Background: Diabetes mellitus type 2 is a growing disease that affects both adults and children. Common risk factors for developing diabetes type 2 are low physical activity and abdominal obesity. The disease can bring complications such as cardiovascular disease and hypoglycemia. Pre-diabetes is a pre-stage to develop diabetes mellitus type 2. However, lifestyle changes can prevent the progress of diabetes mellitus type 2. In order to make the lifestyle changes that are required, motivation is of great importance. Aim: The aim of this study was to describe experiences of furtherance and inhibitive motivational factors to lifestyle changes among persons with pre-diabetes and diabetes mellitus type 2. Method: The method used was a literature study based on qualitative research. The articles in the study were analyzed accordingly to Friberg's five step model and resulted in three themes and eight sub-themes. Results: The themes were; an internal motivating force, support from the surrounding as a motivational factor and inner and outer barriers that inhibit for the motivation. In order to support and motivate persons with pre-diabetes and diabetes mellitus type 2 the nurse must understand what it is that helps persons find the motivation to make lifestyle changes. Conclusion: Promoting and inhibiting motivational factors for lifestyle changes varies from person to person. / Diabetes mellitus typ 2 är en sjukdom som ökar i hela världen. Prediabetes är ett förstadium till diabetes mellitus typ 2. Tidigare forskning visar att livsstilsförändringar är grundläggande för att förhindra riskfaktorer och komplikationer. Motivation är en förutsättning hos personen med diabetes mellitus typ 2 för att genomföra och bibehålla en livsstilsförändring. Sjuksköterskan har en betydelsefull funktion genom att ge stöd och motivera personerna. Vad är det som anses främja och hindra motivationen? Detta examensarbete beskriver personers erfarenheter av faktorer som främjade och hindrade motivationen till livsstilsförändringar vid prediabetes och diabetes mellitus typ 2. Tio artiklar som behandlar ämnet har bearbetats och utifrån dessa har teman utformats. Resultatet visade att inre drivkraft och stöd från omgivningen var betydelsefulla motiverande faktorer till skillnad från inre och yttre barriärer som istället var hindrade för motivationen. Den inre drivkraften är viktig men individuell och sjuksköterskan bör ha ett personcentrerat förhållningssätt för att kartlägga vad som anses motiverande till livsstilsförändring. Mer forskning krävs kring motiverande faktorer till livsstilsförändringar samt sjuksköterskans förmåga att kunna motivera.

Introduction: Diabetes is a global and rapidly increasing disease that in 2014 affected morethan 422 million people, and takes 1,2 million lives per year. The importance of identifyingnew ways to manage and prevent the disease has led science to a new area – modulation ofthe gut microbiota. It is well known that the composition of gut microbiota differs betweennon-diabetic and diabetic adults, and that nutrition is the main way to modulate gutmicrobiota composition. Food and lifestyle are of great importance for the development andtreatment of type 2 diabetes and pre-diabetes, but less is known about whether gut microbiotamodulation is mediating that link. Aim: The aim is to examine whether there is a scientifically well-supported link between diet,gut microbiota and the development or treatment of type 2 diabetes or pre-diabetes in humans. Methods: Systematic review with literature search via PubMed and Cochrane, following themanual from the Swedish Agency for Health Technology Assessment and Assessment ofSocial Services (SBU). Results: Of 12 articles finally included, two studies found a strong impact of diet on diabetesrelatedvariables via modulation of gut microbiota. Another four studies did not find anassociation, and six studies lacked sufficient data to be able to draw a conclusion. Dietinterventions and study design differed between studies, which led to heterogeneous results. Conclusions: This review demonstrates a large knowledge gap in how dietary modificationscan prevent or treat type 2 diabetes or pre-diabetes via changes in gut microbiota.

No description available.

