente la Trinidad Caracas Venezuela Centro Medico Docente la Trinidad, Caracas, Venezuela
| | - Carlos O Mendivil
- Universidad de los Andes Universidad de los Andes Bogotá Colombia Universidad de los Andes, Bogotá, Colombia
| | - Rodolfo A Lahsen
- Clínica Las Condes Clínica Las Condes Santiago Chile Clínica Las Condes, Santiago, Chile
| | - Ruy L Silva-Filho
- Federal University of Pernambuco Federal University of Pernambuco Recife Brazil Federal University of Pernambuco, Recife, Brazil
| | - Luiz A Andreotti
- Diabetes Unit Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil Diabetes Unit, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Mónica E Manrique
- Nutrition and Diabetes Unit Clínica Alemana Santiago Chile Nutrition and Diabetes Unit, Clínica Alemana, Santiago, Chile
| | | | - Ignacio Rangel
- Medical School Monterrey Technological Institute Monterrey Mexico Medical School, Monterrey Technological Institute, Monterrey, Mexico
| | - Maricela Vidrio
- Research Cardiometabolic Unit Occidente SC Guadalajara Mexico Research Cardiometabolic Unit, Occidente SC, Guadalajara, Mexico
| | - Rutila Castañeda
- Center for Clinical Research Center for Clinical Research Mexico City Mexico Center for Clinical Research, Mexico City, Mexico
| | - Manuela Restrepo
- Merck Colombia Merck Colombia Bogotá Colombia Merck Colombia, Bogotá, Colombia
| | - Miguel E Pinto
- School of Medicine Alberto Hurtado Cayetano Heredia University Lima Perú School of Medicine Alberto Hurtado, Cayetano Heredia University, Lima, Perú
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Nieto-Martínez R, González-Rivas JP, Lima-Martínez M, Stepenka V, Rísquez A, Mechanick JI. Diabetes Care in Venezuela. Ann Glob Health 2016; 81:776-91. [DOI: 10.1016/j.aogh.2015.11.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Gomez-Arbelaez D, Sánchez-Vallejo G, Perez M, Garcia RG, Arguello JF, Peñaherrera E, Duarte YC, Casanova ME, Accini JL, Sotomayor A, Camacho PA, Lopez-Jaramillo P. [Hyperglycaemia is associated with worse outcomes in Latin-American individuals with acute myocardial infarction]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2016; 28:9-18. [PMID: 26596523 DOI: 10.1016/j.arteri.2015.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 09/15/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Alterations in glucose metabolism have been reported as risk and poor prognostic factors for acute myocardial infarction (AMI); however in Latin-American population this information is limited. Thus, an evaluation was performed on the association between glycaemic status and short- and long-term outcomes in patients with a first AMI. METHODS A multicentre, prospective, observational, cohort study was conducted in 8 hospitals from Colombia and Ecuador. RESULTS A total of 439 patients with confirmed AMI were included, of which 305 (69.5%) had prediabetes or type2 diabetes mellitus (DM2). Compared with normal glycaemia group, patients with known DM2 had greater risk of prolonged hospital stay (HR: 2.60, 95%CI: 1.38-4.92, P=.003), Killip class iii/iv (HR: 9.46, 95%CI: 2.20-40.62, P=.002), and in-hospital heart failure (HR: 10.76, 95%CI: 3.37-34.31, P<.001). Patients with prediabetes, new DM2, and known DM2 showed higher rates of major adverse cardiovascular events after 3years follow-up. CONCLUSION Glucose metabolism abnormalities have an important significance in the short- and long-term prognosis in Latin-American patients that survive a first AMI.
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Affiliation(s)
- Diego Gomez-Arbelaez
- Fundación Oftalmológica de Santander-FOSCAL, Floridablanca, Colombia; Instituto de Investigaciones MASIRA, Facultad de Medicina, Universidad de Santander-UDES, Bucaramanga, Colombia; División de Endocrinología, Escuela de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| | - Gregorio Sánchez-Vallejo
- Universidad del Quindío, Hospital San Juan de Dios, Fundación Cardiomet-Cequin, Armenia, Colombia
| | - Maritza Perez
- Departamento de Medicina Interna, Universidad Militar Nueva Granada, Bogotá, Colombia
| | - Ronald Gerardo Garcia
- Instituto de Investigaciones MASIRA, Facultad de Medicina, Universidad de Santander-UDES, Bucaramanga, Colombia; Fundación Cardiovascular de Colombia-FCV , Floridablanca, Colombia
| | | | | | | | | | - Jose Luis Accini
- Unidad de Cuidados Intensivos, Clínica Jaller, Universidad Libre, Barranquilla, Colombia
| | | | | | - Patricio Lopez-Jaramillo
- Fundación Oftalmológica de Santander-FOSCAL, Floridablanca, Colombia; Instituto de Investigaciones MASIRA, Facultad de Medicina, Universidad de Santander-UDES, Bucaramanga, Colombia.
