A primary care register for impaired glucose handling (IGH): impact on cardiometabolic profile

Primary Care Diabetes
Adrian Hugh HealdSimon George Anderson

Abstract

Diet and exercise reduce the incidence of diabetes in high-risk individuals as does metformin, although less dramatically. Here we evaluated if lifestyle and pharmacological intervention, for people at risk of diabetes, resulted in an improvement in their cardiometabolic risk profile. In a primary care based study, 92 individuals screened opportunistically and identified to have impaired glucose handling were offered detailed lifestyle advice, at 6 monthly intervals, with targeting of cardiovascular risk factors. Duration of follow-up was 4 years. The relation between fasting and 2h glucose with different cardio-metabolic risk factors over time was assessed using multi-level modeling. There was no significant weight reduction. At 24 months, mean fasting glucose level (6.4 mmol/L (95% CI 6.0-6.8)) was slightly lower than at baseline (6.6 mM (95% CI: 6.4-6.9), F=3.67; p<0.001). For men and women combined, systolic blood pressure (mean difference=-6 mmHg, p=0.013), total cholesterol (-0.66 mmol/L, p<0.0001) and triglycerides (-0.13 mmol/L, p=0.133) fell, whilst HDL-cholesterol (0.12 mmol/L, p=0.047) rose. Diabetes developed in 18/92 participants during follow-up (up to 4 years). Five per cent of participants were started on metfor...Continue Reading

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