References

avk

Архивъ внутренней медицины

The Russian Archives of Internal Medicine

2226-67042411-6564

“SINAPS” LLC

10.20514/2226-6704-2020-10-5-327-339

avk-1086

Research Article

ЛЕКЦИИ

LECTURES

Современные аспекты клиники, диагностики и лечения предиабета

Modern Aspects of the Clinic, Diagnosis and Treatment of Prediabetes

https://orcid.org/0000-0003-4387-7737

Пырикова

Н. В.

Pyrikova

N. V.

Наталья Викторовна Пырикова - кафедра факультетской терапии и профессиональных болезней

Барнаул

Department of faculty therapy and occupational diseases

Barnaul

allinatali@mail.ru

Осипова

И. В.

Osipova

I. V.

Кафедра факультетской терапии и профессиональных болезней

Барнаул

Department of faculty therapy and occupational diseases

Barnaul

Полякова

И. Г.

Polyakova

I. G.

Кафедра факультетской терапии и профессиональных болезней

Барнаул

Department of faculty therapy and occupational diseases

Barnaul

Федеральное государственное бюджетное образовательное учреждение высшего образования «Алтайский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияAltai State Medical UniversityRussian Federation

2020

07102020

105327339

2020

Пырикова Н.В., Осипова И.В., Полякова И.Г.

Pyrikova N.V., Osipova I.V., Polyakova I.G.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.medarhive.ru/jour/article/view/1086

Предиабет является распространенным нарушением углеводного обмена, медико-социальная актуальность которого обусловлена негативным влиянием на показатели заболеваемости сахарным диабет ом (СД) 2 типа и сердечно-сосудистыми заболеваниями (ССЗ). В анализируемых литературных источниках подчеркивается наличие тесной патогенетической взаимосвязи между СД 2 типа/предиабетом и ССЗ. Эта связь становится еще более актуальной, учитывая, с одной стороны, стойкую тенденцию к росту распространенности нарушений углеводного обмена в популяции, а с другой то обстоятельство, что у пациентов с дизгликемией именно сердечно-сосудистые осложнения являются основной причиной смертности. Однако, если значимость СД 2 типа как фактора риска ССЗ широко известна и его наличие сразу стратифицирует большинство пациентов в группу высокого или очень высокого сердечно-сосудистого риска, то вклад предиабета в развитие ССЗ пока остается недооцененным среди терапевтического и кардиологического сообществ. Высокая распространенность предиабета создает предпосылки для дальнейшего роста заболеваемости СД 2 типа и ССЗ в РФ, что требует от врачей различных специальностей настороженности по раннему выявлению предиабета, поскольку своевременно начатые профилактические мероприятия могут значительно снизить риск развития СД 2 типа и его осложнений в будущем. В настоящий момент подтверждена эффективность как немедикаментозной, так и медикаментозной стратегии в предотвращении развития СД 2 типа у лиц с предиабетом, накапливается все больше данных о возможности эффективной профилактики ССЗ при предиабете. По данным современных исследований подчеркивается первичная роль мероприятий по активному изменению образа жизни при лечении и профилактике предиабета, в то же время, эффективность данных мероприятий может быть снижена из-за недостаточной приверженности самих пациентов к их самостоятельному длительному выполнению. Поэтому стратегия назначения метформина с целью профилактики СД 2 типа является абсолютно оправданной, если врач и пациент признают неэффективность или невозможность длительно следовать рекомендациям по активному изменению образа жизни. В статье с позиций современных рекомендаций представлены данные об этиологии, эпидемиологии, диагностике, а также подходы к ведению пациентов с предиабетом.

