2017, Number 2
Evaluation of three methodologies for risk prediction of impaired glucose metabolism in overweighed and obese subjects
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ABSTRACTIntroduction: at present, there is no set strategy in Cuba for the screening of impaired glucose metabolism.
Objective: to evaluate the diagnostic capacity of three methodologies to predict the risk of impaired glucose metabolism in overweighed and obese individuals.
Methods: a longitudinal diagnostic evaluation study was carried out using data from 90 subjects aged 25 to 70 years, which were analyzed two and a half years after the initial assessment. Information about age, sex, personal pathological history, used medication, weight, height, waist circumference and blood pressure as well the glucose concentrations at the beginning and two and a half years later, insulin and triglyceride indexes was collected in addition to estimating the insulinresistance index in the initial evaluation. A risk-score model for type 2 diabetes was also used.
Results: the frequency of impaired glucose metabolism (impaired fasting glycemia and type 2 diabetes) after two and a half years, according to the previous existence or not of impaired fasting glycemia, insulin resistance and moderate/high risk of type 2 diabetes, was higher in subjects with previous impaired fasting glycemia (72,4 % [21/29]), with insulin resistance at the beginning (65.6 % [40/61]) and with moderate/high risk (54,4 % [43/79]) than in those individuals without impaired fasting glycemia, insulin resistance and with low diabetes risk (41.0 % [25/61], p= 0,005; 20.7 % [6/29], p= 0.006 and 27.3 % [3/11], p< 0.0001, respectively). Insulin resistance index and moderate/high risk of type 2 diabetes showed high sensitivity to identify subjects with impaired glucose metabolism (87.0 and 93.5 %, respectively), in contrast to impaired fasting glucose whose sensitivity was low (45.7 %). Of 19 individuals who developed type 2 diabetes two and a half years later, 100 % had moderate/high risk of type 2 diabetes and 94.7 % had insulin resistance at the beginning.
Conclusions: insulin resistance and risk of type 2 diabetes could be very useful in detecting individuals with high risk of developing diabetes.
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