Osteocalcin levels in a healthy population of western Mexico and comparison with populations from around the world. / Niveles de referencia de osteocalcina en población sana de México.

Introduction: Osteocalcin has been shown to have an inverse relationship with blood glucose, insulin resistance and adiposity. Objective: To determine osteocalcin normal serum concentration in Mexican healthy adults and compare it with values reported in other populations. Method: Carboxylated and undercarboxylated osteocalcin serum concentrations were determined in 100 healthy adults by means of enzyme immunoassay; osteocalcin total concentration was calculated. A descriptive comparison was made with other populations' values reported in the literature. Results: Carboxylated and undercarboxylated osteocalcin median concentrations were 3.22 ng/mL and 1.61 ng/mL, respectively. Mean total osteocalcin was 7.40 ± 5.11 ng/mL. There was no significant difference between the osteocalcin values in our population and those of populations where similar quantification methods to ours were used. Conclusion: Osteocalcin total serum concentration mean in the analyzed population was 7.40 ng/mL. There are subtle variations between populations that are attributable to genetic and population factors; however, the quantification method was the only variable that was shown to significantly influence on osteocalcin levels in healthy populations.

Introducción: Se ha demostrado que la osteocalcina tiene una relación inversa con la glucemia, resistencia a la insulina y adiposidad. Objetivo: Determinar la concentración sérica normal de osteocalcina en adultos sanos mexicanos y compararlos con los reportados en otras poblaciones. Método: Se determinó la concentración sérica de osteocalcina carboxilada y pobremente carboxilada en 100 adultos sanos mediante inmunoensayo enzimático; se calculó la concentración de osteocalcina total. Se hizo una comparación descriptiva con valores de otras poblaciones reportadas en la literatura. Resultados: Las medianas de las concentraciones de osteocalcina carboxilada y pobremente carboxilada fueron 3.22 ng/mL y 1.61 ng/mL, respectivamente; la media de osteocalcina total fue 7.40 ± 5.11 ng/mL. No hubo diferencia significativa entre los valores de osteocalcina total en nuestra población y los de poblaciones en las que se utilizaron métodos de cuantificación similares al nuestro. Conclusión: La concentración sérica promedio de osteocalcina total en la población analizada fue de 7.40 ng/mL. Las variaciones sutiles entre poblaciones son atribuibles a factores genéticos y poblacionales, sin embargo, el método de cuantificación fue el único que se comprobó influye significativamente en los niveles de osteocalcina en poblaciones sanas.

Dairy product consumption and type 2 diabetes in an Argentinian population: is there an association?

Introduction: Introduction: dairy products have long been recommended as part of a healthy eating plan, but there is a controversial opinion about whether or not they should be included in the diet of people with type 2 diabetes (T2D). Objective: the aim of this study was to know if there is an association between the intake of total dairy and dairy subgroups and the chance of having T2D, and the status of markers of glucose metabolism. Methods: three hundred and forty-two adult subjects participated in the study. A validated food-frequency questionnaire was applied to establish the dairy intake. Clinical-pathological and anthropometric variables (height, weight, waist circumference and serum concentrations of blood glucose, glycated hemoglobin [HbA1c], high sensitive C-reactive protein [hs-CRP], tumor necrosis factor alpha [TNFα], interleukin [IL] 6 and IL-10) were measured. Consumption tertiles were calculated for each dairy subgroup. Correlation coefficients, multiple linear regression models and logistic regression models were used to assess the relation between dairy product consumption and markers of glucose metabolism. Results: a negative correlation was observed between the consumption of fermented dairy products and IL-10 (r = -0.27, p = 0.0206). Fermented dairy products were inversely associated with blood glucose, and HbA1c. Total dairy intake was positively associated with a lower chance of having diabetes in tertiles 2 and 3 of consumption, in relation to the reference tertile, adjusted for age, smoking habit, and alcohol intake, body mass index (BMI) and dietary variables. Conclusions: with this study, we broaden our understanding of the role of dairy intake in diabetes risk. However, more long-term studies are needed to confirm the associations and explore different confounding factors.

Introducción: Introducción: los lácteos se han recomendado durante mucho tiempo como parte de un plan de alimentación saludable, pero existen opiniones controvertidas sobre si deben incluirse en la dieta de las personas con diabetes tipo 2 (DT2). Objetivo: el objetivo fue conocer si existe asociación entre la ingesta de lácteos totales y subgrupos lácteos y la posibilidad de tener DT2, y el estado de los marcadores del metabolismo de la glucosa. Métodos: participaron 342 sujetos adultos. Se aplicó un cuestionario de frecuencia de consumo para establecer el consumo de lácteos. Se midieron variables clínicas-patológicas y antropométricas (talla, peso, circunferencia de cintura y concentraciones séricas de glucosa en sangre, hemoglobina glicosilada [HbA1c], proteína C reactiva ultrasensible [PCR-us], factor de necrosis tumoral alfa [TNFα], interleuquina [IL] 6 e IL-10). Se calcularon terciles de consumo para cada subgrupo de lácteos. Se utilizaron coeficientes de correlación, modelos de regresión lineal múltiple y regresión logística para evaluar la relación entre el consumo de lácteos y los marcadores del metabolismo de la glucosa. Resultados: los productos lácteos fermentados se asociaron inversamente con la glucosa en sangre y la HbA1c. La ingesta total de lácteos se asoció positivamente con una menor probabilidad de tener diabetes en los terciles 2 y 3 de consumo, en comparación con el tercil de referencia, ajustado por edad, tabaquismo, ingesta de alcohol, índice de masa corporal (IMC) y variables dietéticas. Conclusiones: con este estudio, ampliamos nuestra comprensión del papel de la ingesta de lácteos en el riesgo de diabetes. Sin embargo, se necesitan más estudios a largo plazo para confirmar las asociaciones y explorar diferentes factores de confusión.

Blood glucose monitoring in critically ill adult patients: type of sample and method of analysis. Systematic review and meta-analysis.

