García VL, Alonso RC, Cabrera Pérez-Sanz E

Language: Spanish
References: 0
Page: 302-320
PDF size: 542.69 Kb.

ABSTRACT

Rationale: Early screening of Type 2 Diabetes mellitus (T2DM) is needed in a scenery dominated by risk factors. Objective: To assess changes occurring in select humoral markers of insulin resistance (IR) after 10 years of follow-up in individuals at risk of T2DM. Study design: Prospective, longitudinal, analytical. Study serie: Seventy-four patients (Males: 29.7%; Average age: 56.7 ± 14.3 years; Ages ≥ 60 years: 39.2%) assisted at the medical post number 20 of the Reina Policlinic (county of Centro Habana, Havana city, Cuba) between September 2004 and August 2014 at risk of T2DM (Family history of Diabetes: 54.1%; Blood hypertension: 45.9%; Body Mass Index ≥ 25.0 Kg.m-2: 74.3%). Examined patients had been assigned to either of 3 pharmacological intervention legs: Group A: Metformine: 800 milligrams daily (6.7%); Group B: Atorvastatine: 20 milligrams daily (10.9%); and Group C: No medication (83.8%); respectively. Methods: Glycaemia, insulinemia and C peptide values were assayed before and after a Dextrose load on both moments of the study. Corresponding insulin resistance (IR) indexes were constructed. Biochemical profile was completed with serum creatinine, albumin and lipids, thyroid hormones and cortisol, and glycated hemoglobin (Hb1Ac). T2DM incidence at the study closure was estimated. Results: Preload insulinemia and C peptide C were increased at the initial moment, but this behavior did not translated to the post-load values. Changes observed on closure represented only seasonal variations without clinical repercussion. Humoral behavior was independent from administered medication. IR was a frequent finding at study start: HOMA-IR: 39.1%; ISI: 35.9%. Forty-five-point-nine percent of the study serie had initial values of HbA1c > 5.7%. Incidence of T2DM was 36.5%. Relative risk of T2DM was independent from treatment leg. IR affected more than half of the subjects ( = +20.3%). All (but one of) the patients diagnosed with T2DM exhibited high HbA1c values on closure. Conclusions: Elevated Hb1Ac might signal those subjects at increased risk of T2DM after 10 years of follow-up, in spite of the apparent constancy of traditional humoral markers of IR.