Endocrine Abstracts

Background: Diabetes and prediabetes have become major public health problems in recent decades.

Objectives: The aim of the study was to evaluate the predictive value of risk factors on progression from prediabetes to type 2 diabetes.

Materials and methods: A total of 383 subjects (213 females, 170 males), mean age 51.93±13.47 years and mean BMI 29.11±5.3 kg/m², divided in three groups – 147 with normal glucose tolerance, 122 with impaired fasting glucose (IFG) and 114 with impaired glucose tolerance (IGT), were included in the study and were followed-up a year later. OGTT was performed in all participants; categories of glucose tolerance were defined according to 2006 WHO criteria. Anthropometric, laboratory parameters (HbA1c, lipids, hsCRP, insulin, proinsulin), blood pressure, body fat mass and FINDRISC were assessed.

Results: Progression rates from IFG and IGT to diabetes over 1 year were 12.08 and 19.91 per 100 person-years, respectively. Baseline determinants of progression from IFG to diabetes were age, HbA1c, systolic blood pressure, lack of daily fruit and vegetable intake, FINDRISC, hsCRP; and from IGT to diabetes – overweight and obesity (BMI), waist circumference, HbA1c, lack of daily fruit and vegetable intake. Baseline insulin resistance (HOMA-IR) appeared to be a predictor for the progression from both IFG and IGT to diabetes, while basal insulin secretion (HOMA-%B) - a predictor for the progression from IGT to diabetes. Baseline proinsulin level and proinsulin:insulin ratio were independent predictors for progression to diabetes in both IFG and IGT.

Conclusions: Individuals with IFG or IGT identified through high-risk strategies in Bulgarian population, have a rather high risk of developing diabetes within one year. Overweight and obesity, waist circumference, systolic blood pressure, lack of daily fruit and vegetable intake, insulin resistance appear to be significant determinants of progression to diabetes, which implies for adequate measures for their control aiming at prevention of the disease.