Prediabetes is a common violation of carbohydrate metabolism, the medical and social relevance of which is due to the negative impact on the incidence of type 2 diabetes mellitus (DM) and cardiovascular disease (CVD). The analyzed literature emphasizes the presence of a close pathogenetic relationship between type 2 DM/prediabetes and CVD. This relationship becomes even more relevant, taking into account, on the one hand, the persistent upward trend in the prevalence of carbohydrate metabolism disorders in the population, and on the other hand, the fact that in patients with dysglycemia it is cardiovascular complications that are the main cause of death. However, while the significance of type 2 DM as a risk factor for CVD is widely known and its presence immediately stratifies most patients to a group of high or very high cardiovascular risk, the contribution of prediabetes to the development of CVD remains underestimated among the therapeutic and cardiological communities. The high prevalence of prediabetes creates prerequisites for a further increase in the incidence of type 2 DM and CVD in the Russian Federation, which requires doctors of various specialties to be wary of early detection of prediabetes, since timely preventive measures can significantly reduce the risk of type 2 DM and its complications in the future. Currently, the effectiveness of both non-drug and drug strategies in preventing the development of type 2 DM in people with prediabetes has been confirmed, more and more data are accumulating about the possibility of effective prevention of CVD in prediabetes. According to modern research, the primary role of measures to actively change lifestyle in the treatment and prevention of prediabetes is emphasized, at the same time, the effectiveness of these measures can be reduced due to insufficient commitment of the patients themselves to their independent long-term implementation. Therefore, the strategy of prescribing metformin for the prevention of type 2 diabetes is absolutely justified if the doctor and patient recognize the inefficiency or inability to follow the recommendations for active lifestyle changes for a long time. The article presents the data on the etiology, epidemiology, diagnosis, and approaches to the management of patients with prediabetes from the standpoint of modern recommendations.

предиабетсахарный диабетсердечно-сосудистые заболеванияметформингипергликемия натощакнарушение толерантности к глюкозе

Prediabetesdiabetes mellituscardiovascular diseasemetforminfasting hyperglycemiaimpaired glucose tolerance

References1

Barbarash O.L., Voevoda M.I., Galstyan G.R. Prediabetes as an interdisciplinary problem: definition, risks, approaches to the diagnosis and prevention of type 2 diabetes and cardiovascular complications. Russian Journal of Cardiology. 2019; 24(4): 83-91. doi: 10.15829/1560-4071-2019-4-83-91 [in Russian].

Cho N.H., Shaw J.E., Karuranga S. et al. IDF diabetes atlas: global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018; 138: 271-281.

International diabetes federation. Diabetes Atlas 7th edition. [Electronic resource]. URL: https://www.idf.org/elibrary/epidemiology-research/diabetes-atlas/13diabetes-atlasseventh-edition.html. (date of the application: 17.06.2020).

Gujral U.P., Mohan V., Pradeepa R. et al. Ethnic variations in diabetes and prediabetes prevalence and the roles of insulin resistance and cell function: the CARRS and NHANES studies. J ClinTransl Endocrinol. 2016; 4: 19-27. doi: 10.1016/j.jcte.2016.02.004.

Мenke A., Casagrande S., Geiss L. et al. Prevalence of and trends in diabetes among adults in the United States, 1988–2012. J Am Med Assoc. 2015; 314: 1021-1029. doi: 10.1001/jama.2015.10029.

Andes L.J., Cheng Y.J., Rolka D.B. et al. Prevalence of Prediabetes Among Adolescents and Young Adults in the United States, 2005-2016. JAMA Pediatr. 2019:e194498. doi: 10.1001/jamapediatrics.2019.4498.

Konnov M.V., Deev A.D. Own and parental predictors of prediabetes in children of individuals with early coronary heart disease. Cardiology. 2017; 57(6): 16-21. doi: 10.18087/cardio.2019.7.10266 [in Russian].

Lyu Y.S., Kim S.Y., Bae H.Y. et al. Prevalence and Risk Factors for Undiagnosed Glucose Intolerance Status in Apparently Healthy Young Adults Aged <40 Years: The Korean National Health and Nutrition Examination Survey 2014-2017. Int J Environ Res Public Health. 2019; 16(13). pii: E2393. doi: 10.3390/ijerph16132393.

