| Peer-Reviewed

The National Jordanian Experts Consensus on Diagnosis and Treatment of Prediabetes

Received: 6 February 2021    Accepted: 23 February 2021    Published: 4 March 2021
Views:       Downloads:
Abstract

Background and aims: The prevalence of prediabetes is increasing in Jordan and the Middle East region, which is leading to increased risk of type 2 diabetes and micro- and macro-complications. The aims of the expert panel were to understand and evaluate the current prediabetes situation and practice in Jordan and make recommendations to standardize the management of patients with prediabetes in Jordan. Methods: A panel of diabetes experts met to discuss and review all the current literature related to the region and international guidelines on prediabetes. The panel evaluated and developed a comprehensive understanding, addressing the definition, screening, diagnosis, pharmacological treatment, and management of prediabetes with consideration of local factors. Results: The experts relied on international data to establish criteria with cut-off values for screening and diagnosis to identify asymptomatic patients with prediabetes and diabetes. The panel made protocol recommendations, including lifestyle modifications, and developed potential treatment algorithms to provide guidance on the overall management for Jordanian prediabetic patients. Conclusion: The panel of experts reached consensus recommendations with a tailored detection, screening, and treatment algorithm in anticipation for a country wide adoption and implementation. These recommendations would help increase awareness of prediabetes in Jordan and create local guidelines to better serve Jordanian physicians in the management of patients with prediabetes.

Published in International Journal of Diabetes and Endocrinology (Volume 6, Issue 1)
DOI 10.11648/j.ijde.20210601.18
Page(s) 46-53
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Prediabetes, Consensus, Jordan, Management

