Diabetes Mellitus (dm)
Years of poorly controlled hyperglycemia lead to multiple, primarily vascular complications that affect small vessels (microvascular), large vessels (macrovascular), or both. (For additional detail, see Complications of Diabetes Mellitus.) Microvascular disease underlies 3 common and devastating manifestations of diabetes mellitus: Microvascular disease may also impair skin healing, so that even minor breaks in skin integrity can develop into deeper ulcers and easily become infected, particularly in the lower extremities. Intensive control of plasma glucose can prevent or delay many of these complications but may not reverse them once established. Macrovascular disease involves atherosclerosis of large vessels, which can lead to Immune dysfunction is another major complication and develops from the direct effects of hyperglycemia on cellular immunity. Patients with diabetes mellitus are particularly susceptible to bacterial and fungal infections. Continue reading >>
Metabolic Syndrome As A Precursor Of Cardiovascular Disease And Type 2 Diabetes Mellitus
Abstract Background— The incidence of cardiovascular disease (CVD), coronary heart disease (CHD), and type 2 diabetes mellitus (T2DM) has not been well defined in persons with the metabolic syndrome (at least 3 of the following: abdominal adiposity, low HDL cholesterol, high triglycerides, hypertension, and impaired fasting glucose). The objective was to investigate risk for CVD, CHD, and T2DM according to metabolic syndrome traits. Methods and Results— The study followed a cohort of 3323 middle-aged adults for the development of new CVD, CHD, and T2DM over an 8-year period. In persons without CVD or T2DM at baseline, the prevalence of the metabolic syndrome (≥3 of 5 traits) was 26.8% in men and 16.6% in women. There were 174 incident cases of CVD, 107 of CHD, and 178 of T2DM. In men, the metabolic syndrome age-adjusted relative risk (RR) and 95% CIs were RR=2.88 (95% CI 1.99 to 4.16) for CVD, RR=2.54 (95% CI 1.62 to 3.98) for CHD, and RR=6.92 (95% CI 4.47 to 10.81) for T2DM. Event rates and RRs were lower in women for CVD (RR=2.25, 95% CI 1.31 to 3.88) and CHD (RR=1.54, 95% CI 0.68 to 3.53), but they were similar for T2DM (RR=6.90, 95% CI 4.34 to 10.94). Population-attributable risk estimates associated with metabolic syndrome for CVD, CHD, and T2DM were 34%, 29%, and 62% in men and 16%, 8%, 47% in women. Conclusions— Metabolic syndrome is common and is associated with an increased risk for CVD and T2DM in both sexes. The metabolic syndrome accounts for up to one third of CVD in men and approximately half of new T2DM over 8 years of follow-up. The metabolic syndrome is a constellation of physiological risk factors that occur to a greater degree than expected by chance, as reported in earlier work on clustering of traits.1 The metabolic syndrome traits, as defin Continue reading >>
- Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes
- Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)*
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
Diabetes Mellitus Type 2
Diabetes mellitus type 2 (also known as type 2 diabetes) is a long-term metabolic disorder that is characterized by high blood sugar, insulin resistance, and relative lack of insulin.[6] Common symptoms include increased thirst, frequent urination, and unexplained weight loss.[3] Symptoms may also include increased hunger, feeling tired, and sores that do not heal.[3] Often symptoms come on slowly.[6] Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations.[1] The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon.[4][5] Type 2 diabetes primarily occurs as a result of obesity and lack of exercise.[1] Some people are more genetically at risk than others.[6] Type 2 diabetes makes up about 90% of cases of diabetes, with the other 10% due primarily to diabetes mellitus type 1 and gestational diabetes.[1] In diabetes mellitus type 1 there is a lower total level of insulin to control blood glucose, due to an autoimmune induced loss of insulin-producing beta cells in the pancreas.[12][13] Diagnosis of diabetes is by blood tests such as fasting plasma glucose, oral glucose tolerance test, or glycated hemoglobin (A1C).[3] Type 2 diabetes is partly preventable by staying a normal weight, exercising regularly, and eating properly.[1] Treatment involves exercise and dietary changes.[1] If blood sugar levels are not adequately lowered, the medication metformin is typically recommended.[7][14] Many people may eventually also require insulin injections.[9] In those on insulin, routinely checking blood sugar levels is advised; however, this may not be needed in those taking pills.[15] Bariatri Continue reading >>
