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Browsing by Author "Kyhälä, Tanja"

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  • Kyhälä, Tanja (2019)
    Studies suggest that isolated impaired fasting glucose (iIFG) and isolated impaired glucose tolerance (iIGT) have distinct pathophysiologic phenotype, including differences in whole body insulin sensitivity. The present study was a sub-study of the PREVIEW intervention study, a three-year randomized trial in eight countries. Participants with either iIFG (n = 44) or iIGT (n = 38) who attended all clinical investigation days (0, 2, 6 and 12 months) in Sydney were included. Pre-diabetes as defined by the American Diabetes Association and BMI >25 were inclusion criteria. The aim was to determine if there was a difference in weight change between PREVIEW participants with iIGT or iIFG at any of the measurement points. In addition, we investigated if there were differences in change in fat mass, fat-free mass, HbA1c, blood lipids, insulin and C-peptide between participants with iIGT versus iIFG. A comparison of the mean changes showed that subjects with iIGT lost significantly less fat mass at 6 months than those with iIFG (-7.30, 95% CI [-8.89, -5.71] versus -9.57, 95% CI [-10.79, -8.35] kg, p = 0.027) and the difference remained significant (-6.30, 95% CI [-7.93, -4.67] versus -8.38, 95% CI [-10.99, -5.77] kg, p = 0.038) at 12 months. Furthermore, participants with iIGT regained fat (as fat %) at 12 months unlike participants with iIFG (-3.1, 95% CI [-4.08, -2.12] versus -4.9, 95% CI [-5.88, -3.92] %, p = 0.007). Reduction in HDL cholesterol was less in subjects with iIGT at 2 months than in those with iIFG (-0.08, 95% CI [-0.14, -0.02] versus -0.15, 95% CI [-0.21, -0.09] mmol/L, p = 0.011). Participants with iIGT lost less and regained more weight versus iIFG although the difference was not significant. No other changes were significant. In conclusion, the results support the hypothesis that participants with iIGT find it more difficult to lose fat mass and maintain the loss than those with iIFG. Studies are needed to confirm these findings and to determine the explanation for the difference in fat loss between iIGT and iIFG categories. As weight loss, including fat loss, is the dominant determinant of the reduced risk of T2DM in lifestyle interventions, actions to develop optimal weight loss methods for patients with different pre-diabetic statuses should be taken.