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prediabetes and new-onset diabetes. As a basic characteristic of type 2 diabetes mellitus (T2DM), insulin resistance plays an important role in the development and progression of arteriosclerosis. Insulin resistance is present in prediabetes, and populations
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.1% may have had prediabetes, an important risk factor of overt diabetes and cardiovascular disease ( 2 ). Diabetes leads to complications that cause profound psychological and physical distress, putting a huge burden on health care systems ( 3 , 4 ). The
2nd Department of Internal Medicine, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University in Prague, Srobarova, Prague, Czech Republic
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Diabetes Centre, Institute for Clinical and Experimental Medicine (IKEM), Videnska, Prague, Czech Republic
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department from primary care mainly due to suspicions of thyropathy, other endocrinopathy or diabetes. Patients with negative history of prediabetes or diabetes were screened for diabetes following the standards of the American Diabetes Association and the
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increases with time ( 8 ), there is a need for early identification of high-risk individuals to introduce targeted strategies for preventing and managing this sequela of AP. Prediabetes is one of the most prominent risk factors for new-onset diabetes
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-sectional study, which included 75,880 Chinese adults showed that the prevalence of total diabetes and pre-diabetes, according to the American Diabetes Association (ADA) criteria, reached 12.8 and 35.2%, respectively ( 2 ). Moreover, 70% of patients with pre-diabetes
Danish Diabetes Academy, Odense University Hospital, Odense, Denmark
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Department of Public Health, Research Unit of Epidemiology, Aarhus University, Aarhus, Denmark
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Department of Public Health, Research Unit of Epidemiology, Aarhus University, Aarhus, Denmark
Steno Diabetes Center Aarhus, Aarhus, Denmark
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Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
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National Institute of Public Health, University of Southern Denmark, Odense, Denmark
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Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
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responsible for up to 70% of the postprandial insulin response in healthy individuals whilst being severely impaired in patients with prediabetes and T2D ( 5 , 6 ). Furthermore, GLP-1 responses are lower in individuals with overweight and obesity
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Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
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patient evaluation including comorbidities and life expectancy is essential to reach treatment decisions ( 11 ). The classic cardiovascular risk factors are obesity, type 2 diabetes mellitus (T2DM), prediabetes (PD), hypertension, hyperlipidaemia and
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‘Research of Age and Age-Associated Conditions’ Department, Laboratory of Bioinformatics, The ‘Russian Clinical Research Center for Gerontology’, ‘Chronic Noncommunicable Diseases Primary Prevention in the Healthcare System’ Department, Moscow Institute of Physics and Technology, National Research Centre for Preventive Medicine, National Research Centre for Preventive Medicine, Building 10, Petroverigskiy Lane, Moscow RF 101000, Russian Federation
‘Research of Age and Age-Associated Conditions’ Department, Laboratory of Bioinformatics, The ‘Russian Clinical Research Center for Gerontology’, ‘Chronic Noncommunicable Diseases Primary Prevention in the Healthcare System’ Department, Moscow Institute of Physics and Technology, National Research Centre for Preventive Medicine, National Research Centre for Preventive Medicine, Building 10, Petroverigskiy Lane, Moscow RF 101000, Russian Federation
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deviation degree Patients without glucose intolerance, who had passed the preventive outpatient examination. Patients with prediabetes (preD) (impaired fasting glucose or impaired glucose tolerance or the level of HbA1c from 5.7 to 6.5%. Patients with newly
University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
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University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
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University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
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University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
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Objective
Long-term efficacy of metformin in polycystic ovarian syndrome (PCOS) apart from in those with impaired glucose tolerance or diabetes remains unproven. We aimed to evaluate the impact of metformin in overweight-obese patients with PCOS and normal baseline glycemic homeostasis.
Methods
A 10-year longitudinal follow-up of a retrospective cohort comprising 159 patients with PCOS defined by Rotterdam criteria, BMI ≥25 kg/m2 and normal initial glucose homeostasis (age 28.4 ± 6.4 years, BMI 34.9 ± 6.6 kg/m2) that had been receiving metformin 1000 mg BID. Collection data contained 6085 time-points including anthropometric, hormonal and metabolic parameters.
Results
After the first year body mass (BM) decreased for 3.9 ± 6.8 kg (P < 0.001) and remained stable during the following 3 years. Menstrual frequency (MF) increased to 3.0 ± 3.9 bleeds/year (P < 0.001) after first year to over 11 bleeds/year in the following years. The total testosterone and androstenedione decreased to 15.4 ± 47.9% and 11.3 ± 46.4% within first year, with further decrease in total testosterone and androstenedione to 37.8 ± 61.8 and 24.8 ± 40.5% at the fifth year of the follow-up. The total conversion rate to prediabetes and diabetes was extremely low throughout observation period. Less than 25% of patients continued with metformin for more than 5 years with further dropout to only 6% on metformin therapy at the tenth year of follow-up.
Conclusions
Long-term metformin treatment of overweight-obese women with PCOS and normal baseline glycemic homeostasis resulted in reduction and stabilization of BM, improvements of MF and androgen profile and low conversion rate to diabetes.
School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
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Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia, China
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Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia, China
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Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia, China
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increased by approximately 19-fold ( 2 , 3 ). China now has the largest diabetic population worldwide, and the prevalence of prediabetes has been increasing over recent years ( 4 ). The condition of prediabetes occurs before the development of type 2