INTRODUCTION: The clinical guideline for the management of sepsis, recommends using arterial blood samples for glycaemic control. A multicentre study in 86 Spanish intensive care units (ICU) revealed that 85.4% of ICUs used capillary puncture. OBJECTIVE: To analyse the reliability of glycaemia by comparing different blood samples (arterial, venous, capillary) and instruments (glucometers, gasometers, central laboratory). Secondarily, to estimate the effect of confounding variables and the performance of measuring instruments as determined by different quality standards. METHODOLOGY: Systematic review and meta-analysis with search in PubMed, CINAHL and Embase databases in September-2021 and September-2022, with no time or language limits. Grey literature sources: DART-Europe, OpenGrey and Google Scholar. Results summarised by qualitative (description of results, study characteristics) and quantitative (meta-analysis to assess standardised mean difference) synthesis. Methodological quality of articles assessed with Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). PROTOCOL: https://osf.io/ DOI 10.17605/OSF.IO/T8KYP. RESULTS: A total of 32 articles and 5451 patients were included. No discrepancies were obtained between arterial glucometer vs laboratory samples [bias (95%CI): 0.01 (-0.12 to 0.14) mg/dL]. In contrast, arterial samples with a gasometer did significantly overestimate [bias (95%CI): 0.12 (0.01 to 0.24) mg/dL]. The same trend is seen in capillaries with a glucometer, although not significantly [bias (95%CI): 0.07 (--0.02 to 0.15) mg/dL]. There is discrepancy between studies on the effect of haematocrit and acid-base balance. The greatest consensus is on the poor agreement of glucometer with capillary vs laboratory samples in the presence of shock and vasopressor support, renal failure or during vitamin C treatment. CONCLUSIONS: The evidence to date recommends the use of arterial blood with a blood glucose meter for better reliability of glycaemic analysis and less effect of possible confounding variables, frequently present in the critically ill adult patient.

Association of the triglyceride-glucose index with the occurrence of non-alcoholic fatty liver disease and mortality in elderly inpatients: a prospective observational study.

Introduction: Introduction: non-alcoholic fatty liver disease (NAFLD) is a disease in which there is excessive fat deposition in hepatocytes due to hepatoprotective factors. Objectives: to assess the association of the triglyceride-glucose index with the occurrence of non-alcoholic fatty liver disease and mortality in elderly inpatients. To identify the TyG index as a predictive factor of NAFLD. Methods: this prospective observational study included elderly inpatients admitted to the Department of Endocrinology at the Linyi Geriatrics Hospital, Affiliated to Shandong Medical College, between August 2020 and April 2021. The TyG index was calculated according to an established formula: TyG = Ln [triglycerides (TG) (mg/dl) × Fasting plasma glucose (FPG) (mg/dl) / 2]. Result: a total of 264 patients were enrolled, with 52 (19.7 %) cases occurred NAFLD. Multivariate logistic regression analysis showed that TyG (OR = 3.889; 95 % CI: 1.134-11.420; p = 0.014) and ALT (OR = 1.064; 95 % CI: 1.012-1.118; p = 0.015) were independently associated with the occurrence of NAFLD. Furthermore, receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of TyG was 0.727, with sensitivity = 80.4 % and specificity = 57.8 % at cut off = 8.71. A Cox proportional hazards regression model showed that, after adjusting for age, sex, smoking, drinking, hypertension, and type 2 diabetes, TyG > 8.71 (HR = 3.191; 95 % CI: 1.347 to 7.560; p < 0.001) was an independent risk factor for mortality in the elderly. Conclusions: the TyG index can predict non-alcoholic fatty liver disease and mortality in elderly Chinese inpatients.

Introducción: Introducción: la enfermedad del hígado graso no alcohólico (EHGNA) es una enfermedad en la que una cantidad excesiva de grasa se acumula en los hepatocitos debido a factores hepatoprotectores. Objetivos: evaluar la asociación entre el índice glucemia-triglicéridos con la presencia de hígado graso no alcohólico (EHGNA) y mortalidad en pacientes hospitalizados de avanzada edad. Identificar el índice TyG como factor predictivo de la EHGNA. Métodos: este estudio observacional y prospectivo incluyó a pacientes de avanzada edad hospitalizados en el Departamento de Endocrinología del Hospital de Geriatría de Linyi, Afiliado al Colegio Médico de Shandong, entre agosto de 2020 y abril de 2021. El índice TyG se calculó según una fórmula establecida: TyG = Ln [triglicéridos (TG) (mg/dl) × Glucosa en sangre en ayunas (FPG) (mg/dl) / 2]. Resultado: se incluyeron 264 pacientes, con 52 (19,7 %) casos de EHGNA. El análisis de regresión logística multivariante mostró que el TyG (razón de momios (OR) = 3,889; intervalo de confianza del 95 %: 1,134-11,420; p = 0,014) y ALT (razón de momios (OR) = 1,064; intervalo de confianza del 95 %: 1,012-1,118; p = 0,015) se asociaban de forma independiente con la aparición de EHGNA. Además, el análisis de la curva de características operativas del receptor (ROC) mostró que el área bajo la curva (AUC) de TyG era de 0,727, con una sensibilidad del 80,4 % y una especificidad del 57,8 % en el punto de corte de 8,71. El modelo de regresión de riesgos proporcionales de Cox mostró que, tras ajustar por edad, sexo, tabaquismo, consumo de alcohol, hipertensión y diabetes tipo 2, un TyG > 8,71 (HR = 3,191; intervalo de confianza del 95 %: 1,347 a 7,560; p < 0,001) era un factor de riesgo independiente de mortalidad para los paciente de edad avanzada. Conclusiones: el índice TyG puede predecir la enfermedad del hígado graso no alcohólico y la mortalidad en pacientes chinos hospitalizados de avanzada edad.

Glycaemic and insulinaemic impact of a diabetes-specific oral nutritional supplement with extra-virgin olive oil in patients with type 2 diabetes mellitus at nutritional risk: a randomized, double-blind, crossover, multicentre clinical trial (DIACARE).

Introduction: Introduction: there is controversy about the usefulness of specific enteral nutrition formulas in malnourished patients with diabetes. The effects on blood glucose and other aspects of metabolic control are not fully understood in the scientific literature. Objective: the aim of the study was to compare the glycaemic and insulinaemic response of patients with type 2 diabetes at risk of malnutrition after oral feed between a diabetes-specific formula with AOVE (DSF) and a standard one (STF). Methods: A randomized, double-blind, crossover, multicentre clinical trial was conducted in patients with type 2 diabetes at risk of malnutrition (SGA). The patients were randomized to receive either DSF or STF, a week apart. A glycaemia and insulinaemia curve was made at times 0 minutes, 30 min, 60 min, 90 min, 120 min, and 180 min after the patients drank 200 ml of the oral nutritional supplement (ONS). The principal variables were the area under the curve (AUC0-t) of glucose and insulin. Results: 29 patients (51 % women) were included, who were on average 68.84 (SD 11.37) years old. Regarding the degree of malnutrition, 86.2 % presented moderate malnutrition (B) and 13.8 % severe (C). When the patients received the DSF, they had a lower mean of glucose AUC0-t (-3,325.34 mg/min/dl [95 % CI: -4,3608.34 to -2,290.07]; p = 0.016) and also a lower mean of insulin AUC0-t (-451.14 uU/min/ml [95 % CI: -875,10 to -27.17]; p = 0.038). There were no differences in the degree of malnutrition. Conclusion: compared with STF, DSF with AOVE showed a better glycaemic and insulinaemic response in patients with type 2 diabetes at risk of malnutrition.