References
[1] Williams R. IDF Diabetes Atlas, 9th Edition (2019): Global picture, 35. Viewed 29-10-2019, https://www.diabetesatlas.org/upload/resources/material/20200302_133351_IDFATLAS9e-final-web.pdf.
[2] World Health Organization. (2018). Obesity and overweight. Viewed 29-10-2019, https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
[3] Punthakee Z, Goldenberg R, and Katz P. Diabetes Canada Clinical Practice Guidelines Expert Committee. Definition, classification and diagnosis of Diabetes, Prediabetes and Metabolic Syndrome. Can J Diabetes. 2018 Apr; 42 Suppl 1: S10-S15. doi: 10.1016/j.jcjd.2017.10.003.
[4] World Health Organization. (2006). Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia: Report of a WHO/IDF consultation; WHO: Geneva, Switzerland. Viewed 29-10-2019, http://www.who.int/diabetes/publications/Definition%20and%20diagnosis%20of%20diabetes_new.pdf.
[5] American Diabetes Association. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes. Diabetes Care 2019; 42 (Suppl. 1): S13–S28. https://doi.org/10.2337/dc19-S002.
[6] Garber A, Handelsman Y, Einhorn D, et al. Diagnosis and Management of Prediabetes in the Continuum of Hyperglycemia – When do the Risks of Diabetes Begin? A Consensus Statement from the American College of Endocrinology and the American Association of Clinical Endocrinologists. Endocr Pract. 2008 Oct; 14 (7): 933-46. doi: 10.4158/EP.14.7.933.
[7] Bansal, N. Prediabetes diagnosis and treatment: A review. World J Diabetes. 2015; Mar 15; 6 (2): 296–303.
[8] Moss SE., Klein R, and Klein B E. The Validity of Estimating the Incidence of Diabetic Retinopathy from Prevalence. Am J Epidemiol. 1990; Apr; 131 (4): 644-51. doi: 0.1093/oxfordjournals.aje.a115548.
[9] Gabir, MM, Hanson RL, Dabelea D, Imperatore G, Roumain J, Bennett PH, and Knowleret WC. Plasma Glucose and Prediction of Microvascular Disease and Mortality. Diabetes Care. 2000 Aug; 23 (8): 1113-8. doi: 10.2337/diacare.23.8.1113.
[10] Nielson C. and Lange T. Blood Glucose and Heart Failure in Nondiabetic Patients. Diabetes Care. 2005 Mar; 28 (3): 607-11. doi: 10.2337/diacare.28.3.607.
[11] Nielson C., Lange T. and Hadjokas N. Blood Glucose and Coronary Artery Disease in Nondiabetic Patients. Diabetes Care. 2006 May; 29 (5): 998-1001. doi: 10.2337/diacare.295998.
[12] Yip W C Y, Sequeira IR, Plank LD, and Poppitt SD. Prevalence of Prediabetes across Ethnicities: A review of impaired fasting glucose (IFG) and Impaired Glucose Tolerance (IGT) for classification of dysglycaemia. Nutrients. 2017 Nov 22; 9 (11): 1273. doi: 10.3390/nu9111273.
[13] Knowler WC, Barrett-Connor E, Fowler SE,. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or Metformin. N Engl J Med. 2002 Feb 7; 346 (6): 393-403. doi: 10.1056/NEJMoa012512.
[14] Gillies CL, Abrams KR, Lambert PC, et al. Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. BMJ. 2007 Feb 10; 334 (7588): 299. doi: 10.1136/bmj.39063.689375.55. Epub 2007 Jan 19.
[15] Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, and Laakso A. Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance: the STOP-NIDDM trial. JAMA. 2003 Jul 23; 290 (4): 486-94. doi: 10.1001/jama.290.4.486.
[16] Ratner R, Goldberg R, Haffneret S, et al. Impact of intensive lifestyle and metformin therapy on cardiovascular disease risk factors in the diabetes prevention program. Diabetes Care. 2005 Apr; 28 (4): 888-94. doi: 10.2337/diacare.28.4.888.
[17] Dagenais GR. Dagenais GR, Gerstein HC, et al. Effects of Ramipril and Rosiglitazone on cardiovascular and renal outcomes in people with impaired glucose tolerance or impaired fasting glucose: results of the diabetes reduction assessment with Ramipril and Rosiglitazone medication (DREAM) trial. Diabetes Care. 2008 May; 31 (5): 1007-14. doi: 10.2337/dc07-1868.
[18] Boutayeb A, Lamlili ME, Boutayeb W, Maamri A, Ziyyat A, and Ramdani N. The rise of diabetes prevalence in the Arab region. 2012; Open Journal of Epidemiology 2 (02): 55-60