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Gomez-Arbelaez D, Alvarado-Jurado L, Ayala-Castillo M, Forero-Naranjo L, Camacho PA, Lopez-Jaramillo P. Evaluation of the Finnish Diabetes Risk Score to predict type 2 diabetes mellitus in a Colombian population: A longitudinal observational study. World J Diabetes 2015; 6:1337-1344. [PMID: 26675051 PMCID: PMC4673387 DOI: 10.4239/wjd.v6.i17.1337] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 09/02/2015] [Accepted: 11/25/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To assess the performance of the Finnish Diabetes Risk Score (FINDRISC) questionnaire for detecting and predicting type 2 diabetes mellitus (DM2) in a Colombian population.
METHODS: This is a longitudinal observational study conducted in Floridablanca, Colombia. Adult subjects (age ≥ 35 years) without known diabetes, were included. A modified version of FINDRISC was completed, and the glycemia values from all the subjects were collected from the hospital’s database. Firstly, a cross-sectional analysis was performed and then, the subsample of prediabetic participants was followed for diabetes incidence.
RESULTS: A total of 772 subjects were suitable for the study. The overall prevalence of undiagnosed DM2 was 2.59%, and the incidence of DM2 among the prediabetic participants was 7.5 per 100 person-years after a total of 265257 person-years follow-up. The FINDRISC at baseline was significantly associated with undiagnosed and incident DM2. The area under receiver operating characteristics curve of the FINDRISC score for detecting undiagnosed DM2 in both men and women was 0.7477 and 0.7175, respectively; and for predicting the incidence of DM2 among prediabetics was 71.99% in men and 67.74% in women.
CONCLUSION: The FINDRISC questionnaire is a useful screening tool to identify cross-sectionally unknown DM2 and to predict the incidence of DM2 among prediabetics in the Colombian population.
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Yan ST, Xiao HY, Tian H, Li CL, Fang FS, Li XY, Cheng XL, Li N, Miao XY, Yang Y, Wang LC, Zou XM, Ma FL, He Y, Sai XY. The cutoffs and performance of glycated hemoglobin for diagnosing diabetes and prediabetes in a young and middle-aged population and in an elderly population. Diabetes Res Clin Pract 2015; 109:238-45. [PMID: 26059072 DOI: 10.1016/j.diabres.2015.05.047] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 05/14/2015] [Accepted: 05/23/2015] [Indexed: 12/23/2022]
Abstract
The aims were to compare the appropriate cutoffs of glycated hemoglobin (HbA1c) in a population of varying ages and to evaluate the performance of HbA1c for diagnosing diabetes and prediabetes. A total of 1064 participants in the young and middle-aged group and 1671 in the elderly group were included and underwent HbA1c testing and an oral glucose tolerance test (OGTT). Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated to evaluate the optimal HbA1c cutoffs. Kappa coefficients were used to test for agreement between HbA1c categorization and OGTT-based diagnoses. The optimal HbA1c cutoffs for diagnosing diabetes were 5.7% (39 mmol/mol) in the young and middle-aged group with a sensitivity of 66.7%, specificity of 86.7%, and AUC of 0.821 (95% CI: 0.686, 0.955) and 5.9% (41 mmol/mol) in the elderly group with a sensitivity of 80.4%, specificity of 73.3%, and AUC of 0.831 (0.801, 0.861). The optimal cutoffs for diagnosing prediabetes were 5.6% (38 mmol/mol) and 5.7% (39 mmol/mol) in the young and middle-aged group and in the elderly group, respectively. Agreement between the OGTT-based diagnosis of diabetes or prediabetes and the optimal HbA1c cutoff was low (all kappa coefficients <0.4). The combination of HbA1c and fasting plasma glucose increased diagnostic sensitivities or specificities. In conclusion, age-specific HbA1c cutoffs for diagnosing diabetes or prediabetes were appropriate. Furthermore, the performance of HbA1c for diagnosing diabetes and prediabetes was poor. HbA1c should be used in combination with traditional glucose criteria when detecting and diagnosing diabetes or prediabetes.
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Affiliation(s)
- Shuang-Tong Yan
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Hai-Ying Xiao
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Hui Tian
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
| | - Chun-Lin Li
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Fu-Sheng Fang
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Xiao-Ying Li
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing 100853, China
| | - Xiao-Ling Cheng
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Nan Li
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Xin-Yu Miao
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Yan Yang
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Liang-Chen Wang
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Xiao-Man Zou
- Laboratory of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China
| | - Fang-Ling Ma
- Laboratory of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China
| | - Yao He
- Institute of Geriatrics, Chinese PLA General Hospital, Beijing 100853, China
| | - Xiao-Yong Sai
- Institute of Geriatrics, Chinese PLA General Hospital, Beijing 100853, China
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