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Risk factors for progression to diabetes differ among men, women
Men who increase their physical activity and women who lower their waist circumference may reduce some of their risk for progression from prediabetes to diabetes, according to study findings published in BMJ Open Diabetes Research & Care.
Jingyan Tiang, MD, PhD, associate chief physician and associate professor in the department of endocrinology and metabolism at Shanghai Clinical Center for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine in Shanghai, and colleagues evaluated data from 334 adults (mean age, 57.2 years; 209 women) with prediabetes from the Pingliang community, Yangpu district, Shanghai, between November 2002 and October 2014 to identify sex-related factors affecting 10-year prediabetes outcome.
Participants completed a questionnaire of demographic characteristics, personal and family medical history and lifestyle habits; researchers divided participants according to physical activity level with the lowest tertile designated “inactive” and the highest two tertiles as “active.” HbA1c, triglyceride and cholesterol levels were assessed at baseline and 10-year follow-up visits (mean follow-up, 10.8 years).
At 10 years, 48% of participants continued to have prediabetes, 29.3% had progressed to diabetes and 22.5% reverted to normal glucose regulation. No differences were found between men and women for the change of glucose regulation.
Compared with inactive men, men who were active were more likely to return to normal glucose regulation (OR = 3; 95% CI, 1.09-8.3). For every centimeter increase in waist circumference in women, chances were lowered for return to normal glucose regulation (OR = 0.94; 95% CI, 0.89-0.98).
The risk for progression to diabetes was increased in men with older age (OR = 1.09; 95% CI, 1.03-1.16), higher triglyceride level (OR = 1.75; 95% CI, 1.24-2.49) and higher 2-hour glucose (OR = 1.64; 95% CI, 1.25-2.16). The risk was 3.29 times higher in men who smoked compared with those who did not. Compared with inactive men, men who were active had protective effects on the outcome of progression to diabetes (OR = 0.34; 95% CI, 0.13-0.92). Women had an increased risk for progression to diabetes if they had hypertension at baseline (OR = 2.38; 95% CI, 1.13-5.03), a family history of diabetes (OR = 2.74; 95% CI, 1.23-6.12) or higher baseline waist circumference (OR = 1.05; 95% CI, 1.01-1.1).
“Our study supports the notion that, while a certain proportion of prediabetic population progresses to diabetes, the majority will stay the same or even convert back to normal glucose regulation,” the researchers wrote. “Physical activity in males and lower waist circumference in females favor reversion from prediabetes to normal. ... Intervention toward prediabetes should therefore depend on different individuals with difference risk factors.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.