Iris's story (type 2 prediabetes and pregnancy). Prediabetes conference: relevant studies

Abstract

First of all, we are just referring to one of the diverse situations with high progression to diabetes: nondiabetic hyperglycemia caused by either impaired fasting glycemia, impaired oral glucose tolerance or glycated hemoglobin (A1c) marginally elevated but under 6.5% values. This is because most evidence considers, for methodological reasons, these criteria to define the inclusion of people to be studied.

The previously presented clinic case is about a 22-year-old woman seeking pregnancy and diagnosed with diabetes at the age of 19. In this presentation, we will mention all relevant information for children, adolescents, and young adults.

In this stage characterized by considerable hormonal, phenotypical and social changes, it is important to remember disturbances on insulin action and insulin secretion preceding glycemic abnormalities because they can define possible proactive actions schedules.

In this presentation, we will identify:

• Studies quantifying variable progression risk to diabetes on people with nondiabetic hyperglycemia and data obtained from children and young adults

• Variable vascular impact influence from various diagnoses criteria for hyperglycemia on patients with prediabetes.

Further, we will review studies showing success or failure to reduce diabetes influence on nondiabetic hyperglycemia patients with lifestyle changes and pharmacological interventions. We will show how some favorable results in adults may not be as beneficial in adolescents and young adults. We will indicate studies whose main objectives were related to diabetes influence and vascular impact, which proved that a delay on diabetes diagnosis did not coincide with fewer incidence of vascular events. We will share results showing the benefits on microvasculopathy (some of them being sex-dependent) and macrovasculopathy in long-term follow-up after studies concluded.

Finally, we will discuss evidence concerning difficulties found while comparing populations belonging to different randomized trials. 

To conclude, successful evidence to postpone diabetes when facing nondiabetic hyperglycemia show aspects that need further investigation in children and adolescents. Comparing data to “real world” cases might be done by preemptively incorporating population in stages prior to marginal hyperglycemia. Lastly, it is important to encourage studies combining metabolic issues and prevention of vascular events.