Wang L., Gao P., Zhang M. et al. Prevalence and Ethnic Pattern of Diabetes and Prediabetes in China in 2013. JAMA. 2017; 27:2515-2523. doi: 10.1001/jama.2017.7596.

Younes N., Atallah M., Alam R. et al. HbA1c and blood pressure measurements: relation with gender, body mass index, study field and lifestyle in Lebanese students. Endocr Pract. 2019; 25(11): 1101-1108. doi: 10.4158/EP-2019-0163.

Fazli G.S., Moineddin R., Bierman A.S. et al. Ethnic differences in prediabetes incidence among immigrants to Canada: a populationbased cohort study. BMC Med. 2019; 17(1): 100. doi: 10.1186/s12916-019-1337-2.

Dedov I., Shestakova M., Galstyan G. The prevalence of type 2 diabetes mellitus in the adult population of Russia (NATION study). Diabetes. 2016; 19(2): 104-112. doi:10.1016/j.diabres.2016.02.010 [in Russian].

Breyer M.K., Ofenheimer A., Altziebler J. et al. Marked differences in prediabetes and diabetes associated comorbidities between men and women — epidemiological results from a general population-based cohort aged 6-80 years — the LEAD (Lung, hEart, sociAl, boDy) study. Eur J Clin Invest. 2020:e13207. doi: 10.1111/eci.13207.

Al Amri T., Bahijri S., Al-Raddadi R. et al. The Association Between Prediabetes and Dyslipidemia Among Attendants of Primary Care Health Centers in Jeddah, Saudi Arabia. Diabetes Metab Syndr Obes. 2019; 12: 2735-2743. doi: 10.2147/DMSO.S233717.

Мainous A.G., Tanner R.J., Baker R. et al. Prevalence of prediabetes in England from 2003 to 2011: population-based, cross-sectional study. BMJ Open. 2014; 4:e005002. doi: 10.1136/bmjopen-2014-005002.

American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes — 2018. Diabetes Care. 2018; 41(Suppl 1):S13-S27. doi: 10.2337/dc18-S002.

Standards of specialized diabetes care. Edited by Dedov II, Shestakova MV, Mayorov AY. 8th edition. 2017; 20,1S:1-121. doi: 10.14341/DM20171S8.

Нuang Y., Cai X., Mai W. et al. Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis. BMJ. 2016; 355:i5953. doi: 10.1136/bmj.i5953

Zhang Z., Monro J., Venn B.J. Development and Evaluation of an Internet-Based Diabetes Nutrition Education Resource. Nutrients. 2019 May 28;11(6). pii: E1217. doi: 10.3390/nu11061217.

Nedogoda S.V., Barykina I.N., Salasyuk A.S. Prediabetes: the main causes, symptoms, prevention and treatment. Medicinal Bulletin. 2018; 12, 70(2): 3-13 [in Russian].

Lee M., Saver J.L., Hong K.S. et al. Effect of pre-diabetes on future risk of stroke: meta-analysis. Br Med J. 2012; 344:e3564. doi: 10.1136/bmj.e3564.

Huo X., Gao L., Guo L. et al. Risk of non-fatal cardiovascular diseases in early-onset versus late-onset type 2 diabetes in China: A crosssectional study. Lancet. Diabetes Endocrinol. 2016; 4: 115-124. doi: 10.1016/S2213-8587(15)00508-2.

Hui Y., Wang J., An Y. et al. Premature death and risk of cardiovascular disease in young-onset diabetes: A 23-year follow-up of the Da Qing Diabetes Study. Endocrine. 2019; 65: 46-52. doi: 10.1007/s12020-019-01928-7.

Lee G., Kim S.M., Choi S. et al. The effect of change in fasting glucose on the risk of myocardial infarction, stroke, and all-cause mortality: a nationwide cohort study. Cardiovasc Diabetol. 2018; 17: 51. doi: 10.1186/s12933-018-0694-z.

