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Many Americans Have Pre-Diabetes and Should Be Considered for Metformin Therapy

OBJECTIVE: To determine the proportion of the American population who would merit metformin treatment, according to recent American Diabetes Association (ADA) consensus panel recommendations to prevent or delay the development of diabetes. RESEARCH DESIGN AND METHODS: Risk factors were evaluated in...

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Autores principales: Rhee, Mary K., Herrick, Kirsten, Ziemer, David C., Vaccarino, Viola, Weintraub, William S., Narayan, K.M. Venkat, Kolm, Paul, Twombly, Jennifer G., Phillips, Lawrence S.
Formato: Texto
Lenguaje:English
Publicado: American Diabetes Association 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797985/
https://www.ncbi.nlm.nih.gov/pubmed/19808929
http://dx.doi.org/10.2337/dc09-0341
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author Rhee, Mary K.
Herrick, Kirsten
Ziemer, David C.
Vaccarino, Viola
Weintraub, William S.
Narayan, K.M. Venkat
Kolm, Paul
Twombly, Jennifer G.
Phillips, Lawrence S.
author_facet Rhee, Mary K.
Herrick, Kirsten
Ziemer, David C.
Vaccarino, Viola
Weintraub, William S.
Narayan, K.M. Venkat
Kolm, Paul
Twombly, Jennifer G.
Phillips, Lawrence S.
author_sort Rhee, Mary K.
collection PubMed
description OBJECTIVE: To determine the proportion of the American population who would merit metformin treatment, according to recent American Diabetes Association (ADA) consensus panel recommendations to prevent or delay the development of diabetes. RESEARCH DESIGN AND METHODS: Risk factors were evaluated in 1,581 Screening for Impaired Glucose Tolerance (SIGT), 2,014 Third National Health and Nutrition Examination Survey (NHANES III), and 1,111 National Health and Nutrition Examination Survey 2005–2006 (NHANES 2005–2006) subjects, who were non-Hispanic white and black, without known diabetes. Criteria for consideration of metformin included the presence of both impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), with ≥1 additional diabetes risk factor: age <60 years, BMI ≥35 kg/m(2), family history of diabetes, elevated triglycerides, reduced HDL cholesterol, hypertension, or A1C >6.0%. RESULTS: Isolated IFG, isolated IGT, and IFG and IGT were found in 18.0, 7.2, and 8.2% of SIGT; 22.3, 6.4, and 9.4% of NHANES III; and 21.8, 5.0, and 9.0% of NHANES 2005–2006 subjects, respectively. In SIGT, NHANES III, and NHANES 2005–2006, criteria for metformin consideration were met in 99, 96, and 96% of those with IFG and IGT; 31, 29, and 28% of all those with IFG; and 53, 57, and 62% of all those with IGT (8.1, 9.1, and 8.7% of all subjects), respectively. CONCLUSIONS: More than 96% of individuals with both IFG and IGT are likely to meet ADA consensus criteria for consideration of metformin. Because >28% of all those with IFG met the criteria, providers should perform oral glucose tolerance tests to find concomitant IGT in all patients with IFG. To the extent that our findings are representative of the U.S. population, ∼1 in 12 adults has a combination of pre-diabetes and risk factors that may justify consideration of metformin treatment for diabetes prevention.
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spelling pubmed-27979852011-01-01 Many Americans Have Pre-Diabetes and Should Be Considered for Metformin Therapy Rhee, Mary K. Herrick, Kirsten Ziemer, David C. Vaccarino, Viola Weintraub, William S. Narayan, K.M. Venkat Kolm, Paul Twombly, Jennifer G. Phillips, Lawrence S. Diabetes Care Original Research OBJECTIVE: To determine the proportion of the American population who would merit metformin treatment, according to recent American Diabetes Association (ADA) consensus panel recommendations to prevent or delay the development of diabetes. RESEARCH DESIGN AND METHODS: Risk factors were evaluated in 1,581 Screening for Impaired Glucose Tolerance (SIGT), 2,014 Third National Health and Nutrition Examination Survey (NHANES III), and 1,111 National Health and Nutrition Examination Survey 2005–2006 (NHANES 2005–2006) subjects, who were non-Hispanic white and black, without known diabetes. Criteria for consideration of metformin included the presence of both impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), with ≥1 additional diabetes risk factor: age <60 years, BMI ≥35 kg/m(2), family history of diabetes, elevated triglycerides, reduced HDL cholesterol, hypertension, or A1C >6.0%. RESULTS: Isolated IFG, isolated IGT, and IFG and IGT were found in 18.0, 7.2, and 8.2% of SIGT; 22.3, 6.4, and 9.4% of NHANES III; and 21.8, 5.0, and 9.0% of NHANES 2005–2006 subjects, respectively. In SIGT, NHANES III, and NHANES 2005–2006, criteria for metformin consideration were met in 99, 96, and 96% of those with IFG and IGT; 31, 29, and 28% of all those with IFG; and 53, 57, and 62% of all those with IGT (8.1, 9.1, and 8.7% of all subjects), respectively. CONCLUSIONS: More than 96% of individuals with both IFG and IGT are likely to meet ADA consensus criteria for consideration of metformin. Because >28% of all those with IFG met the criteria, providers should perform oral glucose tolerance tests to find concomitant IGT in all patients with IFG. To the extent that our findings are representative of the U.S. population, ∼1 in 12 adults has a combination of pre-diabetes and risk factors that may justify consideration of metformin treatment for diabetes prevention. American Diabetes Association 2010-01 2009-10-06 /pmc/articles/PMC2797985/ /pubmed/19808929 http://dx.doi.org/10.2337/dc09-0341 Text en © 2010 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Research
Rhee, Mary K.
Herrick, Kirsten
Ziemer, David C.
Vaccarino, Viola
Weintraub, William S.
Narayan, K.M. Venkat
Kolm, Paul
Twombly, Jennifer G.
Phillips, Lawrence S.
Many Americans Have Pre-Diabetes and Should Be Considered for Metformin Therapy
title Many Americans Have Pre-Diabetes and Should Be Considered for Metformin Therapy
title_full Many Americans Have Pre-Diabetes and Should Be Considered for Metformin Therapy
title_fullStr Many Americans Have Pre-Diabetes and Should Be Considered for Metformin Therapy
title_full_unstemmed Many Americans Have Pre-Diabetes and Should Be Considered for Metformin Therapy
title_short Many Americans Have Pre-Diabetes and Should Be Considered for Metformin Therapy
title_sort many americans have pre-diabetes and should be considered for metformin therapy
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797985/
https://www.ncbi.nlm.nih.gov/pubmed/19808929
http://dx.doi.org/10.2337/dc09-0341
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