Prediabetes is associated with elevated risk of clinical outcomes even without progression to diabetes
Authors' conclusion
Progression to diabetes explained less than one-quarter of the risks of clinical outcomes associated with prediabetes. Prediabetes contributes to the risk of clinical outcomes even without progression to diabetes.
Study context
- Population
- Adults aged 46–70 years without diabetes at baseline (1990–1992), Atherosclerosis Risk in Communities (ARIC) Study; ≈55% women, ≈20% Black adultsARIC Study
- Participants
- 10,310 adults
- Exposure
- Prediabetes vs normoglycaemia
- Outcome
- Composite of:
- Complications (ASCVD, HF, CKD, all-cause mortality) before
- After accounting for progression to diabetes
- Follow-up
- ≈30 years
Methodological detailscommunity-based, Cox regression, age- and sex-adjusted, diabetes modelled as a time-varying variable
- Community-based
- Cox regression, age- and sex-adjusted
- Diabetes modelled as a time-varying variable
Main finding
As reported in the abstract
Any complication
Prediabetes vs NormoglycaemiaHazard ratio (95% CI)
Before accounting for progression to diabetes
1.21(1.15–1.27)
After accounting for progression to diabetes
1.18(1.12–1.24)
- Excess risk of any complication in prediabetes remaining after accounting for progression to diabetes
- 85% (95% CI 75, 94%)
Observational data: associations, not effects.
Further findings
Events over follow-up · ≈30 years
- Total events
- 7069
- Atherosclerotic CVD (ASCVD)
- 1937
- HF
- 2109
- Chronic kidney disease (CKD)
- 3288
- Deaths
- 4785
Progression to diabetes among those with prediabetes
- Adults with prediabetes at baseline
- 60%
- Progressed to diabetes
- ≈30%
- Median time to diabetes
- 7 years
Individual complications
- Results were similar for the individual complications
Original publication
Prediabetes is associated with elevated risk of clinical outcomes even without progression to diabetes. Diabetologia. Published 12 November 2024. doi:10.
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