Warren B., Pankow J.S., Matsushita K. et al. Comparative prognostic performance of definitions of prediabetes: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study. Lancet Diabetes Endocrinol. 2017 Jan; 5(1): 34-42. doi: 10.1016/S2213-8587(16)30321-7.

Kristensen S.L., Preiss D., Jhund P.S. et al. Risk Related to Pre-Diabetes Mellitus and Diabetes Mellitus in Heart Failure With Reduced Ejection Fraction: Insights From Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial. Circ Heart Fail. 2016; 9(1). pii: e002560. doi: 10.1161/CIRCHEARTFAILURE.115.002560.

Saleem S.M., Jan S.S., Haq I. et al. Identification of risk factors affecting impaired glucose metabolism among the adult population of district Srinagar. Diabetes Metab Syndr. 2019; 13(2): 1047-1051. doi: 10.1016/j.dsx.2019.01.023.

Rodriguez-Segade S., Rodriguez J., Camiña F. et al. Prediabetes defined by HbA1c and by fasting glucose: differences in risk factors and prevalence. Acta Diabetol. 2019; 56(9): 1023-1030. doi: 10.1007/s00592-019-01342-5.

Cuschieri S., Grech S. Closing the gap — Is type 2 diabetes awareness enough to prevent the growing epidemic? Diabetes Metab Syndr. 2019; 13(3): 1739-1744. doi: 10.1016/j.dsx.2019.03.044.

Man REK, Charumathi S., Gan ATL. et al. Cumulative incidence and risk factors of prediabetes and type 2 diabetes in a Singaporean Malay cohort. Diabetes Res Clin Pract. 2017; 127: 163-171. doi: 10.1016/j.diabres.2017.03.007.

Ligthart S., van Herpt TTW., Leening MJG. et al. Lifetime risk of developing impaired glucose metabolism and eventual progression from prediabetes to type 2 diabetes: a prospective cohort study. Lancet Diabetes Endocrinol. 2016; 4: 44-51. doi: 10.1016/S2213-8587(15)00362-9.

Sánchez E., Betriu À., López-Cano C. et al. ILERVAS project collaborators. Characteristics of atheromatosis in the prediabetes stage: a cross-sectional investigation of the ILERVAS project. Cardiovasc Diabetol. 2019; 18(1): 154. doi: 10.1186/s12933-019-0962-6.

Helck A., Bianda N., Canton G. et al. Intra-individual comparison of carotid and femoral atherosclerotic plaque features with in vivo MR plaque imaging. Int J Cardiovasc Imaging. 2015; 31: 1611-1618. doi: 10.1007/s10554-015-0737-4.

Altin C., Sade L.E., Gezmis E. et al. Assessment of epicardial adipose tissue and carotid/femoral intima media thickness in insulin resistance. J Cardiol. 2017; 69: 843-850. doi: 10.1016/j.jjcc.2016.08.006.

Acar B., Ozeke O., Karakurt M. et al. Association of Prediabetes With Higher Coronary Atherosclerotic Burden Among Patients With First Diagnosed Acute Coronary Syndrome. Angiology. 2019; 70(2): 174-180. doi: 10.1177/0003319718772420.

Sumin A.N., Bezdenezhnykh N.A., Bezdenezhnykh A.V. Pre-surgery status and in-hospital complications of coronary bypass grafting in prediabetes and type 2 diabetes patients. Russian Journal of Cardiology. 2018; (5): 40-48. doi: 10.15829/1560-4071-2018-5-40-48 [in Russian].

Ferrannini E. Definition of intervention points in prediabetes. Lancet Diabetes Endocrinol. 2014; 2: 667-675. doi: 10.1016/S2213-8587(13)70175-X.

