[Two-year follow-up for patients with pre-diabetes that reverted to normal glucose in the first year].
摘要
OBJECTIVE: To investigate the natural outcome in the second year of the patients with impaired glucose regulation (IGR) that reverted to normal glucose tolerance (NGT). METHODS: 463 adults diagnosed as with IGR in the baseline survey based on the criteria of America Diabetic Association 2003 underwent treatment including health education. One and 2 years later blood samples were collected to examine the glucose and lipids. Blood pressure, heart rate, waist, and hip were examined. Questionnaire survey was conducted. RESULTS: One year later 55 of the patients (32.5%) were diagnosed as with isolated impaired glucose tolerance (I-IFG), 86 (50.9%) with I-IGT, and 28 (16.6%) with IFG/IGT at the baseline survey had their diseases reverted to NGT. 53.3% of them remained to be with NGT, 45.6% of them showed the diagnosis transformed into IGR, and the disease in 1.2% of them progressed into diabetes mellitus. In the second year, insulin resistance was significantly relieved and islet beta cell function was significantly improved in the pattern IGR--->NGT-->NGT. Stepwise logistic regression analysis showed that fasting plasma glucose (FPG) in the baseline survey and 1 year later were negatively correlated and HBCI were positively correlated with the reversion and maintenance of NGT. In the second year, the ratio of elevated waist circumference, elevated blood pressure, elevated TG, reduced HDL-c, elevated FPG, more than two metabolic abnormalities and metabolic syndrome of the IGR-->NGT-->NGT group were significantly lower than in the IGR-->NGT-->IGR group ( all P < 0.05). CONCLUSION: FPG, islet beta cell function and TG can be considered as indicators for reversion from IGR to NGT and maintenance of NGT. Those with less metabolic abnormalities at baseline and with more obvious improvement would be more likely to revert to and maintain NGT.