Introdução: A lesão do podócito exerce um papel crítico na nefropatia diabética (ND) e é um fator preditivo de albuminúria patológica e progressão da doença. Neste estudo foi avaliada a expressão gênica de proteínas associadas ao podócito na urina de pacientes diabéticos em diferentes estágios da ND e em indivíduos com pré diabetes. Material e Métodos: Foram estudados 67 pacientes diabéticos com normo (n=34), micro (n=14) ou macroalbuminúria (n=19), dezenove indivíduos pré diabéticos e 15 controles saudáveis. O RNAm de nefrina, podocina, podocalixina, sinaptopodina, Transient Receptor Potential Cation Channel 6 (TRPC6), alfa actinina-4 e TGF1 foi quantificado por PCR em tempo real (2-ΔΔCt) em células do sedimento urinário. A expressão dos genes alvo do podócito foi correlacionada com albuminúria, controle glicêmico e função renal. O desempenho diagnóstico dos genes para albuminúria patológica foi determinado por curva ROC, e o seu efeito independente sobre esse desfecho foi avaliado por análise de regressão de Poisson. Resultados: O RNAm na urina dos genes alvo foi significativamente maior nos pacientes diabéticos em comparação aos não diabéticos, exceto de sinaptopodina e TGFβ1. A expressão de nefrina foi mais elevada nos indivíduos diabéticos micro e macroalbuminúricos comparado aos controles (p=0,04 e p<0,001 respectivamente), pré diabéticos (p<0,05) e normoalbuminúricos (p<0,05). Embora sua expressão tenha sido maior do que nos não diabéticos, os genes TRPC6, podocalixina e alfa actinina-4 não discriminaram os estágios da ND. A correlação da expressão dos genes com albuminúria e hemoglobina glicada foi estatisticamente significativa. Pacientes pré diabéticos tiveram expressão gênica semelhante aos controles. Na análise multivariada, apenas o gene da nefrina foi preditivo de albuminúria patológica. 6 Conclusões: A expressão das proteínas associadas ao podócito na urina foi maior nos pacientes diabéticos, mas não houve correlação direta do RNAm dos genes com níveis crescentes de albuminúria, exceto de nefrina. O gene da nefrina foi o único que discriminou os diferentes estágios da ND e foi preditivo de albuminúria patológica, mas a podocalixina e o TRPC6 também se correlacionaram com albuminúria e controle glicêmico. Neste estudo preliminar não se identificou aumento da expressão gênica das proteínas do podócito na urina em indivíduos com pré diabetes. / Introduction: Podocyte damage plays a critical role in the development of diabetic nephropathy (DN). The present study evaluated gene expression of podocyte-associated proteins in urine of pre-diabetic and diabetic patients at different stages of DN. Material and Methods: We studied 19 pre-diabetic patients, 67 diabetic patients with normo (n = 34), micro (n = 15), or macroalbuminuria (n = 19), and 15 healthy controls. Levels of mRNA of nephrin, podocin, podocalyxin, synaptopodin, transient receptor potential cation channel 6 (TRPC6), alpha-actinin-4, and TGF-1 were quantitatively measured by real-time polymerase chain reaction in urinary sediment. Gene expression was correlated with albuminuria, glycemic control, and renal function. The diagnostic performance of the genes for detecting pathological albuminuria was assessed by the receiver operating characteristic (ROC) curve and Poisson regression. Results: The mRNA expression of target genes in urinary sediment was significantly higher in diabetic compared to pre-diabetic patients and controls. Levels of nephrin were higher in diabetic patients with micro or macroalbuminuria than controls (p= 0.04 and p<0.001, respectively), pre-diabetic (p<0.05), and diabetic patients with normoalbuminuria (p<0.05), and increased with increasing rates of albuminuria. Gene expression was similar in pre-diabetic patients and controls. There was a significant positive correlation of gene expression with albuminuria and glycated hemoglobin. In the multivariate analysis, only nephrinuria predicted pathological albuminuria. Conclusions: The expression of podocyte-associated proteins in urine was higher in diabetic patients, but only nephrin correlated with increasing albuminuria and predicted 8 pathological albuminuria. This preliminary study did not find increased gene transcription in pre-diabetic patients.

