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Observational Study
. 2018:22:17-050.
doi: 10.7812/TPP/17-050.

A Simple Model for Predicting Two-Year Risk of Diabetes Development in Individuals with Prediabetes

Harry Glauber  1 , William M Vollmer  2 , Gregory A Nichols  3
Affiliations
Observational Study

A Simple Model for Predicting Two-Year Risk of Diabetes Development in Individuals with Prediabetes

Harry Glauber et al. Perm J. 2018.

Abstract

Context: Given the dramatic rise in the incidence of type 2 diabetes mellitus (T2DM) in recent decades, identifying individuals at increased risk of T2DM and validating methods to reduce their risk of disease progression is important. With more than one-third of US adults having prediabetes, a more precise stratification of absolute risk of T2DM incidence would help in prioritizing prevention efforts.

Objective: To develop a simple and clinically useful schema to stratify short-term (2-year) absolute risk of T2DM.

Design: Observational study of more than 77,000 adult members (age 18-75 years) from 3 Regions of the Kaiser Foundation Health Plan with prediabetes (hemoglobin A1C [HbA1C] = 5.7%-6.4%).

Main outcome measures: The 2-year probability for development of diabetes as a function of baseline HbA1C and body mass index (BMI).

Results: The 2-year risk of diabetes diagnosis varied widely by HbA1C and BMI. A small subset (5.2%) had a very high risk of T2DM developing within 2 years. Another 13.3% had a moderate 2-year risk of T2DM, whereas most (81.5%) of the population was at much lower risk. Thus, most Kaiser Foundation Health Plan members with prediabetes have only modest risk of progression to T2DM within 2 years.

Conclusion: Using HbA1C and BMI, we created a simple stratification scheme to more precisely estimate risk of T2DM incidence. This will enable more efficient assignment of prevention interventions and clinical and laboratory follow-up to the small subset at highest risk, while minimizing the potentially negative effects of overdiagnosis among the majority with prediabetes who are not at high short-term risk of T2DM.

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Conflict of interest statement

Disclosure Statement

Dr Nichols receives unrelated research funding from Boehringer Ingelheim GmbH, Ingelheim am Rhein, Germany; Sanofi SA, Paris, France; Janssen Pharmaceuticals Inc, Titusville, NJ; and Amarin Pharma Inc, Bedminster, NJ. The author(s) have no other conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Two-year probability for progression from prediabetes to type 2 diabetes on the basis of hemoglobin A1C (HbA1C) and body mass index for 77,107 members, aged 18 to 75 years, of Kaiser Permanente Northwest, Hawaii, and Georgia.
See this image and copyright information in PMC

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