Introducción: Introducción: la utilidad de las fórmulas específicas de nutrición enteral en el paciente desnutrido con diabetes resulta controvertida. Sus efectos sobre la glucosa en sangre y otros aspectos del control metabólico no se conocen del todo en la literatura científica. Objetivo: el objetivo del estudio fue comparar la respuesta glucémica e insulinémica de los pacientes con diabetes tipo 2 (DM2) en riesgo de desnutrición tras la ingesta oral de una fórmula específica para diabetes (DSF) con aceite de oliva virgen extra (AOVE) y una estándar (STF). Métodos: ensayo clínico aleatorizado, doble ciego, cruzado y multicéntrico enpacientes con DM2 en riesgo de desnutrición (SGA). Los pacientes se asignaron aleatoriamente para recibir DSF o STF con una semana de diferencia. Se realizó una curva de glucemia e insulinemia en los siguientes tiempos: 0 minutos, 30 min, 60 min, 90 min, 120 min y 180 min tras la ingesta de 200 ml del suplemento nutricional oral (SNO). Las variables principales fueron el área bajo la curva (AUC0-t) de glucosa e insulina. Resultados: se incluyeron 29 pacientes (51 % mujeres), con una edad media de 68,84 años (DE 11,37). En cuanto al grado de desnutrición, el 86,2 % presentaba desnutrición moderada (B) y el 13,8 %, severa (C). Cuando los pacientes recibieron DSF tuvieron una media más baja de AUC0-t de glucosa (-3325,34 mg/min/dl [IC 95 %: de -4.3608,34 a -2.290,07]; p = 0,016) y también una media más baja de AUC0-t de insulina (-451,14 uU/min/ml [IC 95 %: de -875,10 a -27,17]; p = 0,038) respecto a cuando recibieron STF. No hubo diferencias por el grado de desnutrición. Conclusión: la fórmula con AOVE específica para diabetes mostró una mejor respuesta glucémica e insulinémica en pacientes con diabetes tipo 2 en riesgo de desnutrición respecto a una fórmula estándar.

Night fasting as an alternative to improve nutritional support and glycaemic control in hospitalised patients with exclusive enteral nutrition.

BACKGROUND: Enteral nutrition (EN) assists in the nutritional status of hospitalised patients unable to feed orally. The aim of this study was to determine which method-continuous EN or discontinuous EN, a diet in which the infusion is discontinued for 4h during the night,-is more effective in meeting nutrient recommendations and improving glycaemic control and biochemical parameters related to protein anabolism. METHODS: Patients were divided into two groups: discontinuous (EN administered in mL/h, 18h/day, 4-h night fasting) and continuous (EN administered in mL/h, 22h/day). All patients with EN receive the diet over a 22-h daily period, in which the diet is suspended for two hours/day for daily hospital routines such as bathing, and physiotherapy, and followed for seven days. Evaluated data: prescribed and administered volume, calories, protein, and fibre; capillary blood glucose; erythrogram; serum albumin. RESULTS: 52 patients were followed-up, with 23 (44.2%) in the discontinuous group and 29 (55.8%) in the continuous group. Compared with the continuous group, the discontinuous group received volumes closer to those prescribed, equal or higher calories, and more protein. The capillary glucose values were within the reference range in the discontinuous group, while the continuous group presented elevated values. Both groups presented hypoalbuminaemia, haemoglobin, and haematocrit below the reference values; however, in the discontinuous group, the serum albumin values improved during hospitalisation relative to the continuous. CONCLUSIONS: The method involving discontinuation of EN for 4h was more effective in meeting nutrient recommendations compared with the continuous method. Additionally, in the discontinuous group, we observed a better control of glycaemia when compared to that of the continuous group.

Effects of break in sedentary behaviour on blood glucose control in diabetic patients. Systematic review.

INTRODUCTION: One of the main goals of prescribing physical activity for people with type 2 diabetes is to reduce hyperglycaemia, as it is a risk factor for the development of chronic complications. As less time spent each day in sedentary behaviour would lead to higher glucose consumption by skeletal muscle tissue, this could have significant positive effects on blood glucose control parameters. For this reason, the aim of this study was to analyse the information from different protocols for breaking sedentary behaviour and the association with blood glucose control parameters in patients with type 2 diabetes. MATERIAL AND METHODS: A systematic search was carried out for randomised controlled studies on this topic published in the scientific literature. The following databases were considered: PubMed, Cochrane, EBSCO, WoS, ScienceDirect and Medline. RESULTS: 24 studies were identified and analysed using the COVIDENCE platform. Seven articles were selected for the final analysis, comprising 138 patients. The results show that breaks in sedentary behaviour with light physical activity in people with type 2 diabetes are effective in reducing insulin resistance, the area under the glucose curve, fasting and postprandial blood glucose, and blood glucose variability. CONCLUSIONS: Acute interruption of sedentary behaviour, through light-intensity and short-duration exercise, can improve blood glucose indicators in patients with type 2 diabetes, including short term blood glucose variability.

Impact of flash glucose monitoring on quality of life and glycaemic control parameters in adults with type 1 diabetes mellitus⋆.

INTRODUCTION: Flash glucose monitoring (FGM) improves some glycaemic control variables and quality of life parameters. OBJECTIVE: Our aim was to evaluate the quality of life and glycaemic control parameters after initiating FGM in patients with type 1 diabetes (DM1) in clinical practice. MATERIAL AND METHODS: A prospective observational study in DM1 patients that started using FGM between June 2019 and April 2020. We analysed their scores on the Diabetes Quality of Life (DQOL) questionnaire, Diabetes Distress Scale (DDS), Diabetes Treatment Satisfaction Questionnaire (DTSQ) and glycaemic control parameters at baseline and 3 months after the FGM onset. RESULTS: We recruited 114 patients, 56% male, mean age 37.2 (standard deviation, SD 12.4), with 18.7 (SD 11.5) years of DM1, 24.6% of which used continuous subcutaneous insulin infusion. Differences were observed (baseline vs. 3 months) in the DTSQ score (22 [15.5-27] vs. 25 [22-28], P < 0.001) and in the DQOL score (88 [74-104] vs. 84 [70-101], P = 0.017) but not in the DDS score. HbA1c was 7.8% (SD 1.3) vs. 7.4% (SD 1.1) (P < 0.001), without improvement in other glycaemic control variables, except for the mean number of hypoglycaemic events/14 days: 14 (SD 9) at baseline vs. 11.5 (SD 7) at 3 months (P < 0.001). CONCLUSIONS: The initiation of FGM, combined with a structured educational programme, was associated with improvement in quality of life and patient satisfaction in DM1 patients. An improvement in HbA1c and a reduction in the number of hypoglycaemia events was observed, but not in the rest of glycaemic control parameters.