Introdução: A lesão do podócito exerce um papel crítico na nefropatia diabética (ND) e é um fator preditivo de albuminúria patológica e progressão da doença. Neste estudo foi avaliada a expressão gênica de proteínas associadas ao podócito na urina de pacientes diabéticos em diferentes estágios da ND e em indivíduos com pré diabetes. Material e Métodos: Foram estudados 67 pacientes diabéticos com normo (n=34), micro (n=14) ou macroalbuminúria (n=19), dezenove indivíduos pré diabéticos e 15 controles saudáveis. O RNAm de nefrina, podocina, podocalixina, sinaptopodina, Transient Receptor Potential Cation Channel 6 (TRPC6), alfa actinina-4 e TGF1 foi quantificado por PCR em tempo real (2-ΔΔCt) em células do sedimento urinário. A expressão dos genes alvo do podócito foi correlacionada com albuminúria, controle glicêmico e função renal. O desempenho diagnóstico dos genes para albuminúria patológica foi determinado por curva ROC, e o seu efeito independente sobre esse desfecho foi avaliado por análise de regressão de Poisson. Resultados: O RNAm na urina dos genes alvo foi significativamente maior nos pacientes diabéticos em comparação aos não diabéticos, exceto de sinaptopodina e TGFβ1. A expressão de nefrina foi mais elevada nos indivíduos diabéticos micro e macroalbuminúricos comparado aos controles (p=0,04 e p<0,001 respectivamente), pré diabéticos (p<0,05) e normoalbuminúricos (p<0,05). Embora sua expressão tenha sido maior do que nos não diabéticos, os genes TRPC6, podocalixina e alfa actinina-4 não discriminaram os estágios da ND. A correlação da expressão dos genes com albuminúria e hemoglobina glicada foi estatisticamente significativa. Pacientes pré diabéticos tiveram expressão gênica semelhante aos controles. Na análise multivariada, apenas o gene da nefrina foi preditivo de albuminúria patológica. 6 Conclusões: A expressão das proteínas associadas ao podócito na urina foi maior nos pacientes diabéticos, mas não houve correlação direta do RNAm dos genes com níveis crescentes de albuminúria, exceto de nefrina. O gene da nefrina foi o único que discriminou os diferentes estágios da ND e foi preditivo de albuminúria patológica, mas a podocalixina e o TRPC6 também se correlacionaram com albuminúria e controle glicêmico. Neste estudo preliminar não se identificou aumento da expressão gênica das proteínas do podócito na urina em indivíduos com pré diabetes. / Introduction: Podocyte damage plays a critical role in the development of diabetic nephropathy (DN). The present study evaluated gene expression of podocyte-associated proteins in urine of pre-diabetic and diabetic patients at different stages of DN. Material and Methods: We studied 19 pre-diabetic patients, 67 diabetic patients with normo (n = 34), micro (n = 15), or macroalbuminuria (n = 19), and 15 healthy controls. Levels of mRNA of nephrin, podocin, podocalyxin, synaptopodin, transient receptor potential cation channel 6 (TRPC6), alpha-actinin-4, and TGF-1 were quantitatively measured by real-time polymerase chain reaction in urinary sediment. Gene expression was correlated with albuminuria, glycemic control, and renal function. The diagnostic performance of the genes for detecting pathological albuminuria was assessed by the receiver operating characteristic (ROC) curve and Poisson regression. Results: The mRNA expression of target genes in urinary sediment was significantly higher in diabetic compared to pre-diabetic patients and controls. Levels of nephrin were higher in diabetic patients with micro or macroalbuminuria than controls (p= 0.04 and p<0.001, respectively), pre-diabetic (p<0.05), and diabetic patients with normoalbuminuria (p<0.05), and increased with increasing rates of albuminuria. Gene expression was similar in pre-diabetic patients and controls. There was a significant positive correlation of gene expression with albuminuria and glycated hemoglobin. In the multivariate analysis, only nephrinuria predicted pathological albuminuria. Conclusions: The expression of podocyte-associated proteins in urine was higher in diabetic patients, but only nephrin correlated with increasing albuminuria and predicted 8 pathological albuminuria. This preliminary study did not find increased gene transcription in pre-diabetic patients.

