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

Michael P. Gardner; Jingya Wang; Jonathan M. Hazlehurst; Chris Sainsbury; Jacqueline Blissett; Krishnarajah Nirantharakumar; Neil Thomas; Srikanth Bellary

doi:10.1111/dme.14996

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

Michael P. Gardner, Jingya Wang, Jonathan M. Hazlehurst, Chris Sainsbury, Jacqueline Blissett, Krishnarajah Nirantharakumar, Neil Thomas, Srikanth Bellary

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English
Article number	e14996
Number of pages	10
Journal	Diabetic medicine
Early online date	29 Oct 2022
DOIs	https://doi.org/10.1111/dme.14996
Publication status	E-pub ahead of print - 29 Oct 2022

Bibliographical note

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).

Keywords

epidemiology
incidence
pre-diabetes
progression
type 2 diabetes

Access to Document

10.1111/dme.14996

Diabetic Medicine_2022_Gardner et al_Risk of progression from pre‐diabetes to type 2 diabetes in a large UK adult cohort
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.
Final published version, 172 KBLicence: CC BY-NC 4.0

Cite this

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

abstract = "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.",

keywords = "epidemiology, incidence, pre-diabetes, progression, type 2 diabetes",

author = "Gardner, {Michael P.} and Jingya Wang and Hazlehurst, {Jonathan M.} and Chris Sainsbury and Jacqueline Blissett and Krishnarajah Nirantharakumar and Neil Thomas and Srikanth Bellary",

note = "Copyright {\textcopyright} 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).",

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doi = "10.1111/dme.14996",

language = "English",

journal = "Diabetic medicine",

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T1 - Risk of progression from pre-diabetes to type 2 diabetes in a large UK adult cohort

AU - Gardner, Michael P.

AU - Wang, Jingya

AU - Hazlehurst, Jonathan M.

AU - Sainsbury, Chris

AU - Blissett, Jacqueline

AU - Nirantharakumar, Krishnarajah

AU - Thomas, Neil

AU - Bellary, Srikanth

N1 - 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).

PY - 2022/10/29

Y1 - 2022/10/29

N2 - 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.

AB - 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.

KW - epidemiology

KW - incidence

KW - pre-diabetes

KW - progression

KW - type 2 diabetes

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M3 - Article

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SN - 0742-3071

JO - Diabetic medicine

JF - Diabetic medicine

M1 - e14996

ER -

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

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Keywords

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