Buysschaert M., Medina J.L., Bergman M. et al. Prediabetes and associated disorders. Endocrine. 2015; 48: 371-393. doi: 10.1007/s12020-014-0436-2.

Wasserman D.H., Wang T.J., Brown N.J. The vasculature in prediabetes. Circ Res. 2018; 122: 1135-1150. doi: 10.1161/CIRCRESAHA.118.311912.

Park G.M., Cho Y.R., Lee S.W. et al. Prediabetes is not a risk factor for subclinical coronary atherosclerosis. Int J Cardiol. 2017; 243: 479-484. doi: 10.1016/j.ijcard.2017.05.073.

Reis J.P., Allen N.B., Bancks M.P. et al. Duration of diabetes and prediabetes during adulthood and subclinical atherosclerosis and cardiac dysfunction in middle age: the CARDIA study. Diabetes Care. 2018; 41: 731-738. doi: 10.2337/dc17-2233.

Krysiak R., Szkróbka W., Okopień B. Sexual functioning and depressive symptoms in men with various types of prediabetes: a pilot study. Int J Impot Res. 2018; 30(6): 327-334. doi: 10.1038/s41443-018-0050-6.

Krysiak R., Drosdzol-Cop A., Skrzypulec-Plinta V. et al. Sexual functioning and depressive symptoms in women with various types of prediabetes — a pilot study. Endokrynol Pol. 2018; 69(2): 175-181. doi: 10.5603/EP.2018.0021.

Serlachius A., Elovainio M., Juonala M. et al. The Association Between Social Support, Body Mass Index and Increased Risk of Prediabetes: the Cardiovascular Risk in Young Finns Study. Int J Behav Med. 2017; 24(2): 161-170. doi: 10.1007/s12529-016-9597-0.

Hilding A., Shen C., Östenson C.G. Social network and development of prediabetes and type 2 diabetes in middle-aged Swedish women and men. Diabetes Res Clin Pract. 2015; 107(1): 166-177. doi: 10.1016/j.diabres.2014.09.057.

2017 IDF clinical practice recommendations for managing type 2 diabetes in primary care. [Electronic resource]. URL: https://www.idf.org/e-library/guidelines/128-idf-clinical-practice-recommendationsformanaging-type-2-diabetes-in-primary-care.html. (date of the application: 17.06.2020).

NICE 2017 Type 2 diabetes: prevention in people at high risk. [Electronic resource]. URL: nice. org.uk/guidance/ph38. (date of the application: 17.06.2020).

Diabetes Canada Clinical Practice Guidelines Expert Committee, Ekoe JM, Goldenberg R, Katz P. Screening for Diabetes in Adults. Can J Diabetes. 2018; 42 Suppl 1:S16-S19. doi:10.1016/j.jcjd.2017.10.004.

Wang G., Radovick S., Xu X. et al. Strategy for early identification of prediabetes in lean populations: New insight from a prospective Chinese twin cohort of children and young adults. Diabetes Res Clin Pract. 2018; 146: 101-110. doi: 10.1016/j.diabres.2018.10.003.

Davis P.J., Liu M., Sherman S. et al. HbA1c, lipid profiles and risk of incident type 2 Diabetes in United States Veterans. PLoS One. 2018 Sep 13; 13(9):e0203484. doi:10.1371/journal.pone.0203484.

Vistisen D., Witte D.R., Brunner E.J. et al. Risk of Cardiovascular Disease and Death in Individuals With Prediabetes Defined by Different Criteria: The Whitehall II Study. Diabetes Care. 2018 Apr; 41(4): 899-906. doi:10.2337/dc17-2530.

Paprott R., Scheidt-Nave C., Heidemann C. Determinants of Change in Glycemic Status in Individuals with Prediabetes: Results from a Nationwide Cohort Study in Germany. J Diabetes Res. 2018; 2018: 5703652. doi: 10.1155/2018/5703652.