>Magister Scientiae - MSc / Type 2 diabetes mellitus (T2DM), a metabolic disease characterized by chronic hyperglycemia, is the most prevalent form of diabetes globally, affecting approximately 95 % of the total number of people with diabetes i.e. approximately 366 million. Furthermore, it is also the most prevalent form in South Africa (SA), affecting approximately 3.5 million individuals. This disease and its adverse complications can be delayed or prevented if detected early. Standardized diagnostic tests for T2DM have a few limitations which include the inability to predict the future risk of normal glucose tolerance individuals developing T2DM, they are dependent on blood glucose concentration, its invasiveness, and they cannot specify between T1DM and T2DM. Therefore, there is a need for biomarkers which could be used as a tool for the early and specific detection of T2DM. MicroRNAs are small non-coding RNA molecules which play a key role in controlling gene expression and certain biological processes. Studies show that dysregulation of microRNAs may lead to various diseases including T2DM, and thus, may be useful biomarkers for disease detection. Therefore, identifying biomarkers like microRNAs as a tool for the early and specific detection of T2DM, have great potential for diagnostic purposes. The main focus of this investigation, therefore, is the early detection of T2DM by the identification and validation of novel biomarkers. Furthermore, based on previous studies, the aim of the investigation was to identify differentially expressed miRNAs as well as identify their potential target genes associated with the onset and progression of T2DM. An in silico approach was used to identify miRNAs found to be differentially expressed in the serum/plasma of T2DM individuals. Three publically available target prediction software were used for target gene prediction of the identified miRNA. The target genes were subjected to functional analysis using a web-based software, namely DAVID. Functions which were clustered with an enrichment score > 1.3 were considered significant. The ranked target genes mostly had gene ontologies linked with “transcription regulation”, “neuron signalling, and “metal ion binding”. The ranked target genes were then split into two lists – an up-regulated (ur) miRNA targeted gene list and a down-regulated (dr) miRNA targeted gene list. The in silico method used in this investigation produced a final total of 4 miRNAs: miR-dr-1, miR-ur-1, miR-ur-2, and miR-ur-3. Based on the bioinformatics results, miR-dr-1 and its target genes LDLR, PPARA and CAMTA1, seemed the most promising miRNA for biomarker validation, due to the function of the target genes being associated with T2DM onset and progression. The expression levels of the miRNAs were then profiled in kidney tissue of male Wistar rats that were on a high fat diet (HFD), streptozotocin (STZ)-induced T1DM, and non-diabetic control rats via qRT-PCR analysis. The hypothesis was that similar miRNA expression would be found in the HFD kidney samples compared to serum expression levels of the miRNA obtained from the two databases, since kidneys are involved in cleansing the blood from impurities. This hypothesis proved to be true for all miRNAs except for miR-ur-2. Additionally, miR-ur-1 seemed the most significant miRNA due to it having different expression ratios for T1DM and T2DM (i.e. -7.65 and 4.2 fold, respectively). Future work, therefore, include validation of the predicted target genes to the miRNAs of interest i.e. miR-dr-1: PPARA and LDLR and miR-ur-1: CACNB2, using molecular approaches such as the luciferase assays and western blots.

