Risk of progression from pre-diabetes to type 2 diabetes in a large UK adult cohort

被引:4
作者
Gardner, Michael P. [1 ]
Wang, Jingya [1 ]
Hazlehurst, Jonathan M. [2 ]
Sainsbury, Chris [1 ]
Blissett, Jacqueline [3 ]
Nirantharakumar, Krishnarajah [1 ]
Thomas, Neil [1 ]
Bellary, Srikanth [3 ]
机构
[1] Univ Birmingham, Inst Appl Hlth Res, Birmingham, W Midlands, England
[2] Univ Birmingham, Inst Metab & Syst Res, Birmingham, W Midlands, England
[3] Aston Univ, Sch Hlth & Life Sci, Birmingham, W Midlands, England
关键词
epidemiology; incidence; pre-diabetes; progression; type; 2; diabetes;
D O I
10.1111/dme.14996
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims People with pre-diabetes are at high risk of progressing to type 2 diabetes. This progression is not well characterised by ethnicity, deprivation and age, which we describe in a large cohort of individuals with pre-diabetes. Methods A retrospective cohort study with The Health Improvement Network (THIN) database was conducted. Patients aged 18 years and over and diagnosed with pre-diabetes [HbA1c 42 mmol/mol (6.0%) to 48 mmol/mol (6.5%) were included]. Cox proportional hazards regression was used to calculate adjusted hazard rate ratios (aHR) for the risk of progression from pre-diabetes to type 2 diabetes for each of the exposure categories [ethnicity, deprivation (Townsend), age and body mass index (BMI)] separately. Results Of the baseline population with pre-diabetes (n = 397,853), South Asian (aHR 1.31; 95% CI 1.26-1.37) or Mixed-Race individuals (aHR 1.22; 95% CI 1.11-1.33) had an increased risk of progression to type 2 diabetes compared with those of white European ethnicity. Likewise, deprivation (aHR 1.17; 95% CI 1.14-1.20; most vs. least deprived) was associated with an increased risk of progression. Both younger (aHR 0.63; 95% CI 0.58-0.69; 18 to <30 years) and older individuals (aHR 0.85; 95% CI 0.84-0.87; >= 65 years) had a slower risk of progression from pre-diabetes to type 2 diabetes, than middle-aged (40 to <65 years) individuals. Conclusions South Asian or Mixed-Race individuals and people with social deprivation had an increased risk of progression from pre-diabetes to type 2 diabetes. Clinicians need to recognise the differing risk across their patient populations to implement appropriate prevention strategies.
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页数:10
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