The Effects Of Prediabetes On Growth And Pubertal Development

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Abstract
Prediabetes is an intermediate state of hyperglycemia with glycemic parameters above normal but below the threshold of diabetes. While, the diagnostic criteria of prediabetes are not uniform across various international professional organizations, it remains a state of high risk for development of diabetes with annual conversion rate of 5-10%. Observational evidence suggests as association between prediabetes and early complications of diabetes such nephropathy, small fiber neuropathy, retinopathy and risk of macrovascular disease. Several studies have shown efficacy of lifestyle interventions in diabetes prevention with a relative risk reduction of 40-70% in adults with prediabetes. There is an increasing evidence to support the
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While, pre-diabetes is an asymptomatic condition, there is always pre-diabetes before the onset of diabetes. The elevation of blood sugar is a continuum and hence pre-diabetes cannot be considered an entirely benign condition.

DIAGNOSIS OF PRE-DIABETES

Various organizations have defined prediabetes with criteria that are not uniform. According to World Health Organization (WHO), high risk of diabetes is related to two specifically defined states, impaired fasting glucose (IFG) defined as fasting plasma glucose (FPG) of 6.1-6.9 mmol/L (110-125 mg/dL) and impaired glucose tolerance (IGT) defined as postload plasma glucose of 7.8-11.0 mmol/L (140-200 mg/dL) based on a 2 hour oral glucose tolerance test (OGTT) or a combination of the two (1). The American Diabetes Association (ADA), on the other hand has the same cut-off value for IGT (140-200 mg/dL) but has a lower cut-off value for IFG (100-125 mg/dL) and has additional hemoglobin A1c (HbA1c) based criteria of a level of 5.7-6.4% (2). Several studies have shown poor correlation between HbA1c and IFG and IGT (3-5). The usefulness of diagnosis diabetes or pre-diabetes on basis of IFG and IGT have been challenged due to inability of these blood glucose cut points to capture pathology related to diabetes and probability of developing diabetes in future (6). These cut-offs further loose their credibility due to poor reproducibility of these tests in
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