Over the past few decades, there has been an increase in prevalence of diabetes in the United States. Prevention of diabetes and improving patients' knowledge and awareness of diabetes are crucial for healthcare providers. Using the Health Belief Model (HBM) as a theoretical foundation, the student used the National Diabetes Prevention Program (NDPP) from the Centers for Disease Control and Prevention (CDC), to improve awareness and knowledge of diabetes among obese individuals with prediabetes. The key research question of this project was to determine whether the patients' diabetes knowledge and awareness improved after the NDPP program. A convenience sample of 30 participants was recruited from patients seeking care at a family practice clinic. Data collection was conducted using the Michigan Diabetes Research and Training Center's Diabetes Knowledge Test (DKT). Pretest and posttests were used to evaluate improvement in the participants' knowledge and awareness after administration of education sessions. The t-tests indicated a significant improvement in the patients' knowledge (p < 0.000) and awareness (p < 0.000) of diabetes after the NDPP program. Thus, the NDPP program was effective in improving the patients' diabetes knowledge and awareness. The nationwide adoption of the NDPP program was recommended to reduce the rate of diabetes among high risk individuals. The implication of this Doctor of Nursing Practice (DNP) project to social change was that improving knowledge and awareness of diabetes among obese patients with prediabetes would increase their participation in lifestyle and behavioral modification programs, thus, improving the control of blood sugar levels.

Thesis (M.Sc. (Physiology)) -- University of Limpopo, 2019 / Background Type 2 diabetes mellitus (T2DM) is an increasing challenge globally, and is estimated to affect 439 million adults by 2030. This estimate is linked to an unhealthy lifestyle with characteristics such as low physical activity (PA) and high plasma glucose levels (PGLs). Studies associating PA with insulin resistance and diabetes among adults and adolescents have been conducted widely in developed countries. Such studies are scanty among rural populations, especially in Africa. Assessment of the burden of diabetes and associated lifestyle risk factors in developing countries is essential in order to encourage appropriate intervention strategies to counter the increasing prevalence. Aim and objectives The aim of this study was to investigate the relationship between PA and T2DM among rural young adults aged 22 to 30 years in Ellisras area in Limpopo Province, South Africa Methods A total of 713 young adults (349 males and 364 females) who have been part of the Ellisras Longitudinal Study participated in the current study. Physical activity data was collected using a validated questionnaire. After an overnight fast, participants provided fasting venous blood samples for determination of plasma glucose and insulin. Insulin resistance was estimated using the homeostasis model assessment of insulin resistance. Anthropometric measurements (waist circumference and height) were performed using standard procedures. Linear and logistic regressions were used to assess the relationship between PA, pre-diabetes, insulin resistance and T2DM; and the odds of having T2DM with low PA levels. Results The prevalence of physical inactivity was 67.3 and 71.0% for males and females, respectively. That of pre-diabetes was between 45.7% and 50.2%. The prevalence of diabetes was 9.6% for males and 10.1% for females while for insulin resistance was 22.9% for males and 29.3% for females. Linear regression found a significant relationship (p<0.05) between physical activity and blood glucose (ß =5.715; 95% CI 4.545; 6.885), waist circumference (ß = 37.572; 95% CI 25.970; 49.174) and waist-toheight ratio (ß = 0.192; 95% CI 0.087; 0.296). Logistic regression found a significant (p<0.05) relationship between low physical activity and T2DM (Odds ratio = 2.890; 95% CI 1.715; 4.870) and insulin resistance (Odds ratio = 1.819; 95% CI 1.266; 2.614). Conclusion Physical activity is low in this population, and is independently associated with T2DM and insulin resistance. KEY WORDS Type 2 diabetes mellitus; pre-diabetes; insulin resistance; physical activity; young adults; rural South African population. / Vrije University, Amsterdam, The Netherlands, and the University of Limpopo

