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Prediabetes is more than a pre-disease: additional evidences supporting the importance of its early diagnosis and appropriate treatment

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Abstract

Aim

To identify Prediabetes (PreD) as early and serious diabetes step using clinical-biochemical characteristics in the population of the Primary Prevention Diabetes Buenos Aires (PPDBA) study.

Methods

PPDBA Study evaluated benefits of adopting healthy lifestyles to prevent T2D. It recruited people 45–75 years of age with PreD (impaired fasting glycaemia [IFG], impaired glucose tolerance [IGT] or both, American Diabetes Association criteria), using an opportunistic approach. They completed a FINDRISC questionnaire, and those with a score ≥13 points were invited to participate. When they accepted, we performed an oral glucose tolerance test (OGTT) with a complete lipid profile and HbA1c while physicians completed a clinical history. We recruited 367 persons, and depending on OGTT results, the sample was divided into normals (NGT), PreD, or with diabetes (last one was excluded in our analysis). Data were statistically analyzed using parametric and nonparametric tests and logistic regression to identify parameters associated with PreD.

Results

From the recruited (n = 367) 47.7% have NGT, 48.5% PreD and 3.8% unknown T2D (excluded). People with PreD were significantly older, with a higher percentage of overweight/obesity, BMI, and larger waist circumference than NGT. They also showed significantly higher fasting and 2 h post glucose load, HbA1c, and triglyceride levels. No significant differences were recorded in the blood pressure, lipid profile though both groups had abnormally high LDL-c values. They also had a larger percentage of TG/HDL-c ratios (insulin resistance indicator) (55% vs. 37.5%). Logistic regression analysis showed that PreD was significant associated with age, waist circumference, and triglyceride above target values.

Conclusion

Our findings showed that clinical and biochemical parameters were significantly different between people with PreD and those with NGT. This evidence supports the concept that PreD is a serious dysfunction, which should be early diagnosed and treated properly to prevent its transition to T2D and its complications.

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Acknowledgements

The authors thank the health care teams, the authorities of the Health Secretariats of La Plata, Berisso, and Ensenada cities, as well as the Health Ministry of Buenos Aires Province for their valuable cooperation. Also, thanks to Prof. Peter Kronsbein for careful reading and valuable criticism, and Mrs. Susan Hale Rogers for careful manuscript edition/correction. G.F., M.R., and J.P.R. are fellows/theses of MINCYT (PID‐2012‐0051). L.G. is a PhD fellow in CONICET. J.J.G., G.E. and J.F.E. are CONICET career research members.

Funding

The PPDBA is supported by PID‐2012‐0051, which receives contributions from the Secretary of Science, Technology and Productive Innovation (MINCYT); the National Scientific and Technical Research Council (CONICET), and the Sanofi Argentina Company.

Author information

Authors and Affiliations

  1. CENEXA. Center for Experimental and Applied Endocrinology (UNLP‐CONICET, CA CICPBA), Faculty of Medical Sciences UNLP, La Plata, Argentina

    J. F. Elgart, R. Torrieri, M. Ré, C. Giampieri, J. P. Ricart & J. J. Gagliardino

  2. Cardiometabolic Unit, Hospital Gral. San Martín, La Plata, Argentina

    M. Salazar & W. Espeche

  3. Faculty of Medical Sciences, National University of La Plata (UNLP), La Plata, Argentina

    M. Salazar, W. Espeche, J. M. Angelini, C. Martínez, J. Martínez & M. E. Rodríguez

  4. Chair of Epidemiology, Faculty of Medical Sciences (UNLP), La Plata, Argentina

    G. Etchegoyen

Authors
  1. J. F. Elgart
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  2. R. Torrieri
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  3. M. Ré
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  4. M. Salazar
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  10. G. Etchegoyen
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  13. J. J. Gagliardino
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Corresponding author

Correspondence to J. J. Gagliardino.

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The authors declare no competing interests.

Ethical approval

The study protocol was evaluated and approved by the Bioethical Committee of the National University of La Plata and the Central Ethics Committee of the Ministry of Health of the Province of Buenos Aires. The study was developed according to the Good Practice Recommendations (International Harmonization Conference) and the ethical guidelines of the Helsinki Declaration.

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Informed consent was obtained from all individual participants included in the study.

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Elgart, J.F., Torrieri, R., Ré, M. et al. Prediabetes is more than a pre-disease: additional evidences supporting the importance of its early diagnosis and appropriate treatment. Endocrine 79, 80–85 (2023). https://doi.org/10.1007/s12020-022-03249-8

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  • DOI: https://doi.org/10.1007/s12020-022-03249-8

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