Blood glucose level after infusing an activated charcoal suspension for acute drug poisoning. / Evaluación del impacto glucémico de una formulación líquida de carbón activado en pacientes con intoxicación medicamentosa aguda.

OBJECTIVES: Activated charcoal in suspension contains 600 mg/mL of sucrose. We aimed to assess the impact of an activated charcoal suspension on blood glucose levels in patients with acute medication poisoning. MATERIAL AND METHODS: We identified drug patients whose blood glucose levels were measured before and after administration of activated charcoal to treat poisoning. The impact on blood glucose level was compared to changes after breakfast in a control group not receiving treatment for poisoning. RESULTS: Fifty-five poisoned patients were included. Eighty-two percent had higher blood glucose levels after activated charcoal administration. The mean glucose levels before and 1 hour after treatment were 98.2 mg/dL and 124.2 mg/dL, respectively (P<.001). The increase did not translate to adverse clinical events. Glucose levels increased in 82.6% of the 23 patients in the control group. Mean glucose levels before breakfast and 1 hour later were 117.1 mg/dL and 152.0 mg/dL (P<.001). CONCLUSION: Activated charcoal induces an increase in blood glucose level that is statistically but not clinically significant. The increase is comparable to the increase after breakfast.

OBJETIVO: La suspensión líquida de carbón activado (CA) contiene como excipiente 600 mg/mL de sacarosa. Se evalúa el impacto glucémico de la administración de CA en pacientes con intoxicación medicamentosa aguda (IMA). METODO: Se identificaron pacientes con IMA y determinación de la glucemia antes y después de haber recibido CA. Se compararon estos cambios de glucemia con los generados por el desayuno en un grupo control de no intoxicados. RESULTADOS: Se incluyeron 55 IMA. En el 82% de los casos la glucemia aumentó tras administrar CA. La media de las glucemias previas al carbón fue de 98,2 mg/dL y a la hora posterior de 124,2 mg/dL (p < 0,001). El cambio glucémico no condicionó eventos clínicos adversos. En el grupo control (n = 23) la glucemia aumentó en el 82,6% de los casos. La media de las glucemias antes del desayuno fue de 117,1 mg/dL y la posterior de 152,0 mg/dL (p < 0,001). CONCLUSIONES: La administración de CA induce un aumento estadísticamente significativo de la glucemia, pero sin relevancia clínica y equiparable al producido por un desayuno.

Efficacy and safety of a rosehip seed oil extract in the prevention and treatment of skin lesions in the hands of patients with type 1 diabetes mellitus caused by finger prick blood glucose monitoring; a randomized, open-label, controlled clinical trial. / Eficacia y seguridad del aceite de rosa mosqueta en las lesiones de los dedos provocadas por las punciones capilares para el control glucémico en niños con diabetes tipo 1; un ensayo clínico aleatorizado, abierto, controlado.

INTRODUCTION: This study was intended to assess the efficacy and safety of a rosehip seed oil (RHO) extract in the prevention and treatment of skin lesions in the hands of patients with type 1 diabetes mellitus (T1DM) caused by finger prick blood glucose monitoring. PATIENTS AND METHOD: A prospective, randomized, controlled, open-label, rater-blinded trial in patients aged 6-17 years with T1DM and intensive blood glucose control (≥7 finger pricks daily) for 12 days. Three main variables (erythema, skin thickening, and loss of skin integrity) were assessed using a scale ranging from 0 (absent) to 3 (severe involvement). The study was approved by the ethics committee of the hospital. RESULTS: Sixty-eight children, and thus 136 hands, were included; 80 hands received rosehip seed oil and 56 hands acted as controls. Baseline characteristics of both groups were similar, with 76.3% and 78.6% of the hands respectively showing skin lesions at study start. Median final global assessment was 0.10 (0.03; 0.30) in the group that received rosehip seed oil and 0.06 (0.00; 0.23) in the control group. A statistically significant improvement in global assessment was found in the control group (P=0.049). No significant differences were found when the medians of the other main variables were compared. No adverse effects were recorded. CONCLUSION: A high prevalence of skin lesions secondary to finger prick glucose monitoring, most of them mild lesions, was found at study start. Treatment with rosehip seed oil was safe and was not effective for improving skin lesions.

The effect of a new mixture of sugar and sugar-alcohols compared to sucrose and glucose on blood glucose increase and the possible adverse reactions: A phase I double-blind, three-way randomized cross-over clinical trial.

INTRODUCTION: Several sweeteners are introduced to replace sucrose in the human diet. However, they had their own limitations and concerns, particularly in terms of their taste and their long-term health consequences. This study examined the effect of a new mixture of sugars and sugar alcohol on the postprandial blood glucose levels and its possible gastrointestinal (GI) adverse reactions in human adults. METHODS: In this double-blind three-way randomized clinical trial, adults (21 with type 2 diabetes and 20 healthy) received 300ml of three beverages containing 50g glucose, sucrose, and lacritose (a mixture of lactose, fructose, sucrose, and erythritol) when they were in the fasted state in a random order. Postprandial serum glucose was checked every 30min up to 2h and the gastrointestinal reactions were collected. RESULTS: The mean serum glucose was significantly lower in all time points after ingestion of the lacritose for participants with type 2 diabetes compared to glucose and sucrose (P<0.05). The blood glucose levels were significantly lower in the 30th and 60th min for healthy subjects (P<0.05). Adverse GI reactions were not significant between the test beverages. CONCLUSIONS: The ingestion of a 50g dose of lacritose containing lactose, fructose, sucrose, and erythritol, led to an improved blood glucose levels without any significant adverse effect compared to the same amount of glucose and sucrose. Studying the long-term effects of lacritose on appetite, metabolic markers and adverse reactions is recommended. The trial was registered in Iranian registry of clinical trials: IRCT2015050912571N2.

Effectiveness of an evidence-based protocol for the control of stress-induced hyperglycaemia in critical care. / Efectividad de un protocolo basado en la evidencia para el control de la hiperglucemia por estrés en cuidados intensivos.