Submitted by Verônica Esteves (vevenesteves@gmail.com) on 2018-01-05T16:00:19Z No. of bitstreams: 1 Dissert-Anderson Tavares.pdf: 1862042 bytes, checksum: 2153b40b56c3fdbc8e29efcd55346634 (MD5) / Approved for entry into archive by Verônica Esteves (vevenesteves@gmail.com) on 2018-01-05T16:05:29Z (GMT) No. of bitstreams: 1 Dissert-Anderson Tavares.pdf: 1862042 bytes, checksum: 2153b40b56c3fdbc8e29efcd55346634 (MD5) / Made available in DSpace on 2018-01-05T16:05:29Z (GMT). No. of bitstreams: 1 Dissert-Anderson Tavares.pdf: 1862042 bytes, checksum: 2153b40b56c3fdbc8e29efcd55346634 (MD5) Previous issue date: 2017 / Universidade Federal Fluminense / A inflamação e o estresse oxidativo são os precursores das complicações do diabetes mellitus tipo 2 (DM2). Além disso o baixo controle glicêmico pode levar ao aumento do estresse oxidativo e inflamação, bem como à diminuição da atividade antioxidante. Para testar esta hipótese, comparamos os níveis séricos e plasmáticos de marcadores antioxidantes enzimáticos e não enzimáticos, de estresse oxidativo e de inflamação em indivíduos DM2, pré-diabéticos (pré-DM) e não diabéticos (controles). Os dados (mediana [intervalo interquartis]) relacionados a sexo, idade e níveis de hemoglobina glicada (HbA1c) foram calculados a partir de dados obtidos dos prontuários dos pacientes. O total de 111 indivíduos foi avaliado e dividido nos seguintes grupos de acordo com os níveis de HbA1c: grupo controle (n=12), HbA1c = 5,4 (5,2 - 5,5) %, idade média de 57 (50 - 73) anos; grupo pré-DM (n=12), HbA1c = 6,2 (6,1 - 6.3) %, idade média de 54 (49 - 67) anos; pacientes DM2 (n=89). Os pacientes DM2 foram ainda divididos em três grupos, de acordo com os níveis de HbA1c: Grupo A (HbA1c <7%, 63 (56 - 66) anos, n=28), Grupo B (HbA1c 7-9%, 57 (51 - 62) anos, n=32) e Grupo C (HbA1c >9%, 58 (49 - 63) anos, n=29). Foram avaliados através de KITs específicos as atividades superóxido dismutase (SOD) e glutationa peroxidase (GPX), os níveis de tióis totais, óxido nítrico (•NO), fator de necrose tumoral alfa (TNF-α) e molécula de adesão intercelular 1 (ICAM-1) dos indivíduos. A atividade SOD plasmática foi maior nos indivíduos DM2 do que nos controles, e no Grupo A em relação ao grupo pré-DM. Os níveis de tióis totais foram menores nos grupos DM2 quando comparados ao pré-DM. Os níveis de ICAM-1 dos grupos DM2 foram menores do que no grupo controle, enquanto a atividade GPx, os níveis de •NO total e TNF-a foram semelhantes entre os grupos. Concluindo, os indivíduos com DM2 parecem apresentar estresse oxidativo mais acentuado do que os indivíduos controle e pré-DM, mas o nível de controle glicêmico não pareceu interferir no estado oxidativo e inflamatório dos pacientes com DM2. / Inflammation and oxidative stress are the precursors of type 2 diabetes mellitus (T2DM) complications and poor controlled glycaemia may lead to increased oxidative stress and inflammation and decreased antioxidant activity. To test this hypothesis, we compared serum and plasma levels of antioxidant, oxidative stress and inflammation markers in T2DM, pre-diabetic (pre-DM) and non-diabetics (controls) individuals. Data (median [interquartile range]) related to sex, age and glycated hemoglobin (HbA1c) levels were calculated from data obtained from patients' records. The total of 111 individuals was evaluated and divided into the following groups according to HbA1c levels: control group (n=12), HbA1c = 5.4 (5.2 - 5.5) %, mean age of 57 (50 - 73) years; pre-DM group (n=12), HbA1c = 6.2 (6.1 - 6.3) %, mean age of 54 (49 - 67) years; T2DM pacients (n=89). The T2DM patients were further divided into three groups, according to HbA1c levels: Group A (HbA1c <7%, 63 (56 - 66) years, n=28), Group B (HbA1c 7-9%, 57 (51 - 62) anos, n=32) e Group C (HbA1c >9%, 58 (49 - 63) years, n=29). We measured, through specific KITs, superoxide dismutase (SOD) and glutathione peroxidase (GPX) activity, total thiols, nitric oxide (•NO), tumor necrosis factor alpha (TNF-α) and intercellular adhesion molecule 1 (ICAM-1) levels of the individuals. Plasma SOD activity was higher in DM2 subjects than in controls and in Group A in relation to the pre-DM group. Total thiols levels were lower in T2DM groups when compared to pre-DM. ICAM-1 levels of T2DM groups were lower than in control group, while GPx activity, total •NO and TNF-α levels were similar among groups. In conclusion, individuals with T2DM appear to have more pronounced oxidative stress than control and pre-DM individuals, but the degree of glycemic control did not seem to have interfered in the oxidative and inflammatory status of T2DM patients.