[19] Mokdad AH, Tuffaha M, Hanlon M, et al. Cost of Diabetes in the Kingdom of Saudi Arabia, 2014. J Diabetes Metab 2015, 6: 8 http://dx.doi.org/10.4172/2155-6156.1000575
[20] Alarouj M, Bennakhi A, Alnesef Y, Sharifi M, and Elkum N. Diabetes and associated cardiovascular risk factors in the State of Kuwait: The first national survey. Int J Clin Pract. 2013 Jan; 67 (1): 89-96. doi: 10.1111/ijcp.12064.
[21] Al Zurba Fl, and Al Garf A. Prevalence of diabetes mellitus among Bahrainis attending primary health care centres. EMHJ. 1996; 2 (‎2)‎: 274-282.
[22] Malik M, Bakir A, Saab BA, and King, H. Glucose intolerance and associated factors in the multi-ethnic population of the United Arab Emirates: results of a national survey. Diabetes Res Clin Pract. 2005 Aug; 69 (2): 188-95. doi: 10.1016/j.diabres.2004.12.005.
[23] Mansour AA. Al-Maliky AA, Kasem B, Jabar A, and Mosbeh KA. Prevalence of diagnosed and undiagnosed diabetes mellitus in adults aged 19 years and older in Basrah, Iraq. Diabetes Metab Syndr Obes. 2014 May 2; 7: 139-44. doi: 10.2147/DMSO.S59652. eCollection 2014.
[24] Al-Lawati JA, Panduranga P, Al-Shaikh HA, et al. Epidemiology of Diabetes Mellitus in Oman. Sultan Qaboos Univ Med J. 2015 May; 15 (2): e226-33. Epub 2015 May 28.
[25] Bener A, Zirie M, Janahi IM, Al-Hamaq AO, Musallam M, and Wareham NJ. Prevalence of diagnosed and undiagnosed diabetes mellitus and its risk factors in a population-based study of Qatar. Diabetes Res Clin Pract. 2009 Apr; 84 (1): 99-106. doi: 10.1016/j.diabres.2009.02.003.
[26] Gunaid, AA and Assabri AM. Prevalence of type 2 diabetes and other cardiovascular risk factors in a semirural area in Yemen. East Mediterr Health J. Jan-Feb 2008; 14 (1): 42-56.
[27] Abdul Rahim HF, Husseini A, Giacaman R, Jervell J, and Bjertness E. Diabetes mellitus in an urban Palestinian population: prevalence and associated factors. EMHJ. 2001; 7 (‎1-2)‎: 67-78.
[28] Albache, N. Al Ali R, Rastam S, Fouad FM, Mzayek F, and Maziak W. Epidemiology of Type 2 diabetes mellitus in Aleppo, Syria. J Diabetes. 2010 Jun; 2 (2): 85-91. doi: 10.1111/j.1753-0407.2009.00063.x. Epub 2009 Nov 2.
[29] Hirbli KI, Jambeine MA, Slim HB, Barakat WM, and Habis RJ, Francis ZM. Prevalence of diabetes in greater Beirut. Diabetes Care. 2005 May; 28 (5): 1262. doi: 10.2337/diacare.28.5.1262.
[30] Ben Rodhane H, Ben Ali S, Aissi W, et al. Prevalence of diabetes in Northern African countries: the case of Tunisia. BMC Public Health. 2014 Jan 28; 14: 86. doi: 10.1186/1471-2458-14-86.
[31] Kadiki OA and Roaeid R. Prevalence of diabetes mellitus and impaired glucose tolerance in Benghazi Libya. Diabetes Metab. 2001 Dec; 27 (6): 647-54.
[32] Rguibi M and Belahsen R. Prevalence and associated risk factors of undiagnosed diabetes among adult Moroccan Sahraoui women. Public Health Nutr. 2006 Sep; 9 (6): 722-7. doi: 10.1079/phn2005866.
[33] Ajlouni K, Jaddou H, and Batieha A. Diabetes and impaired glucose tolerance in Jordan: prevalence and associated risk factors. J Intern Med. 1998 Oct; 244 (4): 317-23. doi: 10.1046/j.1365-2796.1998.00369.x.
[34] The Ministry of Health of Jordan. The National Strategy And Plan Of Action Against Diabetes, Hypertension, Dyslipidemia And Obesity in Jordan. Viewed 29Oct., 2019, https://www.moh.gov.jo/EchoBusV3.0/SystemAssets/PDFs/PDFs%20AR/Strategies_AR/%D8%A7%D9%84%D8%A7%D8%B3%D8%AA%D8%B1%D8%A7%D8%AA%D9%8A%D8%AC%D9%8A%D8%A9%20%D8%A7%D9%84%D9%88%D8%B7%D9%86%D9%8A%D8%A9%20%D9%84%D9%84%D9%88%D9%82%D8%A7%D9%8A%D8%A9%20%D9%85%D9%86%20%D8%A7%D9%84%D8%A7%D9%85%D8%B1%D8%A7%D8%B6%20%D8%BA%D9%8A%D8%B1%20%D8%A7%D9%84%D8%B3%D8%A7%D8%B1%D9%8A%D8%A9.pdf.
[35] Tabák AG, Herder C, Rathmann W, Brunne EJr, and Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet. 2012 Jun 16; 379 (9833): 2279-90. doi: 10.1016/S0140-6736(12)60283-9.
[36] International Diabetes Federation (2017). IDF Diabetes Atlas - 8th Edition. Viewed 29-10-2019, https://www.idf.org/e-library/epidemiology-research/diabetes-atlas.html.
