Novel analytical approach for diabetes education based on screening outcomes from Japanese physical examination

Background: We examined the time-course changes in four variables, namely, fasting plasma glucose (FPG) level, fasting insulin level (FIL), homeostasis model assessment beta (HOMA-b) score, and homeostasis model assessment-insulin resistance (HOMA-IR) score. The variables were examined before and after the onset of diabetes mellitus (DM).Methods: In total, 1,333 Japanese men underwent four annual screenings for diabetes from April 2006 to March 2010. DM was defined as an FPG level ³ 126 mg/dL or glycated hemoglobin level ³ 6.5%. The variables were examined in healthy men and those with DM in the body mass index [BMI] ³ 25 and < 25 kg/m2 groups. The projected FPG level and FIL were assessed based on the simulated HOMA-b and HOMA-IR scores, which is considered a novel analytical approach.Results: In total, 99 (7.4%) men developed DM at any point of the screening periods. The HOMA-b values of the BMI ³ 25 kg/m2 group were 117.6% ± 72.9%, 60.4% ± 29.8%, and 43.1% ± 28.1% at baseline, onset, and 4 years after the onset, respectively. Thus, the decrease in the values was steep. Meanwhile, the HOMA-IR values of the BMI < 25 kg/m2 group were 1.7 ± 0.8 and 2.2 ± 1.2 at 1 year before onset and at onset. Hence, there was an important but slight increase in the values. This result indicates that patients presented with reduced insulin secretion and elevated IR during the onset of diabetes. The values of the four variables remained within normal ranges in healthy men.Conclusions: The novel analytical approach has clinical relevance as it provides a visual material for diabetes education, which is useful in providing caution against the risk of developing DM.