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Incidence rates and predictors of diabetes in those with prediabetes: the Strong Heart Study.
MedLine Citation:
PMID:  20578203     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The association between prediabetes as currently defined and incident diabetes in populations with widespread obesity, insulin resistance syndrome, and diabetes is not well defined. In this article, diabetes risk factors and incidence rates in American Indians (AI) with prediabetes are examined.
METHODS: A total of 1677 AI who were nondiabetic at baseline was examined during a median 7.8-year follow-up as part of the Strong Heart Study (SHS). Risk factors for incident diabetes were measured. Prediabetes was defined according to American Diabetes Association 2003 criteria as having impaired glucose tolerance (IGT) (2-h plasma glucose [2-h PG] >or= 140 mg/dL but < 200 mg/dL) and/or impaired fasting glucose (IFG) (fasting plasma glucose [FPG] >or= 100 mg/dL but < 126 mg/dL).
RESULTS: Prediabetes was identified by FPG alone in 87.5%. Diabetes incidence in those with baseline prediabetes was 66.1/1000 person-years, with a hazard ratio (HR) of 2.35 (95% conference interval: 1.84-3.01), compared with participants with normal glucose tolerance (NGT) at baseline. Elevated A(1c), 2-h PG, and fasting insulin (FI); albuminuria; and obesity were significantly associated with conversion from prediabetes to diabetes. Younger age, elevated FI (or body mass index [BMI] in models without FI), and less physical activity were significantly associated with conversion from NGT.
CONCLUSIONS: Prediabetes is an independent predictor of conversion to type 2 diabetes in AI, and most can be identified through a fasting glucose measure. Measures of obesity, A(1c), FPG, 2-h PG, FI, albuminuria, and insulin resistance (IR) help predict this conversion. Obesity is a modifiable risk factor. Strategies to reduce obesity should be emphasized in individuals with prediabetes.
Authors:
Hong Wang; Nawar M Shara; Darren Calhoun; Jason G Umans; Elisa T Lee; Barbara V Howard
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Diabetes/metabolism research and reviews     Volume:  26     ISSN:  1520-7560     ISO Abbreviation:  Diabetes Metab. Res. Rev.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-05     Completed Date:  2010-10-04     Revised Date:  2011-08-01    
Medline Journal Info:
Nlm Unique ID:  100883450     Medline TA:  Diabetes Metab Res Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  378-85     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 John Wiley & Sons, Ltd.
Affiliation:
MedStar Health Research Institute, Hyattsville, MD, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Arizona / epidemiology
Cohort Studies
Diabetes Mellitus, Type 2 / epidemiology*,  etiology
Female
Glucose Intolerance / epidemiology
Humans
Incidence
Indians, North American / statistics & numerical data*
Male
Middle Aged
North Dakota / epidemiology
Obesity / complications
Oklahoma / epidemiology
Prediabetic State / epidemiology*
Risk Factors
South Dakota / epidemiology
Grant Support
ID/Acronym/Agency:
U01 HL041642-12/HL/NHLBI NIH HHS; U01 HL041642-13/HL/NHLBI NIH HHS; U01 HL041642-13S1/HL/NHLBI NIH HHS; U01 HL041642-14/HL/NHLBI NIH HHS; U01 HL041642-15/HL/NHLBI NIH HHS; U01 HL041642-15S1/HL/NHLBI NIH HHS; U01 HL041642-16/HL/NHLBI NIH HHS; U01 HL041642-17/HL/NHLBI NIH HHS; U01 HL041642-17S1/HL/NHLBI NIH HHS; U01 HL041642-18A1/HL/NHLBI NIH HHS; U01 HL041642-19/HL/NHLBI NIH HHS; U01 HL041642-19S1/HL/NHLBI NIH HHS; U01 HL041642-20/HL/NHLBI NIH HHS; U01 HL041654-12/HL/NHLBI NIH HHS; U01 HL041654-13/HL/NHLBI NIH HHS; U01 HL041654-14/HL/NHLBI NIH HHS; U01 HL041654-14S1/HL/NHLBI NIH HHS; U01 HL041654-15/HL/NHLBI NIH HHS; U01 HL041654-16/HL/NHLBI NIH HHS; U01 HL041654-17/HL/NHLBI NIH HHS; U01 HL041654-17S1/HL/NHLBI NIH HHS; U01 HL041654-18A1/HL/NHLBI NIH HHS; U01 HL041654-19/HL/NHLBI NIH HHS; U01 HL041654-20/HL/NHLBI NIH HHS; U01 HL041654-21/HL/NHLBI NIH HHS; U01-HL41642/HL/NHLBI NIH HHS; U01-HL41652/HL/NHLBI NIH HHS; U01-HL65520/HL/NHLBI NIH HHS; U01-HL65521/HL/NHLBI NIH HHS; UL01-HL41654/HL/NHLBI NIH HHS
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