Fares S., Said MSM., Ibrahim W. et al. Accuracy of salivary glucose assessment in diagnosis of diabetes and prediabestes. Diabetes Metab Syndr. 2019; 13(2): 1543-1547. doi: 10.1016/j.dsx.2019.03.010.

Mahat R.K., Singh N., Rathore V. Association of myeloperoxidase with cardiovascular disease risk factors in prediabetic subjects. Diabetes Metab Syndr. 2019; 13(1): 396-400. doi: 10.1016/j. dsx.2018.10.016.

Mahat R.K., Singh N., Rathore V. et al. Cross-sectional correlates of oxidative stress and inflammation with glucose intolerance in prediabetes. Diabetes Metab Syndr. 2019; 13(1): 616-621. doi: 10.1016/j.dsx.2018.11.045.

Yoshida N., Miyake T., Yamamoto S. et al. The Serum Creatinine Level Might Be Associated with the Onset of Impaired Fasting Glucose: A Community-based Longitudinal Cohort Health Checkup Study. Intern Med. 2019; 58(4): 505-510. doi: 10.2169/internalmedicine.0760-18.

Jiménez-Lucena R., Camargo A., Alcalá-Diaz J.F. et al. A plasma circulating miRNAs profile predicts type 2 diabetes mellitus and prediabetes: from the CORDIOPREV study. Exp Mol Med. 2018; 50(12): 168. doi: 10.1038/s12276-018-0194-y.

Al-Hamdan R., Avery A., Salter A. et al. Identification of Education Models to Improve Health Outcomes in Arab Women with Pre-Diabetes. Nutrients. 2019; 11(5). pii: E1113. doi: 10.3390/nu11051113.

Li G., Zhang P., Wang J. et al. Cardiovascular mortality, all-cause mortality, and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da Qing diabetes prevention study: a 23-year follow-up study. Lancet Diabetes Endocrinol. 2014; 2(6): 474-480. doi: 10.1016/S2213-8587(14)70057-9.

Saslow L.R., Daubenmier J.J., Moskowitz J.T. et al. Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes. Nutr Diabetes. 2017; 7(12): 304. doi: 10.1038/s41387-017-0006-9.

Sluik D., Brouwer-Brolsma E.M., Berendsen AAM. et al. Protein intake and the incidence of pre-diabetes and diabetes in 4 populationbased studies: the PREVIEW project. Am J Clin Nutr. 2019; 109(5): 1310-1318. doi: 10.1093/ajcn/nqy388.

Muscogiuri G., Barrea L., Di Somma C. et al. Patient empowerment and the Mediterranean diet as a possible tool to tackle prediabetes associated with overweight or obesity: a pilot study. Hormones (Athens). 2019; 18(1): 75-84. doi: 10.1007/s42000-018-0090-9.

Mirmiran P., Carlström M., Bahadoran Z. et al. Long-term effects of coffee and caffeine intake on the risk of pre-diabetes and type 2 diabetes: Findings from a population with low coffee consumption. Nutr Metab Cardiovasc Dis. 2018; 28(12): 1261-1266. doi: 10.1016/j.numecd.2018.09.001.

RezkAllah S.S., Takla M.K. Effects of Different Dosages of Interval Training on Glycemic Control in People With Prediabetes: A Randomized Controlled Trial. Diabetes Spectr. 2019; 32(2): 125-131. doi: 10.2337/ds18-0024.

Bock B.C., Dunsiger S.I., Wu W.C. et al. Reduction in HbA1c with Exercise videogames among participants with elevated HbA1c: Secondary analysis of the Wii Heart Fitness trial. Diabetes Res Clin Pract. 2019; 154: 35-42. doi: 10.1016/j.diabres.2019.06.011.

Strauss S.M., McCarthy M. Arthritis-Related Limitations Predict Insufficient Physical Activity in Adults With Prediabetes Identified in the NHANES 2011-2014. Diabetes Educ. 2017; 43(2): 163-170. doi: 10.1177/0145721717691849.

