アブストラクト | PURPOSE: Few studies have examined patients with prediabetes in usual, "real-world" clinical practice settings. Among patients with impaired fasting glucose (IFG), we aimed to describe the rates of progression to diabetes and to examine the long-term reduction in diabetes risk associated with regression to normoglycemia at 1 year. METHODS: The UK-based study included 120 055 non-diabetic patients in Clinical Practice Research Datalink from 2001 to 2012 aged 25+ years and with >/=1 fasting plasma glucose (FPG) test between >/=6.1 and <7.0 mmol/l indicating IFG who were followed for progression to diabetes. In a subgroup of 45 167 patients with IFG with subsequent FPG results 1 year later, we assessed the 1-year glycemic status change and estimated the relative hazard of diabetes comparing patients with regression to normoglycemia (IFG-normoglycemia) to those who remained in IFG (IFG-IFG) using a multivariable Cox model. RESULTS: Among patients with IFG with over 414 649 person-years of follow-up, 52% received a subsequent FPG test, and 10% developed diabetes within 1 year after recognition of IFG. The incidence rate of diabetes was 5.86 (95% CI: 5.78 to 5.93) per 100 person-years. In the subgroup analysis, 31% of these patients remained in IFG, while 53% and 16% converted to normoglycemia or diabetes, respectively. The adjusted hazard ratio of developing diabetes was 0.33 (95% CI: 0.31 to 0.35) comparing IFG-normoglycemia to IFG-IFG. CONCLUSIONS: IFG is a high-risk state for diabetes. Regression to normoglycemia from IFG strongly reduces the long-term risk of developing diabetes. Our study also shows the feasibility of identifying patients with IFG in the Clinical Practice Research Datalink. Copyright (c) 2016 John Wiley & Sons, Ltd. |
ジャーナル名 | Pharmacoepidemiology and drug safety |
投稿日 | 2016/5/20 |
投稿者 | Hong, Jin-Liern; McNeill, Ann Marie; He, Jinghua; Chen, Yong; Brodovicz, Kimberly G |
組織名 | Department of Epidemiology, UNC Gillings School of Global Public Health,;University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.;Department of Epidemiology, Merck & Co., Inc., Kenilworth, NJ, USA. |
Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/27193175/ |