[37] Al-Rifai RH and Aziz F. Prevalence of type 2 diabetes, prediabetes, and gestational diabetes mellitus in women of childbearing age in Middle East and North Africa, 2000-2017: protocol for two systematic reviews and meta-analyses. Syst Rev. 2018 Jul 18; 7 (1): 96. doi: 10.1186/s13643-018-0763-0.
[38] World Health Organization. (2016). Jordan. Viewed 29-102019, https://www.who.int/diabetes/country-profiles/jor_en.pdf.
[39] The DECODE Study Group. Age- and Sex-Specific Prevalences of Diabetes and Impaired Glucose Regulation in 13 European Cohorts. Diabetes Care. 2003 Jan; 26 (1): 61-9. doi: 10.2337/diacare.26.1.61.
[40] Al-Shudifat AE, Al-Shdaifat A, Al-Abdouh AA. et al. Diabetes Risk Score in a Young Student Population in Jordan: A Cross-Sectional Study. J Diabetes Res. 2017; 2017: 8290710. doi: 10.1155/2017/8290710.
[41] Dajani R, Khader YS, Fatahallah R, El-Khateeb M, Shiyab A, and Hakooz N. Diabetes mellitus in genetically isolated populations in Jordan: prevalence, awareness, glycemic control, and associated factors. J Diabetes Complications. May-Jun 2012; 26 (3): 175-80. doi: 10.1016/j.jdiacomp.2012.03.009.
[42] Dorcely B, Katz K, Jagannathan R, et al. Novel Biomarkers for prediabetes, diabetes, and associated complications. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2017; 10: 345-361.
[43] The United States Preventive Services Task Force. (2015). Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Screening. Viewed 29 Oct., 2019, https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/screening-for-abnormal-blood-glucose-and-type-2-diabetes.
[44] American Diabetes Association (2018). Standards of Medical Care in Diabetes 2018. Diabetes Care, 41 (1). Viewed 29 Oct., 2019, http://diabetesed.net/wp-content/uploads/2017/12/2018-ADA-Standards-of-Care.pdf.
[45] International Diabetes Federation. (2003). Test2Prevent: Know Your Risk. Viewed 29Oct., 2019, https://www.idf.org/type-2-diabetes-risk-assessment/.
[46] Buysschaert M. Medina JL, Buysschaert B, and Bergmanet M Definitions (and Current Controversies) of Diabetes and Prediabetes. Curr Diabetes Rev. 2016; 12 (1): 8-13. doi: 10.2174/1573399811666150122150233.
[47] Guo F, Moellering, DR, and Garvey WT. Use of HbA1c for diagnoses of diabetes and prediabetes: comparison with diagnoses based on fasting and 2-hr glucose values and effects of gender, race, and age. Metab Syndr Relat Disord. 2014; 12 (5): 258–268.
[48] Knowler WC, Barrett-Connor E, Fowler SE, et al. Diabetes Prevention Program Research Group. Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. N Engl J Med. 2002 Feb 7; 346 (6): 393-403. doi: 10.1056/NEJMoa012512.
[49] The Diabetes Prevention Program Research Group. The 10-Year Cost-Effectiveness of Lifestyle Intervention or Metformin for Diabetes Prevention. Diabetes Care. 2012 Apr; 35 (4): 723-30. doi: 10.2337/dc11-1468.
[50] Lindström J, Louheranta A, Mannelin M, el al. The Finnish Diabetes Prevention Study (DPS) Lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care. 2003 Dec; 26 (12): 3230-6. doi: 10.2337/diacare.26.12.3230.
[51] Li G, Zhang P, Wang P, et al. The long-term effect of lifestyle Interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study. Lancet. 2008 May 24; 371 (9626): 1783-9. doi: 10.1016/S0140-6736(08)60766-7.
[52] Andersen J, Konz EC, Frederich RC, and Wood CL. Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr. 2001 Nov; 74 (5): 579-84. doi: 10.1093/ajcn/74.5.579.
[53] Aroda VR, Knowler WC, Crandall JP, et al. Metformin for diabetes prevention: insights gained from the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study. Diabetologia. 2017 Sep; 60 (9): 1601-1611. doi: 10.1007/s00125-017-4361-9.
[54] Zinman B, Harris SB, Neuman J, et al. Low-dose combination therapy with Rosiglitazone and Metformin to prevent type 2 diabetes mellitus (CANOE trial): a double-blind randomised controlled study. Lancet. 2010 Jul 10; 376 (9735): 103-11. Doi 10.1016/S0140-6736(10)60746-5. Epub 2010 Jun 3.
Cite This Article
  • APA Style