AIM: To assess the effectiveness of the implementation of a protocol for glycaemic control in critical care, in terms of maintenance of a pre-established target of blood glucose level, reduction of hyperglycaemia and prevention of severe hypoglycaemia. METHOD: Prospective "pre-post" quasi-experimental study carried out in a general critical care unit. Adult patients treated with intravenous insulin were included. We recorded all glycaemic tests performed from November 2014 to August 2015 (pre-intervention) and from November 2015 to August 2016 (post-intervention). The intervention consisted of the implementation of an evidence-based glycaemic control protocol to achieve glycaemic levels in a range of 140-180mg/dl. Main variables analysed were: proportion of glycaemic tests in the target range, proportions of severe hypoglycaemia (under 40mg/dl) and hyperglycaemia over 200mg/dl. RESULTS: We analysed 7864 glycaemic tests from 125 patients, 66 pre-intervention and 59 post-intervention. Average age was 66.24±13.99 years, 64% of patients were male. The proportion of tests within the target range was higher in the intervention group (38.82 vs. 44.34 p<.001). Only one case of severe hypoglycaemia was identified, which happened in the pre-intervention period. The rate of severe hyperglycaemia was lower in the post-intervention group (19.19 vs. 16.28 p=.001). CONCLUSIONS: Our experience shows that implementation of evidence-based interventions can improve glycaemic control during critical illness. We found higher glycaemia levels in the target range. The protocol proved useful in the prevention of severe hypoglycaemia. Nurse-led interventions based on clinical data improved health results in our patients.

Asociación del riesgo a desarrollar diabetes mellitus tipo 2 según la calculadora de la asociación americana de diabetes (ADA) y los hábitos tóxicos no ilícitos en pacientes que residen en una comunidad rural de Peravia, República Dominicana / Association of the risk of developing type 2 diabetes mellitus according to the American Diabetes Association (ADA) calculator and non-illicit toxic habits in patients residing in a rural community in Peravia, Dominican Republic

Introducción: la diabetes mellitus tipo 2 (DM2) se define como un trastorno metabólico caracterizado por niveles de glucosa en sangre crónicamente elevados. La DM2 representa el paradigma de las enfermedades crónicas en las que existe una estrecha asociación entre factores familiares y ambientales. Por este motivo, este estudio tiene como finalidad determinar la asociación del riesgo a desarrollar DM2 y los hábitos tóxicos no ilícitos en pacientes que residen en una comunidad rural de Peravia, República Dominicana. Tales incluyen: alcohol, café y té. Metodología: Estudio observacional, transversal, analítico y prospectivo. Se aplicó cuestionario, recolectaron datos antropométricos y se determinó glucosa capilar a la muestra (n=304). Resultados: la prevalencia a presentar un alto riesgo a desarrollar DM2 en la población es de 35.5%, mientras que la prevalencia a presentar riesgo bajo es de 64.5%. En cuanto a hábitos tóxicos, no existió correlación positiva entre consumo de té y desarrollo de DM2. Sin embargo, sí entre el consumo de café y alcohol. Conclusiones: los habitantes de salinas presentan un bajo riesgo a desarrollar DM2, pero utilizan factores de riesgos modificables que aumentan la prevalencia a DM2.

Introduction: Type 2 diabetes mellitus (DM2) is defined as a metabolic disorder characterized by chronically elevated blood glucose levels. DM2 represents the paradigm of chronic diseases in which there is a close association between family and environmental factors. Therefore, the purpose of this study is to determine the association of the risk of developing DM2 and non-illicit toxic habits in patients residing in a rural community in Peravia, Dominican Republic. Such habits include alcohol, coffee and tea. Methodology: Observational, cross-sectional, analytical and prospective study. A questionnaire was applied, anthropometric data was collected, and capillary glucose was determined in the study sample (n=304). Results: the prevalence of presenting a high risk of developing DM2 in the population is 35.5%, while the prevalence of presenting low risk is 64.5%. Regarding toxic habits, there was no positive correlation between tea consumption and the development of DM2. However, this result differed between consumption of coffee and alcohol. Conclusions: the inhabitants of Salinas have a low risk of developing DM2 but are subject to modifiable risk factors that increase said prevalence.

Asociación y riesgo de hipercolesterolemia en prediabéticos de un centro médico de Villa El Salvador, Lima, Perú / Association and risk of hypercholesterolemia among patients with prediabetes from a medical center in Villa El Salvador, Lima, Peru

RESUMEN Objetivo: Evaluar la asociación y el riesgo de hipercolesterolemia en pacientes adultos prediabéticos atendidos en un centro médico del distrito de Villa El Salvador en Lima, Perú. Materiales y métodos: Estudio analítico, prospectivo y transversal, con datos de historias clínicas de consultas médicas de 749 pacientes atendidos en un policlínico del distrito de Villa El Salvador, Lima, Perú. Se incluyó a pacientes adultos asintomáticos que asistieron a evaluaciones de rutina y preventivas. Se excluyó a pacientes con enfermedades endocrino-metabólicas o en tratamiento con fármacos hipoglucemiantes. Las variables de estudio fueron sexo, hipercolesterolemia y prediabetes. El análisis de asociación se realizó por medio de la prueba de chi cuadrado y el riesgo fue evaluado por medio de la oportunidad relativa; asimismo, se realizó el análisis multivariado por medio de regresión logística binaria y se consideró como punto de corte en decisión de significancia estadística el valor alfa igual a 0,05 y un nivel de confianza de 95 %. Resultados: Hubo asociación estadísticamente significativa entre prediabetes e hipercolesterolemia. Las mujeres prediabéticas tuvieron 1,66 veces más riesgo de desarrollar hipercolesterolemia que las mujeres con niveles de glucosa basal normales, mientras que los hombres con prediabetes tuvieron 2,37 veces más riesgo de tener colesterol alto que los hombres con niveles de glucemia basal normales. Conclusiones: La prediabetes se asocia con la hipercolesterolemia, lo cual aumenta su riesgo. Es justificable realizar la medición conjunta del colesterol total en ayunas junto con la medición de la glucosa basal en campañas preventivo-promocionales de salud y en consultas periódicas, así como durante el seguimiento de pacientes con factores de riesgo de diabetes, prediabetes e hipercolesterolemia, a fin de reducir las consecuencias hemodinámicas y cardiovasculares del colesterol elevado en la sangre y el agravamiento de la morbimortalidad conjunta de la hiperglucemia crónica.