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
- Metabolic surgery for treating type 2 diabetes mellitus: Now supported by the world's leading diabetes organizations
Metabolic Syndrome
Tweet Metabolic syndrome is becoming increasingly common. It occurs when a range of metabolic risk factors such as obesity and insulin resistance come together. Metabolic syndrome increases one's risk of developing type 2 diabetes. A number of alternative terms exist to describe the condition, such as syndrome X, Reaven’s syndrome and in Australia, CHAOS. What are the risk factors for metabolic syndrome? The set of risk factors for metabolic syndrome generally include: Obesity - generally in the abdominal region. Outwardly, this is manifested as excess fat tissue in and around the abdomen of the person Insulin resistance or intolerance to glucose - this means that the body cannot properly use blood sugar or insulin Proinflammatory state - higher amounts of C-reactive protein in the blood Prothrombotic state - higher amounts of fibrinogen or plasminogen activator inhibitor-1 present in the bloodstream Atherogenic Dyslipidemia - disorders in the blood fat, with high levels of ‘bad' cholesterol and low levels of ‘good’ cholesterol Higher blood pressure People who suffer from metabolic syndrome are at a much greater risk of developing type 2 diabetes as well as other diseases. What are the symptoms of metabolic syndrome? You may recognise some of the following symptoms of metabolic syndrome: Tiredness - particularly after meals Inability to focus properly - ‘brain fog’ Acanthosis nigricans - browning (hyperpigmentation) of folds of skin such as on the neck, armpits, groin and between the buttocks Most commonly, patients suffering from metabolic syndrome will exhibit two major symptoms: Abdominal obesity Diagnosis of metabolic syndrome An accurate form of diagnosis is not yet universally accepted. Some experts believe that a combination of three of the following Continue reading >>
- Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)*
- Ultraviolet Radiation Suppresses Obesity and Symptoms of Metabolic Syndrome Independently of Vitamin D in Mice Fed a High-Fat Diet
- Why Diabetes Is Dangerous: How to Recognize the Signs of this Metabolic Disease
Mechanisms In Endocrinology: Metabolic And Inflammatory Pathways On The Pathogenesis Of Type 2 Diabetes
Abstract Obesity is the main risk factor for type 2 diabetes (T2D). Studies performed over the last 20 years have identified inflammation as the most important link between these two diseases. During the development of obesity, there is activation of subclinical inflammatory activity in tissues involved in metabolism and energy homeostasis. Intracellular serine/threonine kinases activated in response to inflammatory factors can catalyse the inhibitory phosphorylation of key proteins of the insulin-signalling pathway, leading to insulin resistance. Moreover, during the progression of obesity and insulin resistance, the pancreatic islets are also affected by inflammation, contributing to β-cell failure and leading to the onset of T2D. In this review, we will present the main mechanisms involved in the activation of obesity-associated metabolic inflammation and discuss potential therapeutic opportunities that can be developed to treat obesity-associated metabolic diseases. Invited Author's profile L A Velloso MD, PhD is Professor of Medicine and Head of the Obesity and Co-Morbidities Research Center at the University of Campinas, Brazil. Professor Velloso's current research interests include characterization of the inflammatory mechanisms involved in the dysfunction of the hypothalamus in obesity. Introduction Type 2 diabetes (T2D) results from the combination of insulin resistance and a relative deficiency of insulin production (1). Despite the fact that both insulin resistance and insulin insufficiency may be induced by a number of factors that comprise genetic defects, sedentary lifestyle, dietary factors and endocrine disruptors, among others (1, 2, 3, 4, 5), inflammation has emerged as a unifying mechanism capable of affecting both the action and production of insuli Continue reading >>
What Is Type 2 Diabetes?