    Mohamad Omar Abu Hijleh, Firas Annabi, Mousa Abujbara, Abdelkarim Alkhawaldeh, Fares Haddad, et al. (2021). The National Jordanian Experts Consensus on Diagnosis and Treatment of Prediabetes. International Journal of Diabetes and Endocrinology, 6(1), 46-53. https://doi.org/10.11648/j.ijde.20210601.18

    Copy | Download

    ACS Style

    Mohamad Omar Abu Hijleh; Firas Annabi; Mousa Abujbara; Abdelkarim Alkhawaldeh; Fares Haddad, et al. The National Jordanian Experts Consensus on Diagnosis and Treatment of Prediabetes. Int. J. Diabetes Endocrinol. 2021, 6(1), 46-53. doi: 10.11648/j.ijde.20210601.18

    Copy | Download

    AMA Style

    Mohamad Omar Abu Hijleh, Firas Annabi, Mousa Abujbara, Abdelkarim Alkhawaldeh, Fares Haddad, et al. The National Jordanian Experts Consensus on Diagnosis and Treatment of Prediabetes. Int J Diabetes Endocrinol. 2021;6(1):46-53. doi: 10.11648/j.ijde.20210601.18

    Copy | Download

  • @article{10.11648/j.ijde.20210601.18,
      author = {Mohamad Omar Abu Hijleh and Firas Annabi and Mousa Abujbara and Abdelkarim Alkhawaldeh and Fares Haddad and Jihad Haddad and Muwafaq Alhyari and Harry Howlett and Nadim Jarrah and Nadima Shegem and Murad Al-Naqshbandi},
      title = {The National Jordanian Experts Consensus on Diagnosis and Treatment of Prediabetes},
      journal = {International Journal of Diabetes and Endocrinology},
      volume = {6},
      number = {1},
      pages = {46-53},
      doi = {10.11648/j.ijde.20210601.18},
      url = {https://doi.org/10.11648/j.ijde.20210601.18},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20210601.18},
      abstract = {Background and aims: The prevalence of prediabetes is increasing in Jordan and the Middle East region, which is leading to increased risk of type 2 diabetes and micro- and macro-complications. The aims of the expert panel were to understand and evaluate the current prediabetes situation and practice in Jordan and make recommendations to standardize the management of patients with prediabetes in Jordan. Methods: A panel of diabetes experts met to discuss and review all the current literature related to the region and international guidelines on prediabetes. The panel evaluated and developed a comprehensive understanding, addressing the definition, screening, diagnosis, pharmacological treatment, and management of prediabetes with consideration of local factors. Results: The experts relied on international data to establish criteria with cut-off values for screening and diagnosis to identify asymptomatic patients with prediabetes and diabetes. The panel made protocol recommendations, including lifestyle modifications, and developed potential treatment algorithms to provide guidance on the overall management for Jordanian prediabetic patients. Conclusion: The panel of experts reached consensus recommendations with a tailored detection, screening, and treatment algorithm in anticipation for a country wide adoption and implementation. These recommendations would help increase awareness of prediabetes in Jordan and create local guidelines to better serve Jordanian physicians in the management of patients with prediabetes.},
     year = {2021}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - The National Jordanian Experts Consensus on Diagnosis and Treatment of Prediabetes
    AU  - Mohamad Omar Abu Hijleh
    AU  - Firas Annabi
    AU  - Mousa Abujbara
    AU  - Abdelkarim Alkhawaldeh
    AU  - Fares Haddad
    AU  - Jihad Haddad
    AU  - Muwafaq Alhyari
    AU  - Harry Howlett
    AU  - Nadim Jarrah
    AU  - Nadima Shegem
    AU  - Murad Al-Naqshbandi
    Y1  - 2021/03/04
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijde.20210601.18
    DO  - 10.11648/j.ijde.20210601.18
    T2  - International Journal of Diabetes and Endocrinology
    JF  - International Journal of Diabetes and Endocrinology
    JO  - International Journal of Diabetes and Endocrinology
    SP  - 46
    EP  - 53
    PB  - Science Publishing Group
    SN  - 2640-1371
    UR  - https://doi.org/10.11648/j.ijde.20210601.18
    AB  - Background and aims: The prevalence of prediabetes is increasing in Jordan and the Middle East region, which is leading to increased risk of type 2 diabetes and micro- and macro-complications. The aims of the expert panel were to understand and evaluate the current prediabetes situation and practice in Jordan and make recommendations to standardize the management of patients with prediabetes in Jordan. Methods: A panel of diabetes experts met to discuss and review all the current literature related to the region and international guidelines on prediabetes. The panel evaluated and developed a comprehensive understanding, addressing the definition, screening, diagnosis, pharmacological treatment, and management of prediabetes with consideration of local factors. Results: The experts relied on international data to establish criteria with cut-off values for screening and diagnosis to identify asymptomatic patients with prediabetes and diabetes. The panel made protocol recommendations, including lifestyle modifications, and developed potential treatment algorithms to provide guidance on the overall management for Jordanian prediabetic patients. Conclusion: The panel of experts reached consensus recommendations with a tailored detection, screening, and treatment algorithm in anticipation for a country wide adoption and implementation. These recommendations would help increase awareness of prediabetes in Jordan and create local guidelines to better serve Jordanian physicians in the management of patients with prediabetes.
    VL  - 6
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Jordan Center for Thyroid, Endocrine Diseases and Diabetes, Jordan Hospital & Medical Center, Amman, Jordan

  • Islamic Hospital, Amman, Jordan

  • The National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan

  • >Al Raja’a Medical Center, Amman, Jordan

  • King Hussein Medical Center, Royal Medical Services, Amman, Jordan

  • Prince Hamzah Hospital, Ministry of Health, Amman, Jordan

  • Prince Hamzah Hospital, Ministry of Health, Amman, Jordan

  • Global Diabetes Amersham, London, United Kingdom

  • The Specialty Hospital, Amman, Jordan

  • Caritas Jordan, Amman, Jordan

  • Merck Serono Middle East, Dubai, UAE

  • Sections