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Outcome of intensive integrated intervention in participants with impaired glucose regulation in China

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Abstract

Introduction

This study investigated the outcomes and identified influencing factors of intensive integrated intervention over 2 years in Chinese patients with impaired glucose regulation (IGR).

Methods

Adults in Beijing, China, were screened for IGR using the 75 g oral glucose tolerance test. Participants with IGR received lifestyle and health education; those who still had IGR after 1 year were randomly assigned to either a routine care group or to an intensive integrated intervention group.

Results

Of 2344 adults screened, 463 had IGR. Of these, 210 adults had IGR after 1 year and were therefore recruited and randomized to an intensive integrated intervention group (n=106) or a control group (n=104). The percentage of patients who reached the set targets of plasma glucose, blood pressure, body mass index, or triglycerides was significantly higher in the intensive integrated intervention group. None of the patients within the intensive integrated intervention group progressed to diabetes, whereas eight (9.3%) cases of the control group developed type 2 diabetes mellitus (T2DM). Logistic regression analysis showed that both an increase in waist circumference and systolic blood pressure (SBP) were positively correlated with the development of T2DM, whereas improvement in islet beta cell function was negatively correlated with the development of T2DM.

Conclusions

Intensive integrated intervention may significantly decrease the conversion rate of IGR to T2DM, and increase the conversion ratio to normal glucose tolerance. The increase of waist circumference or SBP and the deterioration of islet beta cell function may be important risk factors for progression from prediabetes to diabetes.

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References

  1. Wild S, Sicree R, Roglic G, King H, Green A. Global prevalence of diabetes. Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047–1053.

    Article  PubMed  Google Scholar 

  2. Yang WY, Lu JM, Weng JP, et al. Prevalence of diabetes among men and women in China. N Engl J Med. 2010;362:1090–1101.

    Article  PubMed  CAS  Google Scholar 

  3. Harris MI. Impaired glucose tolerance: prevalence and conversion to NIDDM. Diabetic Med. 1996;13(Suppl 2):S9–S11.

    PubMed  CAS  Google Scholar 

  4. The DECODE Study Group. Glucose tolerance and cardiovascular mortality. Comparison of fasting and 2-hour diagnostic criteria. Arch Intern Med. 2001;161:397–404.

    Article  Google Scholar 

  5. Tominaga M, Eguchi H, Manaka H, Igarashi K, Kato T, Sekikawa A. Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. Diabetes Care. 1999;22:920–924.

    Article  PubMed  CAS  Google Scholar 

  6. Zimme PZ. The pathogenesis and prevention of diabetes in adults. Genes, autoimmunity and demography. Diabetes Care. 1995;18:1050–1064.

    Google Scholar 

  7. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care. 2003;26:3160–3167.

    Article  Google Scholar 

  8. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and β cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–419.

    Article  PubMed  CAS  Google Scholar 

  9. Pan XR, Li GW, Hu YH, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care. 1997;20:537–544.

    Article  PubMed  CAS  Google Scholar 

  10. Knowler WC, Barrett-Connor E, Fowler SE, et al. Diabetes prevention program research group reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.

    Article  PubMed  CAS  Google Scholar 

  11. Lindstrom J, Louheranta A, Mannelin M, Rastas M, Salminen V, Eriksson J. The Finnish Diabetes Prevention Study (DPS): lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care. 2003;26:3230–3236.

    Article  PubMed  Google Scholar 

  12. Mensink M, Feskens EJM, Saris WHM, Debruin TWA, Blaak EE. Study on lifestyle intervention and impaired glucose tolerance Maastricht (SLIM): preliminary results after one year. Int J Obes Relat Metab Disord. 2003;27:377–384.

    Article  PubMed  CAS  Google Scholar 

  13. Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M. STOP-NIDDM Trail Research Group. Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial. Lancet. 2002;359:2072–2077.

    Article  PubMed  CAS  Google Scholar 

  14. Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M. STOP-NIDDM Trial Research Group. Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance: the STOP-NIDDM trial. JAMA. 2003;290:486–494.

    Article  PubMed  CAS  Google Scholar 

  15. Li CL, Pan CY, Lu JM, et al. Effect of metformin on patients with impaired glucose tolerance. Diabet Med. 1999;16:477–481.

    Article  PubMed  Google Scholar 

  16. Yang WY, Lin LX, Qi JW, et al. The preventive effect of Acarbose and Metformin on the IGT population from becoming diabetes mellitus: a 3-year multicentral prospective study. Chin J Endocrinol Metab. 2001;17:131–134.

    CAS  Google Scholar 

  17. Kawamori R, Tajima N, Iwamoto Y, Kashiwagi A, Shimamoto K, Kaku K. Voglibose for the prevention of type 2 diabetes mellitus: a randomised, double-blind trial in Japanese subjects with impaired glucose tolerance. Nippon Rinsho. 2010;68:873–881.

    PubMed  Google Scholar 

  18. Azen SP, Peters RK, Berkowitz K, Kjos S, Xiang A, Buchanan TA. TRIPOD (Troglitazone In the Prevention Of Diabetes): a randomized, placebo-controlled trial of troglitazone in women with prior gestational diabetes mellitus. Control Clin Trials. 1998;19:217–231.

    Article  PubMed  CAS  Google Scholar 

  19. The DREAM (Diabetes Reduction Assessment with ramipril and rosiglitazone Medication) Trial Investigators. Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomized controlled trial. Lancet. 2006;368:1096–1105.

    Article  Google Scholar 

  20. Weyer C, Bogardus C, Pratley RE. Metabolic characteristics of individuals with impaired fasting glucose and/or impaired glucose tolerance. Diabetes. 1999;48:2197–2203.

    Article  PubMed  CAS  Google Scholar 

  21. Abdul-Ghani MA, Jenkinson CP, Richardson DK, Tripathy D, Defronzo RA. Insulin secretion and action in subjects with impaired fasting glucose and impaired glucose tolerance: results from the Veterans Administration Genetic Epidemiology Study. Diabetes. 2006;55:1430–1435.

    Article  PubMed  CAS  Google Scholar 

  22. DeFronzo RA, Banerji MA, Bray GA, et al. Determinants of glucose tolerance in impaired glucose tolerance at baseline in the Actos Now for Prevention of Diabetes (ACT NOW) study. Diabetologia. 2010;53:435–445.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China

    Yan-Hui Lu, Chun-Lin Li & Hui Tian

  2. Department of Endocrinology, Chinese PLA General Hospital, 28 Fu Xing Road, Beijing, China

    Ju-Ming Lu

  3. Beijing Hypertension Federation, Beijing, China

    Shu-Yu Wang & Run-Ping Zheng

  4. Department of Endocrinology, Chinese PLA General Hospital, 28 Fu Xing Road, Beijing, China

    Xian-Ling Wang

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  1. Yan-Hui Lu
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  2. Ju-Ming Lu
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  7. Xian-Ling Wang
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Correspondence to Ju-Ming Lu.

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Lu, YH., Lu, JM., Wang, SY. et al. Outcome of intensive integrated intervention in participants with impaired glucose regulation in China. Adv Therapy 28, 511–519 (2011). https://doi.org/10.1007/s12325-011-0022-4

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  • DOI: https://doi.org/10.1007/s12325-011-0022-4

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