Introdução: Glicemia de jejum alterada tem sido associada a maior risco de desenvolver diabetes, comparando a indivíduos normoglicêmicos. Apesar de diabetes ser relacionado a aterosclerose e a piores desfechos cardiovasculares, os dados de literatura relacionando glicemia de jejum alterada à doença aterosclerótica são conflitantes. Os objetivos deste trabalho foram determinar (a) a incidência de diabetes em indivíduos com glicemia de jejum normal ou alterada em 1998 após um seguimento de até 12 anos; (b) se a glicemia de jejum alterada em 1998 e/ou diabetes incidente estiveram associados com aterosclerose subclínica no Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) ou à variável combinada de eventos clínicos não-fatais e escore de cálcio coronariano maior ou igual a 400. Métodos: Avaliamos 1.536 trabalhadores da Universidade de São Paulo, que participaram de um programa de avaliação em 1998 (idade 23-63 anos) e da linha de base do ELSA-Brasil (2008-2010). Apresentamos as taxas de incidência de diabetes brutas e ajustadas para todos os indivíduos e também estratificados por gênero e por índice de massa corpórea (IMC) em 1998. Utilizamos modelos de regressão brutos e ajustados para estimar a associação entre glicemia de jejum alterada em 1998 ou diabetes incidente com a espessura de íntima-média de carótidas (EIMC), escore de cálcio coronariano (CACS, do inglês Coronary Artery Calcium Score) e a variável composta CACS >= 400 ou eventos cardiovasculares incidentes (infarto do miocárdio ou revascularização). Resultados: Encontramos diabetes incidente em 177 indivíduos. A incidência de diabetes em nossa amostra foi de 9,8/1.000 pessoas-ano (Intervalo de confiança de 95% [IC95%]: 7,7-13,6). A incidência foi mais elevada entre os homens (11,2/1.000 pessoas-ano, IC95%: 8,6-15,0) do que entre as mulheres (8,5/1.000 pessoas-ano, IC95%: 5,3-15,3). Glicemia de jejum alterada em 1998 mostrou associação com maior risco de progressão para diabetes ao longo do seguimento (hazard ratio [HR]: 3,17; IC95%: 2,14-4,68) e HR: 7,42; IC95%: 4,75-11,57 para glicemias de jejum entre 100 e 109mg/dl e entre 110 e 125mg/dl, respectivamente). Glicemias entre 110 e 125mg/dl em 1998 foram associadas a maiores valores de EIMC (beta=+0,028; IC95%: 0,003 a 0,053) na linha de base do ELSA-Brasil. Ao excluir da análise aqueles com diabetes incidente, houve associação limítrofe, não-significativa, entre maiores valores de EIMC e glicemia de jejum entre 110 e 125mg/dl em 1998 (?=0,030; IC95%: -0,005 a 0,065). Ambos os níveis de glicemia de jejum alterada em 1998 não se mostraram associados ao CACS ou à variável composta de CACS >= 400 ou eventos cardiovasculares incidentes nos modelos de ajuste completo. Diabetes incidente foi associado a maiores valores de EIMC (em milímetros) (?