ABSTRACT Objective: To evaluate the association and risk of hypercholesterolemia among adult patients with prediabetes treated at a medical center in the district of Villa El Salvador in Lima, Peru. Materials and methods: An analytical, prospective and cross-sectional study conducted with data from medical consultation records of 749 patients treated at a polyclinic in the district of Villa El Salvador in Lima, Peru. Asymptomatic adult patients who had routine and preventive checkups were included in the research. Patients with endocrine and metabolic disorders or being treated with hypoglycemic drugs were excluded. The study variables were sex, hypercholesterolemia and prediabetes. The association analysis was performed using the chi-square test and the risk was evaluated by means of the odds ratio. In addition, the multivariate analysis was conducted through a binary logistic regression, and an alpha value of 0.05 and a confidence level of 95 % were considered as the cut-off point to determine the statistical significance. Results: There was a statistically significant association between prediabetes and hypercholesterolemia. Females with prediabetes were 1.66 times more likely to develop hypercholesterolemia than females with normal baseline glucose levels, while males with prediabetes were 2.37 times more likely to have high cholesterol than males with normal baseline blood glucose levels. Conclusions: Prediabetes is associated with hypercholesterolemia, thus increasing its risk. It is justifiable to carry out the joint measurement of fasting total cholesterol and baseline glucose in disease prevention and health promotion campaigns, regular checkups and follow-up of patients with risk factors for diabetes, prediabetes and hypercholesterolemia. This helps reduce the hemodynamic and cardiovascular consequences of high cholesterol levels and the worsening of the joint morbidity and mortality of chronic hyperglycemia.

Fasting glucose in the first trimester: An initial approach to diagnosis of gestational diabetes. / Glucemia basal en el primer trimestre como acercamiento inicial al diagnóstico de la diabetes en el embarazo.

OBJECTIVES: To establish whether fasting glucose levels in the first trimester (FGFT)of pregnancy ≥ 92 mg/dL (5.1 mmol/L) (FGFT) anticipate the occurrence of maternal-fetal complications of gestational diabetes mellitus. To assess whether FGFT can replace diagnosis of GDM using the classical two-step oral glucose tolerance test (OGTT). METHODS: A retrospective study of 1425 pregnancies with FGFT and O'Sullivan Test (OST) and/or OGTT according to OST results in the second trimester. FGFT sensitivity and specificity were assessed as compared to the conventional diagnosis of GDM. The relationship between maternal-fetal complications and FGFT was assessed in the total group and after excluding mothers who received specific medical treatment for GDM. RESULTS: Sensitivity and specificity of FGFT levels ≥ 92mg/dL were 46.4% and 88.8% as compared to diagnosis of GDM using Carpenter and Coustan criteria. In the total group, a statistically significant relationship was found between FGFT levels ≥ 92 mg/dL and newborn weight (3228±86 versus 3123±31g; P<.05), as well as a higher rate of macrosomia (6.9% versus 3.5%; P<.05). This association persisted after excluding patients diagnosed with and treated for GDM (weight: 3235±98 versus 3128±31 g; P<.05; percentage of macrosomia: 7.2% versus 3.4%; P<.05). CONCLUSIONS: FGFT is not a good substitute for conventional diagnosis of GDM in the second trimester. Pregnant women with FGFT levels ≥ 92 mg/dL, even with no subsequent diagnosis of GDM, are a risk group for fetal macrosomia and could benefit from dietary measures and physical exercise.

Relación entre el ojo seco y la diabetes mellitus tipo 2

La diabetes mellitus es una patología metabòlica que altera los niveles de glucosa en el cuerpo, siendo más prevalente la tipo 2, la cual puede llegar a modular enfermedades sistémicas que causan diferentes desórdenes metabòlicos y cambios celulares. En cuanto a las alteraciones oftalmológicas, se pueden resaltar la retinopatía diabética y el ojo seco, siendo esta última una condición inflamatoria crónica que ocaciona daños en la superficie ocular. Por lo tanto, esta revisión brindará información de los factores asociados al desarrollo de ojo seco en la diabetes, resaltando cambios en la glicemia y el rol del metabolismo de glucosa sobre estructuras oculares tales como como la glándula lagrimal, glándulas de Meibomio, y en la microvasculatura, que pueden condicionar a trastornos neuropáticos que conducen a la sintomatologia ocular. De igual modo, se describen eventos biológicos como cambios en la expresión epigenética, estrés oxidativo e inflamación que presumiblemente juegan un papel importante en las diabetes y ojo seco, por lo cual la evaluación y análisis de la lágrima en esta población se hace necesaria, teniendo en cuenta los cambios en las estructuras oculares en la diabetes y las novedosas investigaciones sobre biomarcadores de diabetes a través de la película lagrimal.

Diabetes mellitus is a metabolic pathology that alters glucose levels in the body, being type 2 more prevalent, which can lead to modular systemic diseases that cause different metabolic disorders and cellular changes. Regarding ophthalmological alterations, diabetic retinopathy and dry eye can be highlighted, the latter being a chronic inflammatory condition causing damage to the ocular surface. Therefore, this review will provide information on the factors associated with the development of the dry eye in diabetes, highlighting changes in glycemia and the role of glucose metabolism on ocular structures such as the lacrimal gland, Meibomian glands, and the microvasculature, which can condition neuropathic disorders that lead to ocular symptoms, biological events such as changes in epigenetic expression, oxidative stress, and inflammation are prescribed, which presumably play an important role in diabetes and dry eye, for which the evaluation and analysis of tears in this population is done necessary, taking into account the changes in the ocular structures in diabetes and the new research on biomarkers of diabetes through the tear film.

Genotipificación de haptoglobina como factor de riesgo cardiovascular en pacientes diabeticos del Hospital Clínico Viedma

Objetivo: en pacientes con diabetes mellitus el genotipo de haptoglobina es considerado un factor de riesgo para la aparición de una cardiopatía, se ha reportado que en diabéticos el genotipo Hp 2-2 genera un riesgo cinco veces mayor de presentar una enfermedad cardiovascular comparado con pacientes diabéticos con otro genotipo. Este estudio tiene como objetivo la determinación del genotipo de haptoglobina en pacientes diabéticos que acuden al laboratorio el Hospital Clínico Viedma de noviembre de 2018 a enero de 2019. Métodos: se analizaron 76 sueros de pacientes diabéticos en ayunas y que contaban con una solicitud de perfil lipídico. Para la determinación de los tres genotipos de haptoglobina se usó un kit comercial de enzimoinmunoanalisis (ELISA Hp-Epitope); para la determinación de la glicemia y el perfil lipídico se usó el método enzimático. Resultados: del total de la población estudiada de pacientes diabéticos un 12 % presenta el genotipo Hp 2-2 en aquellos pacientes no controlados, los valores de glicemia (201 mg/dl) son estadísticamente significativas en relación con los otros dos genotipos. También estos pacientes diabéticos no controlados con genotipo Hp 2-2 presentan niveles de colesterol, LDL, VLDL y triglicéridos significativamente elevados en relación con los otros dos genotipos. Conclusiones: nuestros resultados coinciden con estudios previos el cual señalan que pacientes diabéticos que poseen el genotipo Hp 2-2 tiene mayor riesgo a sufrir una enfermedad cardiovascular en comparación con los otros 2 genotipos.

