Changes of carbohydrate metabolism and insulin resistance parameters at different compliance levels in young people
https://doi.org/10.15829/1728-8800-2024-4059
EDN: OBSVNP
Abstract
Aim. To analyze early disorders of carbohydrate metabolism and insulin resistance (IR) at different compliance levels in young people.
Material and methods. Ninety-four patients (45 men/49 women; median (Me)=33 [28,7-38] years) were examined. This prospective observational study used data of the questionnaire of the quantitative assessment of the adherence to treatment (QAA-25), fasting plasma glucose levels, oral glucose tolerance test, levels of glycated hemoglobin (HbA1c), insulin and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Statistical processing was carried out in IBM SPSS Statistics 26.
Results. Only 15,8% had high adherence to medical support, 8,9% — lifestyle modification (LM) and general compliance, 10,9% — drug therapy. The means for most types of adherences were in the low range. In the low and medium LM groups, over 18 months the number of patients with elevated HbA1c levels increased from 7,1 to 18,8% (p=0,021) and IR from 12% to 31,8% (p=0,000). In patients with low overall LM compared to high ones, the probability of HbA1c increase raised by 5,5 times, and hyperinsulinemia by 1,16 times.
Conclusion. In an 18-month prospective study, young adults with low compliance levels showed an increase in the incidence of hyperinsulinemia, IR, and prediabetes.
About the Authors
A. V. Sineglazova
Kazan State Medical University
Russian Federation
Russian Federation
Kazan
A. Sh. Fakhrutdinova
Kazan State Medical University
Russian Federation
Russian Federation
Kazan
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Supplementary files
What is already known about the subject?
- The high prevalence of prediabetes and insulin resistance increases the incidence of cardiometabolic diseases, which dictates the need for more careful attention to these risk factors, including in the context of medication adherence, especially at a young age.
What might this study add?
- Determination of glycated hemoglobin level in young people made it possible to additionally diagnose prediabetes in 11% of cases after the first examination and in 18% based on the results of prospective observation. More than half of the patients had low compliance according to the QAA-25 questionnaire. Prospective follow-up revealed that patients with lower levels of general medication adherence had greater risks of prediabetes and insulin resistance.
Review
For citations:
Sineglazova A.V., Fakhrutdinova A.Sh. Changes of carbohydrate metabolism and insulin resistance parameters at different compliance levels in young people. Cardiovascular Therapy and Prevention. 2024;23(6):4059. (In Russ.) https://doi.org/10.15829/1728-8800-2024-4059. EDN: OBSVNP
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