Risk of Death Associated With Reversion From Prediabetes to Normoglycemia and the Role of Modifiable Risk Factors
Authors' conclusion
In this cohort study, although reversion from prediabetes to normoglycemia within a 3-year period did not mitigate the overall risk of death compared with persistent prediabetes, risk of death associated with reversion to normoglycemia varied based on whether individuals were physically active or had obesity. These findings highlight the importance of lifestyle modification among those with prediabetes status.
Study context
- Population
- Participants with prediabetes, Taiwan MJ Cohort Study, recruited 1996–2007; 62.9% male, 100% Asian, mean age 44.6 years
- Participants
- 45,782 participants
- Exposure
- Reversion to normoglycemia or progression to diabetes vs persistent prediabetes
- Reversion to normoglycemian = 17,021
- Progression to diabetesn = 1,786
- Outcome
- All-cause mortality, cardiovascular disease (CVD)-related mortality and cancer-related mortality
- Follow-up
- Median (IQR) 8 (5-12) years
Methodological detailsCox proportional hazards regression, Data analysis September 18, 2021, to October 24, 2022
- Cox proportional hazards regression
- Data analysis September 18, 2021, to October 24, 2022
Main finding
As reported in the abstract
Risk of death by change in prediabetes status
Each group vs persistent prediabetesHazard ratio (95% CI)
Progression to diabetesall-cause death
1.50(1.25–1.79)
Progression to diabetesCVD-related death
1.61(1.12–2.33)
Reversion to normoglycemiaall-cause death
0.99(0.88–1.10)
Reversion to normoglycemiacancer-related death
0.91(0.77–1.08)
Reversion to normoglycemiaCVD-related death
0.97(0.75–1.25)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| All-cause death, physically active subgroupReversion to normoglycemiavs Persistent prediabetes | 0.72 (0.59–0.87) | |
| 0.512Hazard ratio (log scale) |
- All-cause death, physically active subgroup: reversion in physically active vs persistent prediabetes in physically inactive
Risk of death, subgroup with obesity
- Reversion to normoglycemia, HR
- 1.10 (95% CI, 0.82-1.49)
- Persistent prediabetes, HR
- 1.33 (95% CI, 1.10-1.62)
Original publication
Risk of Death Associated With Reversion From Prediabetes to Normoglycemia and the Role of Modifiable Risk Factors. JAMA Netw Open. Published 1 March 2023. doi:10.
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