Endocrine Abstracts

Introduction: Prediabetes is a very prevalent disease. About 27.4% of Portuguese adults suffer from this condition. Prediabetes is defined as intermediate hyperglycemia state associated with the simultaneous presence of insulin resistance and β-cell dysfunction as diabetes, with increased risk of developing macro and microvascular complications. Approximately 7% of individuals with prediabetes will progress to diabetes per year. This study aims to characterize a population with prediabetes and to evaluate the risk of developing micro and macrovascular complications and progression to diabetes.

Methods: We did a retrospective observational study including 188 individuals with prediabetes diagnosis.The following variables were analysed: age, family history, disease duration, metabolic control (HbA1c), body mass index (BMI), treatment and prevalence of macro and microvascular complications. Statistical analysis performed in SPSS with significance index P<0.05.

Results: Of 188 prediabetic patients 60.6% were males with a mean age of 67.7 years. The mean age of diagnosis was 58 years and 37.2% had family history of diabetes. The mean follow-up was 6.6 years in which 16% evolved to diabetes. The 84% (n=158) of patients that remain with prediabetes presented at diagnosis, a mean HbA1c of 5.8% and a mean BMI of 30.7 kg/m². The most prevalent macro and microvascular complications were acute myocardial infarction (5.06%) and nephropathy (4.43%). Lifestyle therapy was recommended to all patients at diagnosis, however in 48% of patients were recommended pharmacological therapy. Metformin was the therapeutic of choice in 89.5%. Comparing prediabetic patients with pharmacological approach (n=76) and those who remained untreated (n=82), the treated group had a higher initial BMI (31.5 vs 30.1 kg/m², P=0.038), greater weight loss (−2.76 vs −2.4%, P=0.046) and a higher incidence of diabetic nephropathy (3.8% vs 0.63%, P=0.041). There was no difference in the remaining macro and microvaculares complications. Regarding the risk of progression to diabetes there was a lower progression in the treated group than in the untreated patients (9.5% vs 21.2%, P=0.03).

Conclusion: We found that the early pharmacological approach in patients with prediabetes was favourable in relation to the weight profile and progression to diabetes although there was a higher incidence of diabetic nephropathy.