Re: Expanded definition of "prediabetes"


"Ozgirl" <are_we_there_yet@xxxxxxxxxx> wrote in message news:94efh1Fnt7U1@xxxxxxxxxxxxxxxxxxxxx


"Ellen K." <firstinitiallastname@xxxxxxxxxxxxxx> wrote in message news:vtlEp.24129$oq.8679@xxxxxxxxxxxxxxx

"Ozgirl" <are_we_there_yet@xxxxxxxxxx> wrote in message news:94dm69FiqcU1@xxxxxxxxxxxxxxxxxxxxx


"Susan" <susan@xxxxxxxxxxxx> wrote in message news:94cvq7Fk7pU2@xxxxxxxxxxxxxxxxxxxxx
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On 5/28/2011 11:52 AM, Cheri wrote:

I agree with that.

Me, too.

Besides, we know fasting is the last to rise; using it, plus a number so high above normal means diabetes has to be very well advanced. Misses so many opportunities to prevent damage and progression.

Susan

That is so not so. Pre diabetes (which you now claim should be called diabetes) has always been diagnosed by an and/or situation with IFG and IGT.


While A1c and GTT are used to make the diagnosis, in the US a patient is not given those tests unless FBG is at least in the "pre-diabetic" range.

I'm sorry Ellen, I am not understanding the relevance of what you are saying here.

The study is separating people into two categories, those with just IFG and those with just IGT. The study is just one that clarifies that FBG is not always "the last to rise". Susan has often claimed that FBG is last to rise but hasn't backed it up with cites. I personally had an advantage over some in here in that I had a meter at home because of previous gestational diabetes. I saw my FBG rise over time, long before post prandials. Because of my history of RH and GD I knew I was a candidate for type 2 but back then I didn't know you could actually prevent it.



I think if your FBG was rising before you experienced post-prandial spikes, this is another example of how individual this disease is.

One question that occurs to me now is how could you get reactive hypoglycemia if you weren't having spikes? I.e. what was the reaction to?


http://care.diabetesjournals.org/content/26/3/868.long

"OBJECTIVE—Isolated impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are two risk categories for type 2 diabetes. This study compared both categories with respect to the degree of insulin secretion abnormalities and insulin resistance.

RESEARCH DESIGN AND METHODS—This is a crossover comparison of a population at high risk for type 2 diabetes. The subjects were recruited from the Risk Factor in Impaired Glucose Tolerance for Atherosclerosis and Diabetes (RIAD) study. They underwent a 75-g oral glucose tolerance test, with measurement of specific insulin, C-peptide, proinsulin, and free fatty acids at baseline and every 30 min after load for 2 h. Factor analysis was performed to evaluate the importance of insulin resistance and secretion abnormalities in both categories.

RESULTS—All categories of prediabetic hyperglycemia had a higher cardiovascular risk factor level when adjusted for sex, age, and BMI compared to control subjects with normal glucose tolerance. Subjects with isolated IFG were more insulin resistant than those with IGT. By contrast, subjects with isolated IGT exhibited a more severe deficit in early- and late-phase insulin secretion versus IFG subjects. As shown with factor analysis, in IFG the insulin resistance factor explained 28.4% of the variance, whereas in IGT the insulin secretion factor was dominant, explaining 31.1% of the total variance.

CONCLUSIONS—Our cross-sectional data from the RIAD study demonstrate that isolated IFG and isolated IGT are different with respect to the degree of insulin resistance and anomalies in insulin secretion, and that subjects with IGT exhibit a deficit in the early and late phases of insulin secretion. This finding may be important for a differential approach in primary prevention of type 2 diabetes."






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Relevant Pages

  • Re: Prehypertension, Prediabetes Predict Heart Risk
    ... Diabetes Care. ... be considered for metformin therapy. ... Isolated IFG, isolated IGT, and IFG and IGT were ...
    (alt.support.diabetes)
  • Re: Expanded definition of "prediabetes"
    ... Besides, we know fasting is the last to rise; using it, plus a number so high above normal means diabetes has to be very well advanced. ... Pre diabetes has always been diagnosed by an and/or situation with IFG and IGT. ... This study compared both categories with respect to the degree of insulin secretion abnormalities and insulin resistance. ... subjects with isolated IGT exhibited a more severe deficit in early- and late-phase insulin secretion versus IFG subjects. ...
    (alt.support.diabetes)
  • Re: Expanded definition of "prediabetes"
    ... Besides, we know fasting is the last to rise; using it, plus a number so high above normal means diabetes has to be very well advanced. ... Pre diabetes has always been diagnosed by an and/or situation with IFG and IGT. ... This study compared both categories with respect to the degree of insulin secretion abnormalities and insulin resistance. ... subjects with isolated IGT exhibited a more severe deficit in early- and late-phase insulin secretion versus IFG subjects. ...
    (alt.support.diabetes)
  • Pre Diabetes
    ... "Epidemiological studies indicate that the development of type 2 diabetes ... insulin resistance can be detected long before ... the deterioration of glucose intolerance occurs. ... (IFG). ...
    (alt.support.diabetes)
  • Re: Expanded definition of "prediabetes"
    ... Besides, we know fasting is the last to rise; using it, plus a number so high above normal means diabetes has to be very well advanced. ... Pre diabetes has always been diagnosed by an and/or situation with IFG and IGT. ... This study compared both categories with respect to the degree of insulin secretion abnormalities and insulin resistance. ...
    (alt.support.diabetes)