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. 2022 Oct 7:13:1041808.
doi: 10.3389/fendo.2022.1041808. eCollection 2022.

Are the determinants of the progression to type 2 diabetes and regression to normoglycemia in the populations with pre-diabetes the same?

Zeinab Alizadeh  1 , Hamid Reza Baradaran  1   2   3 , Karim Kohansal  4 , Farzad Hadaegh  4 , Fereidoun Azizi  5 , Davood Khalili  4   6
Affiliations

Are the determinants of the progression to type 2 diabetes and regression to normoglycemia in the populations with pre-diabetes the same?

Zeinab Alizadeh et al. Front Endocrinol (Lausanne). .

Abstract

Background: We aimed to determine the predictors of regression to normoglycemia and progression to diabetes among subjects with pre-diabetes in a single model concurrently.

Methods: The present study included 1329 participants aged 20 to 70 years with prediabetes from the population-based cohort of the Tehran Lipid and Glucose Study, with a 10-year follow-up. Glycemic status at follow-up was categorized as regression to normoglycemia: fasting plasma glucose [FPG] of <5.55 and 2h-plasma glucose [PG] of <7.77 mmol/L, and not taking antidiabetic medications. Glycemic status at follow-up was categorized as progression to diabetes: FPG ≥7 or 2h-PG of ≥11.1 mmol/L, or taking antidiabetic medications. Glycemic status determined whether the patients remained in prediabetes category (isolated impaired fasting glycaemia [iIFG] [(5.55≤FPG<7 and 2h-PG<7.77 mmol/L); isolated impared glucose tolarence [iIGT] (7.77 ≤ 2h-PG<11.1 and FGP<5.55 mmol/L)]. With prediabetes as a reference, multinomial logistic regression was utilized to identify the determinants of glycemic changes.

Results: Approximately 40% of participants returned to normoglycemia (n = 578), and similar percentage of participants progressed to diabetes (n = 518). Based on the multivariable multinomial model, regression to normoglycemia was associated with age (relative risk ratio [RRR] = 0.97; 95% CI, 0.95-0.99), female sex (RRR = 1.72; 95% CI, 1.18-2.50), high education level of ≥12 years (RRR = 2.10; 95% CI, 1.19-3.70), and combined IFG/impaired glucose tolerance (IGT) versus IFG (RRR = 0.45; 95% CI, 0.29-0.70). The risk of progression to diabetes increased with body mass index (RRR = 1.10; 95% CI, 1.05-1.15), waist circumference (RRR = 0.97; 95% CI, 0.96-0.99), positive familial history of diabetes (RRR = 1.62; 95% CI, 1.07-2.45), and combined IFG/IGT versus IFG (RRR = 2.54; 95% CI, 1.71-3.77).

Conclusion: A small percentage of patients with prediabetes remain in this condition, but the majority go on to develop diabetes or regress to normoglycemia. Both directions had distinct predictors.

Keywords: Cardiometabolic disorders; normoglycemia; pre-diabetes; progression; regression; type 2 diabetes.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram describing the study population.
See this image and copyright information in PMC

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References

    1. Shang Y, Marseglia A, Fratiglioni L, Welmer AK, Wang R, Wang HX, et al. . Natural history of prediabetes in older adults from a population-based longitudinal study. J Intern Med (2019) 286(3):326–40. doi: 10.1111/joim.1292 - DOI - PMC - PubMed
    1. Bennasar-Veny M, Fresneda S, López-González A, Busquets-Cortés C, Aguiló A, Yañez AM. Lifestyle and progression to type 2 diabetes in a cohort of workers with prediabetes. Nutrients (2020) 12:1538. doi: 10.3390/nu12051538 - DOI - PMC - PubMed
    1. Richter B, Hemmingsen B, Mi M, Takwoingi Y. Development of type 2 diabetes mellitus in people with intermediate hyperglycaemia (Review). Cochrane Database of Systematic Reviews (2018) 10(10). doi: 10.1002/14651858.CD012661.pub2 - DOI - PMC - PubMed
    1. Azizi F, Zadeh-Vakili A, Takyar M. Review of rationale, design, and initial findings: Tehran lipid and glucose study. Int J Endocrinol Metab (2018) 16(4 Suppl):e84777. doi: 10.5812/ijem.84777 - DOI - PMC - PubMed
    1. Azizi F, Ghanbarian A, Momenan AA, Hadaegh F, Mirmiran P, Hedayati M, et al. . Prevention of non-communicable disease in a population in nutrition transition: Tehran lipid and glucose study phase II. Trials (2009) 10:1–15. doi: 10.1186/1745-6215-10-5 - DOI - PMC - PubMed

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