Sandoval-Rosario M., Nayeri B.M., Rascon A. et al. Prevalence of Arthritis Among Adults with Prediabetes and Arthritis-Specific Barriers to Important Interventions for Prediabetes — United States, 2009-2016. MMWR Morb Mortal Wkly Rep. 2018; 67(44): 1238-1241. doi: 10.15585/mmwr.mm6744a4.

Dunbar J.A., Hernan A.L., Janus E.D. on behalf of the Melbourne Diabetes Prevention Study (MDPS) research group, et al. Challenges of diabetes prevention in the real world: results and lessons from the Melbourne Diabetes Prevention Study. BMJ Open Diabetes Res Care. 2015; 3:e000131. doi: 10.1136/bmjdrc-2015-000131.

DPPOS. Lancet Diabetes Endocrinol. Published online September 14, 2015. [Electronic resource]. URL: http://dx.doi.org/10.1016/S2213-8587(15)00291-0 (date of the application: 17.06.2020).

Garber A.J., Abrahamson M.J., Barzilay J.I. et al. AACE/ACE Comprehensive type 2 diabetes management algorithm 2017. Endocrine Practice. 2017; 23(2): 207-227. doi:10.4158/CS-2018-0535.

Goldberg R.B., Temprosa M.G., Mather K.J. et al. Lifestyle and metformin interventions have a durable effect to lower CRP and tPA levels in the Diabetes Prevention Program except in those who develop diabetes. Diabetes Care. 2014; 37(8): 2253-2260. doi: 10.2337/dc13-2471.

Mohan M., Al-Talabany S., McKinnie A. et al. Metformin regresses left ventricular hypertrophy in normotensive patients with coronary artery disease without type 2 diabetes mellitus — the met-remodel trial. Heart 2018; 104:A6. doi: 10.1136/heartjnl-2018-BCS.6.

Zhou L., Liu H., Wen X. et al. Effects of metformin on blood pressure in nondiabetic patients. J Hypertens. 2017; 35(1): 18-26. doi: 10.1097/HJH.0000000000001119.

Goldberg R.B., Aroda V.R., Bluemke D.A. et al. Effect of Long-Term Metformin and Lifestyle in the Diabetes Prevention Program and Its Outcome Study on Coronary Artery Calcium. Circulation. 2017; 136(1): 52-64. doi: 10.1161/CIRCULATIONAHA.116.025483.

Ming J., Xu S., Liu C. et al. Effectiveness and safety of bifidobacteria and berberine in people with hyperglycemia: study protocol for a randomized controlled trial. Trials. 2018; 19(1): 72. doi: 10.1186/s13063-018-2438-5.

Barthow C., Hood F., McKinlay E. et al. Food 4 Health — He Oranga Kai: Assessing the efficacy, acceptability and economic implications of Lactobacillus rhamnosus HN001 and β-glucan to improve glycated haemoglobin, metabolic health, and general well-being in adults with pre-diabetes: study protocol for a 2 × 2 factorial design, parallel group, placebo-controlled randomized controlled trial, with embedded qualitative study and economic analysis. Trials. 2019; 20(1): 464. doi: 10.1186/s13063-019-3553-7.

Atkinson F.S., Villar A., Mulà A. et al. Abscisic Acid Standardized Fig (Ficus carica) Extracts Ameliorate Postprandial Glycemic and Insulinemic Responses in Healthy Adults. Nutrients. 2019; 11(8). pii: E1757. doi: 10.3390/nu11081757.

Yoo J.Y., Yum K.S. Effect of Coenzyme Q10 on Insulin Resistance in Korean Patients with Prediabetes: A Pilot Single-Center, Randomized, Double-Blind, Placebo-Controlled Study. Biomed Res Int. 2018; 2018:1613247. eCollection 2018. doi: 10.1155/2018/1613247.

The authors declare that there are no conflicts of interest present.