Objective: in patients with diabetes mellitus, the haptoglobin genotype is considered a risk factor for the onset of heart disease. It has been reported that in diabetics, the Hp 2-2 genotype generates a five-fold greater risk of developing cardiovascular disease compared to diabetic patients with another genotype. This study aims to determine the haptoglobin genotype in diabetic patients who come to the Viedma Clinical Hospital laboratory from November 2018 to January 2019. Methods: 76 sera from fasting diabetic patients with a lipid profile request were analyzed. For the determination of the three haptoglobin genotypes, a commercial enzyme immunoassay kit (Hp-Epitope ELISA) was used; The enzymatic method was used to determine glycemia and lipid profile. Results: of the total studied population of diabetic patients, 12% have the Hp 2-2 genotype. In those uncontrolled patients, the glycemia values (201 mg/dl) are statistically significant in relation to the other two genotypes. These uncontrolled diabetic patients with the Hp 2-2 genotype also have significantly elevated levels of cholesterol, LDL, VLDL and triglycerides in relation to the other two genotypes. Conclusions: our results coincide with previous studies which indicate that diabetic patients who have the Hp 2-2 genotype have a greater risk of suffering from cardiovascular disease compared to the other 2 genotypes.

Opiniones y recomendaciones de la Sociedad Argentina de Diabetes. Glucemia en ayunas alterada: ¿es oportuno utilizar el punto de corte en 100 mg/dl en Argentina? / Opinions and recommendations of the Argentine Diabetes Society. Impaired fasting blood glucose: is it appropriate to use a cut-off point of 100 mg/dl in Argentina?

Establecer el punto de corte entre la glucemia en ayunas normal y la alterada resulta de suma importancia a los efectos de considerar a un paciente en riesgo, tanto de progresar a estdos más avanzados de la enfermedad como de sufrir complicaciones micro y macroangiopáticas. Desde 2006 la Sociedad Argentina de Diabetes (SAD), sobre la base de la evidencia considerada en ese momento, estableció el límite inferior de la glucemia alterada en ayunas (GAA) en 110 mg/dl; posteriormente, durante 2022, la Comisión Directiva de la SAD convocó a un grupo de expertos con el objeto de evaluar si esta recomendación debía mantenerse o, al igual que otras sociedades científicas de prestigio, adoptar a tal efecto 100 mg/dl. En este documento de Opiniones y Recomendaciones se encuentran los fundamentos por los cuales la SAD adoptará, de ahora en más, 100 mg/dl como límite inferior de la GAA, en base a las nuevas evidencias científicas que muestran que desde este punto de corte se produce un aumento en la progresión a la diabetes mellitus y de las complicaciones tanto macro como microangiopáticas.

To establish the cut-off point between normal and impaired fasting glycemia (IFG) is extremely important for the purposes of considering a patient at risk both of progressing to more advanced stages of the disease and of suffering micro- and macroangiopathic complications. Since 2006, the Argentine Diabetes Society (ADS), based on the evidence considered at that time, established the lower limit of IFG at 110 mg/d, laterduring the year 2022, The Board of Directors of the ADS vened a group of experts in order to assess whether this recommendation should be maintained or, like other prestigious scientific societies, adopt 100 mg/dl for this purpose. This Opinions and Recommendations document contains therationale for which the SAD will adopt, from now on, 100 mg/dlas the lower limit of the IFG, based on the new scientific edence that shows that from this cut-off point it produces increase in progression to diabetes and both macro and microangiopathic complications.

Correlación entre tiempo en rango y hemoglobina glicosilada en personas con diabetes mellitus: revisión sistemática / Correlation between time on target and glycated hemoglobin in people with diabetes mellitus: systematic review / Correlação entre tempo no alvo e hemoglobina glicada de pessoas com diabetes mellitus: revisão sistemática

Objetivo: analizar la correlación entre el tiempo en rango y la hemoglobina glicosilada de personas que viven con diabetes mellitus y realizan la monitorización continua de la glucemia o el automonitoreo de la glucemia capilar Método: revisión sistemática de etiología y riesgo basada en las directrices del JBI e informada según los Preferred Reporting Items for Systematic Reviews and Meta-Analyses, abarcando seis bases de datos y la literatura gris. La muestra incluyó 16 estudios y la calidad metodológica fue evaluada utilizando las herramientas del JBI. Protocolo registrado en Open Science Framework, disponible en https://doi.org/10.17605/OSF.IO/NKMZB. Resultados: tiempo en rango (70-180 mg/dl) mostró una correlación negativa con la hemoglobina glicosilada, mientras que el tiempo por encima del rango (>180 mg/dl) mostró una correlación positiva. Los coeficientes de correlación variaron entre -0,310 y -0,869 para el tiempo en rango, y entre 0,66 y 0,934 para el tiempo por encima del rango. Un estudio se realizó en una población que hacía el automonitoreo. Conclusión: hay una correlación estadísticamente significativa entre el tiempo en rango y el tiempo por encima del rango con la hemoglobina glicosilada. Cuanto mayor sea la proporción en el rango glucémico adecuado, más cerca o por debajo del 7% estará la hemoglobina glicosilada. Se necesitan más estudios que evalúen esta métrica con datos del automonitoreo de la glucemia.

Objective: to analyze the correlation between time on target and glycated hemoglobin in people living with diabetes mellitus and carrying out continuous blood glucose monitoring or self-monitoring of capillary blood glucose. Method: systematic review of etiology and risk based on JBI guidelines and reported according to Preferred Reporting Items for Systematic Reviews and Meta- Analyses, covering six databases and grey literature. The sample included 16 studies and methodological quality was assessed using JBI tools. Protocol registered in the Open Science Framework, available at https://doi.org/10.17605/OSF.IO/NKMZB. Results: time on target (70-180 mg/dl) showed a negative correlation with glycated hemoglobin, while time above target (>180 mg/dl) showed a positive correlation. Correlation coefficients ranged between -0.310 and -0.869 for time on target, and between 0.66 and 0.934 for time above target. A study was carried out on a population that performed self-monitoring. Conclusion: there is a statistically significant correlation between time on target and time above target with glycated hemoglobin. The higher the proportion in the adequate glycemic range, the closer to or less than 7% the glycated hemoglobin will be. More studies are needed to evaluate this metric with data from self-monitoring of blood glucose.

