Journal Article

Incidental Risk of Type 2 Diabetes Mellitus among Patients with Confirmed and Unconfirmed Prediabetes

Savitz, Lucy A., Joy, Elizabeth A., Cannon, Wayne, Gren, Lisa H., Hamilton, Sharon, Kim, Jaewhan, Brunisholz, Kimberly D., Hashibe, Mia

2016

Overview

To determine the risk of type 2 diabetes (T2DM) diagnosis among patients with confirmed and unconfirmed prediabetes (preDM) relative to an at-risk group receiving care from primary care physicians over a 5-year period. Utilizing data from the Intermountain Healthcare (IH) Enterprise Data Warehouse (EDW) from 2006-2013, we performed a prospective analysis using discrete survival analysis to estimate the time to diagnosis of T2DM among groups. Adult patients who had at least one outpatient visit with a primary care physician during 2006-2008 at an IH clinic and subsequent visits through 2013. Patients were included for the study if they were (a) at-risk for diabetes (BMI ≥ 25 kg/m2 and one additional risk factor: high risk ethnicity, first degree relative with diabetes, elevated triglycerides or blood pressure, low HDL, diagnosis of gestational diabetes or polycystic ovarian syndrome, or birth of a baby weighing >9 lbs); or (b) confirmed preDM (HbA1c ≥ 5.7-6.49% or fasting blood glucose 100-125 mg/dL); or (c) unconfirmed preDM (documented fasting lipid panel and glucose 100-125 mg/dL on the same day). Of the 33,838 patients who were eligible for study, 57.0% were considered at-risk, 38.4% had unconfirmed preDM, and 4.6% had confirmed preDM. Those with unconfirmed and confirmed preDM tended to be Caucasian and a greater proportion were obese compared to those at-risk for disease. Patients with unconfirmed and confirmed preDM tended to have more prevalent high blood pressure and depression as compared to the at-risk group. Based on the discrete survival analyses, patients with unconfirmed preDM and confirmed preDM were more likely to develop T2DM when compared to at-risk patients. Unconfirmed and confirmed preDM are strongly associated with the development of T2DM as compared to patients with only risk factors for disease.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / At risk populations / Biology and life sciences / Blood / Blood Glucose - analysis / Blood Pressure / Body mass / Body Mass Index / Chronic illnesses / Clinical medicine / Complications and side effects / Data warehouses / Development and progression / Diabetes / Diabetes mellitus / Diabetes mellitus (non-insulin dependent) / Diabetes Mellitus, Type 2 - diagnosis / Diabetes Mellitus, Type 2 - epidemiology / Diabetes, Gestational - diagnosis / Diagnosis / Disease prevention / Fasting / Female / Glucose / Health care / Health risks / Hemoglobin / High density lipoprotein / Humans / Hypertension / Hypertriglyceridemia - complications / Hypertriglyceridemia - diagnosis / Incidence / Internal medicine / Laboratories / Laboratory testing / Lifestyles / Longitudinal Studies / Male / Medical personnel / Medicine and Health Sciences / Mental depression / Middle Aged / Minority & ethnic groups / Patients / People and Places / Physicians / Polycystic ovary syndrome / Polycystic Ovary Syndrome - complications / Polycystic Ovary Syndrome - diagnosis / Population studies / Prediabetic state / Prediabetic State - complications / Prediabetic State - diagnosis / Pregnancy / Preventive medicine / Primary care / Prospective Studies / Public health / Quality control / Risk analysis / Risk Factors / Salt / Studies / Survival / Triglycerides / Type 2 diabetes / Weight control