The first signs of type 2 diabetes can be identified more than 20 years before diagnosis, according to a new investigation presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) this year in Berlin.
The Japanese study monitored more than 27,000 non -diabetic adults (average age of 49 years) between 2005 and 2016 and found that the increase in fasting glucose, the highest body mass index (BMI) and insulin sensitivitydecreased were detectable up to 10 years before the diagnosis of diabetes as well as prediabetes.
"As the vast majority of people with type 2 diabetes go through the stage of prediabetes, our findings suggest that high metabolic markers for diabetes are detectable more than 20 years before their diagnosis," says Dr. Hiroyuki Sagesakaof the Aizawa hospital in Matsumoto, Japan.She directed the research, together with Professor Mitsuhisa Komatsu, Postgraduate Medicine School at Shinshu University, Matsumoto, Japan and her colleagues.
Previous investigations suggest that risk factors such as obesity and elevation of fasting glucose may be present up to 10 years before diabetes are diagnosed to someone.However, until now the moment was not known when people who develop diabetes and those who do not differ substantially from each other.
Sagesaka and his colleagues evaluated the trajectories of fasting glycemia, BMI and insulin sensitivity in individuals who developed diabetes and prediabetes separately.At the beginning of the study, 27,392 non -diabetic individuals had an fasting glucose and an average blood glucose (HBA1C) measured and followed to a diagnosis of type 2 diabetes or prediabetes, or until the end of 2016, which happened first.
During the study period, 1067 new cases of type 2 diabetes were identified. The findings showed that, on average, several risk factors were more common among people who developed type 2 diabetes compared to those who did not.In particular, BMI, fasting glucose and insulin resistance increased up to 10 years before diagnosis, and these differences were expanded over time.
For example, average fasting glucose: 10 years before diagnosis: 101.5 mg / dl developed diabetes compared to 94.5 mg / dl that did not do so;5 years before diagnosis: 105 mg / dl compared to 94 mg / dl;and 1 year before - 110 mg / dl vs 94 mg / dl.
Of 15,778 individuals with normal blood glucose in the initial health exam, 4781 developed prediabetes during the study period, and the same anomalies, although to a slightest degree, were present at least 10 years before the diagnosis of prediabetes.
The investigation has important implications since it is estimated that 425 million adults (from 20 to 79 years old) lived with diabetes in 2017, and it is forecast that this will increase to 629 million by 2045.
“Because prevention trials in people with prediabetes seem to be less successful in the long -term monitoring, we may have to intervene long before the prediabetes stage to prevent the progression of full -fledged diabetes.A much earlier intervention route, whether related to lifestyle or drugs., is guaranteed, ”says Dr. Sagesaka.
This is an observational study, so firm conclusions cannot be drawn on the cause and effect, and the authors indicate several limitations, including the fact that the time elapsed between the diagnosis of prediabetes and diabetes is not known, so the timeline of the evolution of diabetes is not known.