Diabetes is a disease that's characterized by high blood sugar, which doctors refer to as hyperglycemia. In type 2 diabetes, the two main contributors to high blood sugar are insulin resistance and a drop in your body's production of insulin. These two factors are what makes type 2 diabetes different from type 1 diabetes, gestational diabetes, and other types of diabetes. What Is Insulin Resistance? Insulin — the hormone that allows your body to regulate sugar in the blood — is made in your pancreas. Insulin resistance is a state in which the body’s cells do not use insulin efficiently. As a result, it takes more insulin than normal to transport glucose (the main type of sugar found in the bloodstream) into cells, where it can be used for fuel or stored for later use. Insulin resistance develops over time, and as the body becomes more and more insulin resistant, the pancreas responds by releasing more and more insulin. This higher-than-normal level of insulin in the bloodstream is called hyperinsulinemia. For a while, the pancreas may be able to keep up with the body’s increased need for insulin, and blood sugar levels may stay within the normal range — about 70 to 100 mg/dl before meals and lower than 140 mg/dl after meals. Eventually, however, the pancreas can no longer keep up, and blood sugar levels begin to rise. What Causes Type 2 Diabetes? It's not known for certain why some people develop type 2 diabetes and some do not. There are several factors, however, that can increase a person's risk of developing type 2 diabetes: Obesity Being obese or overweight puts you at significant risk for developing type 2 diabetes. Four out of five people with type 2 diabetes are overweight or obese. Prediabetes Prediabetes is a condition in which your blood sugar levels Continue reading >>
What Is Insulin Resistance? Does It Mean You're Going To Get Type 2 Diabetes?
If your doctor has told you that you have this condition, you're probably asking these questions. It means your body can't respond properly to the insulin it makes. Over time, this sends your blood sugar levels up. That can set you up for type 2 diabetes, as well as heart disease, but it doesn't have to. Exercise and a good diet can help you stay healthy. You can't tell that you have insulin resistance by how you feel. You'll need to get a blood test that checks your blood sugar levels. Likewise, you won’t know if you have most of the other conditions that are part of insulin resistance syndrome (high blood pressure, low "good" cholesterol levels, and high triglycerides) without seeing your doctor. If you already have insulin resistance, you can take actions that will help your health. Exercise. Go for at least 30 minutes a day of moderate activity (like brisk walking) 5 or more days a week. If you're not active now, work up to that. Get to a healthy weight. If you're not sure what you should weigh or how to reach a weight loss goal, ask your doctor. You may also want to talk with a nutritionist and a certified personal trainer. Eat a healthy diet. Think fruits, vegetables, whole grains, nuts, beans, fish, legumes, and other lean protein. Some people with insulin resistance may also need to take metformin. Continue reading >>
Insulin Resistance, Type 2 Diabetes And Metabolic Disorder
Insulin Resistance, Type 2 Diabetes and Metabolic Disorder What do they ALL have in common? Insulin resistance is a condition where the body produces insulin but does not use it correctly. When there is insulin resistance glucose builds up in the blood instead of being absorbed by the cells, leading to pre-diabetes or type 2 diabetes (IDF, 2016). Metabolic syndrome, also called insulin resistance syndrome, is a group of traits and medical conditions linked to obesity, which puts people at risk for cardiovascular disease and type 2 diabetes (IDF, 2016). Metabolic Syndrome is defined as the presence of any three of the following: 1. Large waist size 2. High triglycerides in the blood 3. High blood pressure 4. Higher then normal glucose levels. It is important to mention that not all people with insulin resistance suffer from this disorder. Clinical insulin resistance and pre-diabetes are likely to progress to type 2 diabetes if not targeted for early intervention. What put´s us at RISK? Most notable in the review of scientific studies is the relation between cardiovascular fitness, nutrition and insulin resistance. The major contributors to this condition are excess weight and physical inactivity. Experts believe that obesity, especially excess weight around the waist, is the primary cause. Studies have shown that belly fat produces hormones and other substances that can cause serious health problems such as insulin resistance, high blood pressure, imbalanced cholesterol and cardiovascular disease. READY FOR THE GOOD NEWS? With the appropriate management, in particular nutrition and lifestyle changes, these conditions are potentially reversible or at the very least their progression can be controlled. The Western diet has been linked to obesity and a series of different Continue reading >>
Metabolic Syndrome
