what is the glycemic “mini-curve” and what does it change for the diagnosis

Radical change in diagnoses diabetes and pre-diabetes. The International Diabetes Federation (IDF) has approved a new protocol for detecting the disease and its early forms which could allow an advance of at least two years compared to current procedures. The test is based on the first hour of the glucose load curve and redefines the parameters which marked the boundary between sick and healthy patients.

A decision that could have decisive effects on the prevention of the disease from which they suffer in Italy almost 4 million people. The new test is also based on the contribution of Italian scientific research. Here’s what will change for patients.

The rapid test for diabetes

The International Diabetes Federation, which brings together and coordinates all diabetology societies and associations of people affected by diabetes in the world, has redefined in a new position statement the blood sugar limits for which one is considered to have diabetes or to suffer from -diabetes (intermediate hyperglycemia). The new criterion for actual disease is set at a level of blood glucose levels above 209 mg/dlwhile for the intermediate phase it will be enough to exceed 155 mg/dl.

This is because the levels can be measured in the first hour of the glycemic load, an important change for the diagnosis of the disease as explained by Dr. Giorgio Sesti, professor of Internal Medicine at the Sapienza University of Rome and president of the SIMI Internal Medicine Society, in some statements: “The new diagnostic criteria at the first hour of the load curve allow for early identification of subjects at increased risk of diabetes or already diabetics, who escape this diagnosis with the current diagnostic criteria.”

“This means that it will be possible to formulate the diagnosis of diabetes and pre-diabetes through a ‘mini-curve’ of glucose load of just one hour. But most of all, will allow us to intercept a series of subjects that current criteria do not allow us to identify as either pre-diabetics or diabetics. The ‘mini-curve’ represents a more practical and sensitive method to ‘capture’ a greater number of subjects at risk of developing frank diabetes and to recognize subjects with already established diabetes earlier” concluded Dr. Sesti.

The IDF reached these conclusions after having reviewed much of the scientific literature on the diagnosis of the disease and its intermediate phase. In recent years, much attention has been paid to the ability of first-hour glucose curve data to predict a subsequent increase in the risk of developing diabetes. This is not a completely new method, but it is already used for diagnosis gestational diabetes.

An important contribution to this decision came from Italy, thanks to the research carried out by“Magna Grecia” University of Catanzaro and by the Sant’Andrea La Sapienza University Hospital of Rome. In recent years, collaboration between these two institutions on the topic has led to the publication of over 40 articles that have directed the IDF to make the final decision to change the diagnostic criteria and allow rapid testing for diabetes.

What changes for patients

These new criteria for the diagnosis of diabetes and pre-diabetes could first of all allow for greater early detection of the disease. An effect on future patients could be to improve the vascular pathologies associated with the disease. In fact, complications of this type are often already present at the time of diagnosis. By effectively anticipating the test by two years, it could be much easier to prevent the patient from reaching this stage, both through drug therapy and through lifestyle changes, which diabetes is often associated with.

But the rapid test for diabetes also allows for the very early detection of intermediate hyperglycemia, or pre-diabetesAnd. This opens up new scenarios for the prevention of the disease. Discovering this pathology almost two years in advance allows you to block its progression, provided you apply rigid changes to the lifestyle that determines it. As a result, the rapid test realizes a real possibility of preventing diabetes.

The diabetes situation in Italy is serious and worsening. According to data released during the International Day against Diabetes, 14 November 2023, there are more than 4 million people affected in our country. 80 thousand people with diabetes die, it’s about 9 cases per hour that could be prevented. In the world, almost one in 10 adults suffers from the pathology and of these, almost all are affected by type 2 diabetes, which is acquired through a sedentary lifestyle and an unbalanced diet.

The latest data available regarding hospitalizations speak of more 15,000 cases in 2021, but these are largely cases that could be avoided by paying more attention to one’s health. The consequences are also economic. Healthcare spends more 50 million euros every year for hospitalizations of people with diabetes considered potentially avoidable. On average, the 4 million Italian diabetic patients are each hospitalized at least once a year. This is because the pathology exposes you to the risk of many other diseases.

It is also a very debilitating disease that significantly worsens the quality of life of those who suffer from it. In fact, it increases the risk of cardiovascular diseases, angina, heart attack, stroke, peripheral vascular disease, secondary to cerebral and peripheral arteriosclerosis. In diabetic patients these pathologies have a double to quadruple chance of occurring than in a healthy patient.

Then there are neuropathies, which affect one in two people affected by diabetes. These are mainly peripheral neuropathies, with pain and tingling in the hands, feet and legs, which can degenerate into skin ulcers. From these derives one of the most well-known problems of diabetes, the diabetic foot. Ulcers can in fact become infected and lead to gangrene in the long term, forcing doctors to amputate part of the infected limb to prevent the infection from spreading to the rest of the body, causing the patient’s death.

Other well-known complications of diabetes are eye complications. Excess blood sugar can cause retinopathy and therefore blindness. The situation is also complicated kidneys, which can completely stop working and force the patient to require dialysis.