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


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.

Publication DOI: https://doi.org/10.1111/dme.14996
Divisions: College of Health & Life Sciences > School of Psychology
College of Health & Life Sciences > Aston Institute of Health & Neurodevelopment (AIHN)
College of Health & Life Sciences > Applied Health Research Group
College of Health & Life Sciences
College of Health & Life Sciences > School of Biosciences
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College of Health & Life Sciences > Chronic and Communicable Conditions
Additional Information: Copyright © 2022, The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License [https://creativecommons.org/licenses/by-nc/4.0/], which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. Funding statement: This study was funded by both the Type 2 Diabetes in the Youth (T2DMY) project and West Midlands NIHR Clinical Research Network (CRN).
Uncontrolled Keywords: epidemiology,incidence,pre-diabetes,progression,type 2 diabetes,Internal Medicine,Endocrinology, Diabetes and Metabolism,Endocrinology
Publication ISSN: 1464-5491
Full Text Link:
Related URLs: https://onlinel ... .1111/dme.14996 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2022-10-29
Published Online Date: 2022-10-29
Accepted Date: 2022-10-25
Authors: Gardner, Michael P.
Wang, Jingya
Hazlehurst, Jonathan M.
Sainsbury, Chris
Blissett, Jacqueline (ORCID Profile 0000-0002-0275-6413)
Nirantharakumar, Krishnarajah
Thomas, Neil
Bellary, Srikanth (ORCID Profile 0000-0002-5924-5278)


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