Metabolic syndrome is the medical term for a combination of diabetes, high blood pressure and obesity. It puts you at greater risk of getting coronary heart disease, stroke and other conditions that affect the blood vessels. On their own, diabetes, high blood pressure and obesity can damage your blood vessels, but having all three together is particularly dangerous. They're very common conditions that are all linked, which explains why metabolic syndrome affects an estimated one in four adults in the UK. Symptoms of metabolic syndrome Metabolic syndrome may be diagnosed if you have three or more of the following symptoms: a waist circumference of 94cm (37 inches) or more in European men, or 90cm (35.5 inches) or more in South Asian men a waist circumference of 80cm (31.5 inches) or more in European and South Asian women high triglyceride levels (fat in the blood) and low levels of HDL ("good" cholesterol) in the blood, which can lead to atherosclerosis (where arteries become clogged up by fatty substances such as cholesterol) high blood pressure that's consistently 140/90mmHg or higher an inability to control blood sugar levels (insulin resistance) an increased risk of developing blood clots, such as deep vein thrombosis (DVT) a tendency to develop inflammation (irritation and swelling of body tissue) What causes metabolic syndrome? Metabolic syndrome is associated with being overweight or obese, and a lack of physical activity. It's also linked to insulin resistance, which is a key feature of type 2 diabetes. Blood sugar levels are controlled by a hormone called insulin. If you have insulin resistance, too much glucose can build up in your bloodstream. Your chances of developing metabolic syndrome are greater if you have a family history of type 2 diabetes, or you've h Continue reading >>
- Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)*
- Ultraviolet Radiation Suppresses Obesity and Symptoms of Metabolic Syndrome Independently of Vitamin D in Mice Fed a High-Fat Diet
- Why Diabetes Is Dangerous: How to Recognize the Signs of this Metabolic Disease
Metabolic Syndrome
What is metabolic syndrome? Metabolic syndrome is a cluster of metabolic risk factors that come together in a single individual. These metabolic factors include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for blood clotting. Affected individuals are most often overweight or obese. An association between certain metabolic disorders and cardiovascular disease has been known since the 1940s. Metabolic syndrome is considered to be a risk factor for cardiovascular diseases and type 2 diabetes. Insulin resistance refers to the diminished ability of cells to respond to the action of insulin in promoting the transport of the sugar glucose, from blood into muscles and other tissues. Type 2 diabetes is caused by insulin resistance. Metabolic syndrome is also known as syndrome X, insulin resistance syndrome, or dysmetabolic syndrome. How is metabolic syndrome defined? Based on the guidelines from the National Heart, Lung, and Blood Institute (NHLBI) and the American Heart Association (AHA), any three of the following traits in the same individual meet the criteria for the metabolic syndrome: Abdominal obesity: a waist circumference of 102 cm (40 in) or more in men and 88 cm (35 inches) or more in women. For Asian Americans, the cutoff values are ≥90 cm (35 in) in men or ≥80 cm (32 in) in women Serum triglycerides 150 mg/dl or above. HDL cholesterol 40mg/dl or lower in men and 50mg/dl or lower in women. Blood pressure of 130/85 or more. Fasting blood glucose of 100 mg/dl or above. Metabolic syndrome is a group of risk factors that raises your risk for heart disease and other health problems, such as diabetesexternal link icon and stroke. These risk factors can increase your risk for health problems even if they're onl Continue reading >>
- Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)*
- Ultraviolet Radiation Suppresses Obesity and Symptoms of Metabolic Syndrome Independently of Vitamin D in Mice Fed a High-Fat Diet
- Why Diabetes Is Dangerous: How to Recognize the Signs of this Metabolic Disease
Metabolic Syndrome (syndrome X) And Pre- And Type 2 Diabetes
A root cause of Metabolic Syndrome is Insulin Resistance. The latter condition increases the risk of developing Pre-Diabetes and Type 2 Diabetes, which may result in a heart attack or stroke. People with often Insulin Resistance-linked blood glucose levels that are higher than normal but not yet in the Type 2 Diabetes range have Pre-Diabetes. Doctors sometimes call this condition impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the blood test used to diagnose it. The good news is that Pre-Diabetes doesn’t have to lead to Type 2 Diabetes because it can be reversed. But if it is neglected, this disorder may become Type 2 Diabetes, which must be managed for one's lifetime in the vast majority of cases and often requires daily insulin. Type 2 Diabetes, itself, is a severely increased risk factor for blindness, kidney disease and the need for amputation. So it is critical that you understand the interaction of Insulin Resistance and the various forms of Diabetes in order to learn about heart disease prevention and avoid the onset of other serious health complications. The human body processes food into glucose, which then passes through the cell wall to be turned into energy via insulin, a hormone produced in the pancreas. Pre-and Type 2 Diabetes are disorders of that metabolism and a malfunction of the process. People with one form or another of Diabetes either cannot use the insulin that is produced or the pancreas produces little or no insulin. As the pancreas struggles to keep up with the body’s need for more insulin, excessive levels of glucose and insulin build up in the blood stream, often leading directly to Pre- and Type 2 Diabetes. Metabolic Syndrome, also known as Syndrome X, has several tell-tale symptoms: excessive abdominal f Continue reading >>
- Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)*
- Ultraviolet Radiation Suppresses Obesity and Symptoms of Metabolic Syndrome Independently of Vitamin D in Mice Fed a High-Fat Diet
- Metabolic surgery for treating type 2 diabetes mellitus: Now supported by the world's leading diabetes organizations
Metabolic Syndrome
Metabolic syndrome is a collection of conditions that often occur together and increase your risk of diabetes, stroke and heart disease. The main components of metabolic syndrome include obesity, high blood pressure, high blood triglycerides, low levels of HDL cholesterol and insulin resistance. Healthy eating and increased physical activity are the keys to avoiding or overcoming problems related to metabolic syndrome. Consult your doctor about ways to manage metabolic syndrome. On this page: Metabolic syndrome is a collection of disorders that occur together and increase your risk of developing type 2 diabetes or cardiovascular disease (stroke or heart disease). The causes of metabolic syndrome are complex and not well understood, but there is thought to be a genetic link. Being overweight or obese and physically inactive adds to your risk. Metabolic syndrome is sometimes called syndrome X or insulin-resistance syndrome. As we get older, we tend to become less active and may gain excess weight. This weight is generally stored around the abdomen, which can lead to the body becoming resistant to the hormone insulin. This means that insulin in the body is less effective, especially in the muscles and liver. More than 35 per cent of Australian adults have metabolic syndrome. This is higher in people with diabetes. Diagnosis of metabolic syndrome Metabolic syndrome is not a disease in itself, but a collection of risk factors for that often occur together. A person is diagnosed as having metabolic syndrome when they have any three or more of: central (abdominal) obesity – excess fat in and around the stomach (abdomen) raised blood pressure (hypertension) high blood triglycerides low levels of high density lipoproteins (HDL) – the ‘good’ cholesterol impaired fasting g Continue reading >>
- Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)*
- Ultraviolet Radiation Suppresses Obesity and Symptoms of Metabolic Syndrome Independently of Vitamin D in Mice Fed a High-Fat Diet
- Why Diabetes Is Dangerous: How to Recognize the Signs of this Metabolic Disease
Brain Signaling Systems In The Type 2 Diabetes And Metabolic Syndrome: Promising Target To Treat And Prevent These Diseases
The changes in the brain signaling systems play an important role in etiology and pathogenesis of Type 2 diabetes mellitus (T2DM) and metabolic syndrome (MS), being a possible cause of these diseases. Therefore, their restoration at the early stages of T2DM and MS can be regarded as a promising way to treat and prevent these diseases and their complications. The data on the functional state of the brain signaling systems regulated by insulin, IGF-1, leptin, dopamine, serotonin, melanocortins and glucagon-like peptide-1, in T2DM and MS, are analyzed. The pharmacological approaches to restoration of these systems and improvement of insulin sensitivity, energy expenditure, lipid metabolism, and to prevent diabetic complications are discussed. Currently, more than 30% of the populations worldwide are overweight and have metabolic dysfunctions that without the appropriate treatment would go over to severe Type 2 diabetes mellitus (T2DM). At the early stages of T2DM significant changes occur in the brain signaling systems, resulting in the impairment of metabolism and the functions of nervous, cardiovascular and the other systems. Restoration of the brain signaling is regarded as a promising way to treat and prevent diabetic pathology. In the review the changes in the brain signaling systems in T2DM and the pharmacological approaches to their restoration are discussed. Currently, more than 30% of the populations worldwide are overweight and have metabolic disorders. Without treatment and prevention of these disorders, they would go over to prediabetes that is characterized by decreased insulin sensitivity and then, in accordance with the adverse scenario, to overt Type 2 diabetes mellitus (T2DM) and metabolic syndrome (MS) commonly associated with cardiovascular, nervous, end Continue reading >>
- A vegan diet could prevent, treat and even reverse type 2 diabetes, say leading experts this Diabetes Week (12-18 June).
- Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)*
- Unbelievable: Treat Diabetes, Asthma, Cholesterol And Kidney Diseases With Okra Water- Now You Can Make It Yourself
The Role Of Testosterone In Type 2 Diabetes And Metabolic Syndrome In Men
REVIEW O papel da testosterona no diabetes melito tipo 2 e síndrome metabólica em homens Farid Saad Bayer Schering Pharma AG, Berlin, Germany and Gulf Medical University School of Medicine, Ajman, UAE ABSTRACT Over the last three decades, it has become apparent that testosterone plays a significant role in glucose homeostasis and lipid metabolism. The metabolic syndrome is a clustering of risk factors predisposing to diabetes mellitus type 2, atherosclerosis and cardiovascular morbidity and mortality. The main components of the syndrome are visceral obesity, insulin resistance, glucose intolerance, raised blood pressure and dyslipidemia (elevated triglycerides, low levels of high-density lipoprotein cholesterol), and a pro-inflammatory and thrombogenic state. Cross-sectional epidemiological studies have reported a direct correlation between plasma testosterone and insulin sensitivity, and low testosterone levels are associated with an increased risk of type 2 diabetes mellitus, dramatically illustrated by androgen deprivation in men with prostate carcinoma. Lower total testosterone and sex hormone-binding globulin (SHBG) predict a higher incidence of the metabolic syndrome. There is evidence that hypotestosteronemia should be an element in the definition of the metabolic syndrome since low levels of testosterone are associated with or predict the development of the metabolic syndrome and of diabetes mellitus. Administration of testosterone to hypogonadal men reverses part of the unfavorable risk profile for the development of diabetes and atherosclerosis. So far, studies on the effects of normalization of testosterone in hypogonadal men on glucose homeostasis are limited, but convincing, and if diabetes mellitus is viewed in the context of the metabolic syndrome, the Continue reading >>
The Metabolic Syndrome As Predictor Of Type 2 Diabetes
The San Antonio Heart Study Abstract OBJECTIVE—The oral glucose tolerance test identifies high-risk subjects for diabetes, but it is costly and inconvenient. To find better predictors of type 2 diabetes, we evaluated two different definitions of the metabolic syndrome because insulin resistance, which is commonly associated with this clustering of metabolic factors, frequently precedes the onset of type 2 diabetes. RESEARCH DESIGN AND METHODS—We compared the ability of the National Cholesterol Education Program (NCEP) definition, a modified version of the 1999 World Health Organization (WHO) definition that excludes the 2-h glucose requirement, and impaired glucose tolerance (IGT) to predict incident type 2 diabetes. In the San Antonio Heart Study, 1,734 participants completed a 7- to 8-year follow-up examination. RESULTS—IGT and the NCEP definition had higher sensitivity than the modified WHO definition (51.9, 52.8, and 42.8%, respectively). IGT had a higher positive predictive value than the NCEP and modified WHO definitions (43.0, 30.8, and 30.4%, respectively). The combination of the IGT and NCEP definitions increased the sensitivity to 70.8% with an acceptable positive predictive value of 29.7%. Risk for incidence of type 2 diabetes using the NCEP definition was independent of other risk factors, including IGT and fasting insulin (odds ratio 3.30, 95% CI 2.27-4.80). The NCEP definition performed better with fasting glucose ≥5.4 mmol/l (sensitivity 62.0% and positive predictive value 30.9%). CONCLUSIONS—The metabolic syndrome predicts diabetes independently of other factors. However, the NCEP definition performs better than the modified 1999 WHO definition. Lowering the fasting glucose cutoff to 5.4 mmol/l improves the prediction of diabetes by the metabol Continue reading >>
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
- Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)*
- Ultraviolet Radiation Suppresses Obesity and Symptoms of Metabolic Syndrome Independently of Vitamin D in Mice Fed a High-Fat Diet
