Determinants of Change in Glycemic Status in Individuals with Prediabetes: Results from a Nationwide Cohort Study in Germany
Previous studies investigating determinants of changes in glycemic status among individuals with prediabetes mainly focused on glucose-defined prediabetes. In this study, we examined determinants of a regression to normoglycemia or a progression to diabetes among individuals with HbA1c-defined predi...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2018/5703652 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832559806408294400 |
|---|---|
| author | Rebecca Paprott Christa Scheidt-Nave Christin Heidemann |
| author_facet | Rebecca Paprott Christa Scheidt-Nave Christin Heidemann |
| author_sort | Rebecca Paprott |
| collection | DOAJ |
| description | Previous studies investigating determinants of changes in glycemic status among individuals with prediabetes mainly focused on glucose-defined prediabetes. In this study, we examined determinants of a regression to normoglycemia or a progression to diabetes among individuals with HbA1c-defined prediabetes. The study included 817 participants (18–79 years) with prediabetes (HbA1c 5.7–6.4% (39–47 mmol/mol)) at baseline. Glycemic status at follow-up was categorized as diagnosed diabetes (self-reported physician diagnosis or antidiabetic medication), undiagnosed diabetes (HbA1c ≥ 6.5% (≥48 mmol/mol)), prediabetes (as defined at baseline), and normoglycemia (HbA1c < 5.7% (<39 mmol/mol)). Determinants of glycemic changes were identified by multinomial logistic regression (OR (95% CI)), with those remaining in the prediabetic state as reference. During a mean follow-up time of 12.0 years, 33.8% of the participants reverted to normoglycemia, 7.2% progressed to undiagnosed diabetes, 12.8% progressed to diagnosed diabetes, and 46.2% remained prediabetic. Determinants of a regression to normoglycemia were female sex (male vs. female: 0.67 (0.46; 0.98)) and higher HDL cholesterol levels (1.17 (1.02; 1.35) per 10 mg/dl). Determinants of a progression to undiagnosed or diagnosed diabetes were higher values of BMI (1.10 (1.02; 1.18); 1.13 (1.06; 1.21) per kg/m2), waist circumference (1.04 (1.01; 1.07); 1.06 (1.03; 1.09) per cm), alanine aminotransferase (1.06 (1.03; 1.09); 1.07 (1.03; 1.10) per U/l), and gamma-glutamyl transferase (1.02 (1.00; 1.03); 1.03 (1.01; 1.04) per U/l). Higher age (1.04 (1.02; 1.06) per year), female sex (male vs. female: 0.56 (0.33; 0.97)), and parental history of diabetes (yes vs. no: 1.82 (1.05; 3.15)) were further associated with a progression to diagnosed diabetes, whereas higher triglyceride levels (1.03 (1.01; 1.06) per 10 mg/dl) were associated with a progression to undiagnosed diabetes. In conclusion, among the investigated determinants, potentially modifiable anthropometric and metabolic markers were associated with glycemic changes in individuals with HbA1c-defined prediabetes. The findings of this study demonstrate the need for more refined case finding strategies for diabetes prevention. |
| format | Article |
| id | doaj-art-fc586307361d4db69a05c48d04b73fc7 |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-fc586307361d4db69a05c48d04b73fc72025-02-03T01:29:17ZengWileyJournal of Diabetes Research2314-67452314-67532018-01-01201810.1155/2018/57036525703652Determinants of Change in Glycemic Status in Individuals with Prediabetes: Results from a Nationwide Cohort Study in GermanyRebecca Paprott0Christa Scheidt-Nave1Christin Heidemann2Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, GermanyDepartment of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, GermanyDepartment of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, GermanyPrevious studies investigating determinants of changes in glycemic status among individuals with prediabetes mainly focused on glucose-defined prediabetes. In this study, we examined determinants of a regression to normoglycemia or a progression to diabetes among individuals with HbA1c-defined prediabetes. The study included 817 participants (18–79 years) with prediabetes (HbA1c 5.7–6.4% (39–47 mmol/mol)) at baseline. Glycemic status at follow-up was categorized as diagnosed diabetes (self-reported physician diagnosis or antidiabetic medication), undiagnosed diabetes (HbA1c ≥ 6.5% (≥48 mmol/mol)), prediabetes (as defined at baseline), and normoglycemia (HbA1c < 5.7% (<39 mmol/mol)). Determinants of glycemic changes were identified by multinomial logistic regression (OR (95% CI)), with those remaining in the prediabetic state as reference. During a mean follow-up time of 12.0 years, 33.8% of the participants reverted to normoglycemia, 7.2% progressed to undiagnosed diabetes, 12.8% progressed to diagnosed diabetes, and 46.2% remained prediabetic. Determinants of a regression to normoglycemia were female sex (male vs. female: 0.67 (0.46; 0.98)) and higher HDL cholesterol levels (1.17 (1.02; 1.35) per 10 mg/dl). Determinants of a progression to undiagnosed or diagnosed diabetes were higher values of BMI (1.10 (1.02; 1.18); 1.13 (1.06; 1.21) per kg/m2), waist circumference (1.04 (1.01; 1.07); 1.06 (1.03; 1.09) per cm), alanine aminotransferase (1.06 (1.03; 1.09); 1.07 (1.03; 1.10) per U/l), and gamma-glutamyl transferase (1.02 (1.00; 1.03); 1.03 (1.01; 1.04) per U/l). Higher age (1.04 (1.02; 1.06) per year), female sex (male vs. female: 0.56 (0.33; 0.97)), and parental history of diabetes (yes vs. no: 1.82 (1.05; 3.15)) were further associated with a progression to diagnosed diabetes, whereas higher triglyceride levels (1.03 (1.01; 1.06) per 10 mg/dl) were associated with a progression to undiagnosed diabetes. In conclusion, among the investigated determinants, potentially modifiable anthropometric and metabolic markers were associated with glycemic changes in individuals with HbA1c-defined prediabetes. The findings of this study demonstrate the need for more refined case finding strategies for diabetes prevention.http://dx.doi.org/10.1155/2018/5703652 |
| spellingShingle | Rebecca Paprott Christa Scheidt-Nave Christin Heidemann Determinants of Change in Glycemic Status in Individuals with Prediabetes: Results from a Nationwide Cohort Study in Germany Journal of Diabetes Research |
| title | Determinants of Change in Glycemic Status in Individuals with Prediabetes: Results from a Nationwide Cohort Study in Germany |
| title_full | Determinants of Change in Glycemic Status in Individuals with Prediabetes: Results from a Nationwide Cohort Study in Germany |
| title_fullStr | Determinants of Change in Glycemic Status in Individuals with Prediabetes: Results from a Nationwide Cohort Study in Germany |
| title_full_unstemmed | Determinants of Change in Glycemic Status in Individuals with Prediabetes: Results from a Nationwide Cohort Study in Germany |
| title_short | Determinants of Change in Glycemic Status in Individuals with Prediabetes: Results from a Nationwide Cohort Study in Germany |
| title_sort | determinants of change in glycemic status in individuals with prediabetes results from a nationwide cohort study in germany |
| url | http://dx.doi.org/10.1155/2018/5703652 |
| work_keys_str_mv | AT rebeccapaprott determinantsofchangeinglycemicstatusinindividualswithprediabetesresultsfromanationwidecohortstudyingermany AT christascheidtnave determinantsofchangeinglycemicstatusinindividualswithprediabetesresultsfromanationwidecohortstudyingermany AT christinheidemann determinantsofchangeinglycemicstatusinindividualswithprediabetesresultsfromanationwidecohortstudyingermany |