=0,034; IC95%: 0,015 a 0,053), a CACS >= 400 (Razão de chances=2,84; IC95%: 1,17-6,91) e ao desfecho combinado de CACS >= 400 ou eventos cardiovasculares incidentes (Razão de chances=3,50; IC95%: 1,60-7,65). Conclusões: Glicemia de jejum alterada em 1998, especialmente nos valores mais próximos dos limiares de corte para diabetes, foram associados a maior incidência de diabetes ao longo do seguimento e a maiores valores de EIMC quando da avaliação inicial do ELSA-Brasil. Diabetes incidente entre as avaliações foi associado a maior risco cardiovascular / Introduction: Impaired fasting glucose has been associated with higher risk of incident diabetes, compared to normoglycemic individuals. Although diabetes mellitus is related to atherosclerosis and higher long-term cardiovascular burden, there are conflicting data about the association between impaired fasting glucose and atherosclerotic disease. We aimed (a) to determine diabetes incidence rates in individuals with normal or impaired fasting glucose in 1998 after follow-up of up to 12 years, (b) whether impaired fasting glucose in 1998 and/or incident diabetes were associated with subclinical atherosclerosis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) or the combined variable of non-fatal clinical events or a coronary calcium score >= 400. Methods: We evaluated 1,536 civil servants from the University of São Paulo, who participated in both 1998 (aged 23-63 years) and ELSA-Brasil baseline (2008-2010) assessments and had complete data. We presented crude and adjusted diabetes incident rates for all individuals and then stratified by sex and body mass index (BMI) in 1998. We used crude and adjusted regression models to estimate the association between impaired fasting glucose in 1998 or incident diabetes and coronary intima-media thickness (CIMT), coronary artery calcium score (CACS) and the composite variable of a CACS?400 or incident cardiovascular events (myocardial infarction or revascularization). Results: We found incident diabetes in 177 individuals. Diabetes incidence in our sample was 9.8/1,000 person-years (95% confidence interval [95%CI]:7.7-13.6). Diabetes incidence was higher in men (11.2/1,000 person-years, 95%CI: 8.6-15.0) than women (8.5/1,000 person-years, 95%CI: 5.3 to 15.3). Impaired fasting glucose in 1998 was associated with a higher risk of progression to diabetes during follow-up (hazard ratio [HR]: 3.17; 95%CI: 2.14-4.68 and HR: 7.42; 95%CI: 4.75-11.57 for a fasting plasma glucose between 100 to 109mg/dl and 110 to 125 mg/dl, respectively). Fasting plasma glucose levels between 110 to 125 mg/dl in 1998 were associated with higher CIMT (beta=+0.028; 95%CI: 0.003 to 0.053) in ELSA-Brasil baseline. Excluding those with incident diabetes, there was a non-significant borderline association between higher CIMT (in mm) and fasting plasma glucose 110 to 125mg/dl (beta=0.030; 95%CI: -0.005 to 0.065). Fasting plasma glucose levels in 1998 were not associated with CACS or the composite variable of a CACS ? 400 or incident cardiovascular events in full-adjusted models. Incident diabetes was associated with higher CIMT (in mm) (beta=0.034; 95%CI: 0.015 to 0.053), CACS >= 400 (OR=2.84; 95%CI: 1.17-6.91) and the combined outcome of a CACS >= 400 or incident cardiovascular event (OR=3.50; 95%CI: 1.60-7.65). Conclusions: Elevated fasting plasma glucose in 1998, especially those near diabetes diagnosis limits were associated with higher diabetes incidence during follow-up and higher CIMT in ELSA-Brasil baseline assessment. Incident diabetes between assessments was associated with higher cardiovascular burden