Objetivo: analisar a correlação entre o tempo no alvo e a hemoglobina glicada de pessoas que vivem com diabetes mellitus e realizam a monitorização contínua da glicemia ou a automonitorização da glicemia capilar. Método: revisão sistemática de etiologia e de risco pautada nas diretrizes do JBI e reportada conforme Preferred Reporting Items for Systematic Reviews and Meta-Analyses, abrangendo seis bases de dados e a literatura cinzenta. A amostra incluiu 16 estudos e a qualidade metodológica foi avaliada utilizando as ferramentas do JBI. Registrado protocolo no Open Science Framework, disponível em https://doi.org/10.17605/OSF.IO/NKMZB. Resultados: tempo no alvo (70-180 mg/dl) apresentou correlação negativa com a hemoglobina glicada, enquanto o tempo acima do alvo (>180 mg/dl) mostrou correlação positiva. Os coeficientes de correlação variaram entre -0,310 e -0,869 para o tempo no alvo, e entre 0,66 e 0,934 para o tempo acima do alvo. Um estudo foi efetuado com população que realizava a automonitorização. Conclusão: há correlação estatisticamente significativa entre o tempo no alvo e o tempo acima do alvo com a hemoglobina glicada. Quanto maior a proporção na faixa glicêmica adequada, mais próxima ou inferior a 7% estará a hemoglobina glicada. São necessários mais estudos que avaliem essa métrica com dados da automonitorização da glicemia.

Relación entre el Finnish Diabetes Risk Score, glucemia en ayunas y hemoglobina A1c / Relationship between the Finnish Diabetes Risk Score, fasting blood glucose and glycohemoglobin A1c

Introducción: el Finnish Diabetes Risk Score (FINDRISC) mostró alta sensibilidad y especificidad para la detección de personas que evolucionarían a diabetes mellitus (DM) en las poblaciones estudiadas, por lo cual se decidió utilizarlo entre quienes concurrieron por diferentes motivos a realizarse análisis de laboratorio en centros de la Asociación de Laboratorios de Alta Complejidad (ALAC), con el objeto de identificar personas con diferentes niveles de riesgo de presentar alteraciones de la glucemia en ayunas (GA) y de la HbA1c. Objetivos: explorar la asociación entre la puntuación del FINDRISC con GA y HbA1c, estableciendo el punto de corte de mayor sensibilidad y especificidad para encontrar una GA ≥100 mg/dL y una HbA1c ≥5,7% (38,8 mmol/mol), en una población que concurrió a centros de la ALAC. Materiales y métodos: se incluyeron 1.175 individuos de 45 laboratorios de la ALAC, procesamiento local de glucemia y centralizado de HbA1c (high performance liquid chromatography, HPLC). Análisis estadístico: chi-cuadrado, Odds Ratio, ANOVA, test de Tukey, regresión logística binomial y curvas ROC. Resultados: los puntajes totales del FINDRISC se asociaron de manera positiva y estadísticamente significativa, tanto con los valores de GA como con los niveles de HbA1c. Entre sus variables, una edad mayor o igual a 45 años, un perímetro abdominal de alto riesgo, un índice de masa corporal mayor o igual a 25 Kg/m., la presencia de antecedentes familiares de DM (padres, hermanos o hijos) y la existencia de antecedentes de medicación antihipertensiva se asociaron de manera significativa con valores de GA iguales o superiores a 100 mg/dL y/o niveles de HbA1c iguales o mayores a 5,7% (38,8 mmol/mol). No se halló asociación significativa con la realización de actividad física (al menos 30 minutos diarios) ni con el registro de ingesta diario de frutas y verduras. Los valores medios de GA y HbA1c en individuos con puntajes totales del FINDRISC menores o iguales a 11 fueron de 89,9 mg/dL y 5,2% (33,0 mmol/mol), respectivamente, elevándose hasta valores medios de 116,1 mg/dL y 6,1% (43,0 mmol/mol) en los individuos con puntajes iguales o superiores a 21, siguiendo una asociación del tipo "dosis/respuesta". Por curvas ROC, un FINDRISC de 13 presenta una sensibilidad del 81,89%, especificidad del 67,60% y 70,55% de diagnósticos correctos de HbA1c ≥5,7% (38,8 mmol/mol), y una sensibilidad del 72,50%, especificidad del 70,62% y 71,20% de diagnósticos correctos para encontrar personas con una GA ≥100 mg/dL. Conclusiones: el puntaje del FINDRISC se relacionó con niveles crecientes de GA y HbA1c, resultando útil para encontrar personas con GA ≥100 mg/dL y HbA1c ≥5,7% (38,8 mmol/mol) en la población estudiada.

Introduction: the Finnish Diabetes Risk Score (FINDRISC) has high sensitivity and specificity for the identification of people at risk of diabetes mellitus (DM) in various populations. Therefore, we aimed to use this index to identify individuals at risk of having alterations in fasting glycemia (FG) and HbA1c among those who underwent laboratory analysis at ALAC, Argentina. Objectives: to explore the relationships of the FINDRISC score with the fasting blood glucose (FG) concentration and glycated hemoglobin (HbA1c) level, and to establish appropriate cut-off scores to predict FG ≥100 mg/dL and HbA1c ≥5.7% (38.8 mmol/mol) in this population. Materials and methods: we recruited 1,175 individuals from 45 ALAC laboratories for whom FG and HbA1c had been measured. We analyzed the data using the chi square test, odds ratios, ANOVA plus Tukey's post-hoc test, binomial logistic regression, and receiver operating characteristic (ROC) curves. Results: total FINDRISC score significantly positively correlated with both FG and HbA1c. Of the constituent variables, age ≥45 years, a large waist circumference, a body mass index ≥25 kg/m., a close family history of DM, and the use of antihypertensive medication were significantly associated with FG ≥100 mg/dL and/or HbA1c ≥5.7% (38.8 mmol/mol). However, no significant association was found with physical activity or the daily consumption of fruit and vegetables. The mean FG and HbA1c for individuals with total FINDRISC scores ≤11 were 89.9 mg/dL and 5.2% (33.0 mmol/mol), respectively, which increased to 116.1 mg/dL and 6.1% (43.0 mmol/mol) for individuals with scores ≥21, with a dose/response-type relationship. ROC analysis showed that a FINDRISC of 13 was associated with a sensitivity of 81.89%, a specificity of 67.60%, and a correct diagnosis rate of 70.55% for HbA1c ≥5.7% (38.8 mmol/mol); and a sensitivity of 72.50%, a specificity of 70.62%, and a correct diagnosis rate of 71.20% for FG ≥100 mg/dL. Conclusions: FINDRISC score increases with increasing FG and HbA1c, and is a useful means of identifying people with FG ≥100 mg/dL and HbA1c ≥5.7% (38.8 mmol/mol).