Division of Pediatric Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, United States.
Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States.
Front Endocrinol (Lausanne). 2022 Jun 22;13:916785. doi: 10.3389/fendo.2022.916785. eCollection 2022.
Prediabetes, the precursor of type 2 diabetes (T2D), is on the rise in the US, but the determinants of its progression are poorly characterized in youth.
To determine the impact of nutrition visits, as a surrogate marker of lifestyle modification, on the trajectory of prediabetes over a 4-year period.
Adherence to nutrition visits could reduce BMI and lower HbA1c.
A 4-year retrospective study of 108 youth with prediabetes who were recommended to receive medical nutrition therapy every 3 months following their diagnosis. Subjects were divided into 2 groups: the non-adherent group who had ≤1 nutrition visit/year, and the adherent group with ≥2 nutrition visits/year.
There were 46 male subjects, mean age 12.4 ± 3.6y; and 62 female subjects, mean age, 13.3 ± 3.0y, p=0.2. The adherent group (n=44, 41.5%) had higher BMI z-scores, but similar values for HbA1c, metformin use, and racial/ethnic composition compared to the non-adherent group. Overall, 18(17.0%) subjects progressed to T2D in 4y and consisted of 14(22.6%) of the 62 non-adherent subjects and 4(9.1%) of the 44 adherent subjects. The non-adherent subjects progressed to T2D at a mean duration of 25.8 ± 12.6 months while the adherent subjects progressed at a mean duration of 34.9 ± 11.8 months. The hazard ratio of progression from prediabetes to T2D for the non-adherent versus adherent group was 3.88 (95%CI 1.26-11.98, p=0.02). The results remained significant after adjusting for age, sex, race/ethnicity, BMI, and metformin use.
Adherence to nutrition visits was associated with a 4-fold reduction in the likelihood to progress from prediabetes to T2D in US youth.
前驱糖尿病是 2 型糖尿病（T2D）的前兆，在美国呈上升趋势，但年轻人前驱糖尿病进展的决定因素仍不清楚。
确定营养访视作为生活方式改变的替代标志物，对 4 年内前驱糖尿病轨迹的影响。
营养访视的依从性可以降低 BMI 和降低 HbA1c。
对 108 名患有前驱糖尿病的年轻人进行了一项为期 4 年的回顾性研究，这些人在确诊后每 3 个月被建议接受医学营养治疗。受试者分为两组：非依从组（每年接受≤1 次营养访视）和依从组（每年接受≥2 次营养访视）。
男性 46 例，平均年龄 12.4 ± 3.6 岁；女性 62 例，平均年龄 13.3 ± 3.0 岁，p=0.2。与非依从组相比，依从组（n=44，41.5%）的 BMI z 评分较高，但 HbA1c、二甲双胍使用和种族/民族构成相似。总体而言，18（17.0%）名受试者在 4 年内进展为 T2D，其中 62 名非依从受试者中有 14（22.6%）例，44 名依从受试者中有 4（9.1%）例。非依从组进展为 T2D 的平均时间为 25.8 ± 12.6 个月，而依从组进展为 T2D 的平均时间为 34.9 ± 11.8 个月。非依从组从前驱糖尿病进展为 T2D 的风险比为 3.88（95%CI 1.26-11.98，p=0.02）。调整年龄、性别、种族/民族、BMI 和二甲双胍使用后，结果仍然显著。
在美国年轻人中，营养访视的依从性与从前驱糖尿病进展为 T2D 的可能性降低 4 倍相关。
