Prediabetes: problems of diagnostics and treatment of initial carbohydrate metabolism disorders in real-world practice (data from the PROFILE outpatient registry)

Abstract

Aim. To study the main characteristics of a cohort of patients with initial carbohydrate metabolism disorders (impaired glucose tolerance (IGT) or prediabetes), as well as real-world metformin prescription rate according to the PROFILE outpatient registry.Material and methods. This cross-sectional study was conducted within the PROFILE registry — an outpatient registry of the specialized cardiology department of the research center. All patients with cardiovascular diseases and related risk factors who sought con­sul­tation in this department were included. The PROFILE registry data­base, compiled on the basis of case report forms (CRFs), was used to determine the number of patients with an established diagnosis of IGT, the main characteristics of this cohort. We compared subgroups of pa­tients without carbohydrate metabolism disorders and with type 2 di­abetes (T2D), as well as assessed metformin prescription rate in pa­tients with IGT.Results. At the time of the study, 2619 people were included in the PROFILE registry, of which 1321 (50,4%) were men. According to the CRFs (initial visit), the diagnosis of IGT was established in 290 (11,1%) patients. In this cohort, there were 129 (44,5%) men, while the mean age of all patients with IGT was 61,4±12,3 years. Patients with prediabetes and diabetes were significantly more likely (p<0,05) to have obesity, hypertension, dyslipidemia, and heart failure than patients with normal carbohydrate metabolism parameters. Drug prevention of diabetes was recommended only to 13 (4,5%) patients with IGT. In the group receiving metformin, there were significantly more patients with obesity — 84,6 vs 52,2% (p=0,022). A tendency was also found for more frequent drug prevention of diabetes in adherent patients with IGT — 84,6 vs 59,9% (p=0,074).Conclusion. Within the outpatient registry of patients with cardio­vas­cular diseases and related risk factors, the IGT was established in 11,1% of patients. Women predominated in this cohort. Patients with prediabetes occupied an intermediate position in comorbidity bur­den between individuals with normal glycemia and patients with diabe­tes. Metformin therapy for prediabetes in real-world practice was pre­scribed only in 4,5% of cases.#Working group of the PROFILE registry: Budaeva I. V., Voronina V. P., Dmitrieva N. A., Drapkina O. M., Zagrebelny A. V., Kutishenko N. P., Lerman O. V., Lukina Yu. V., Martsevich S. Yu., Nekoshnova E. S., Tolpygina S. N., Shepel R. N.

Keywords

• prediabetes
• impaired glucose tolerance
• drug prophylaxis
• metformin