Open AccessIncidental Risk of Type 2 Diabetes Mellitus among Patients with Confirmed and Unconfirmed Prediabetes
Author(s) -
Kimberly D. Brunisholz,
Elizabeth A. Joy,
Mia Hashibe,
Lisa H. Gren,
Lucy Savitz,
Sharon Hamilton,
W. H. Can,
Jaewhan Kim
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0157729
Subject(s) - prediabetes , medicine , diabetes mellitus , type 2 diabetes , prospective cohort study , type 2 diabetes mellitus , gestational diabetes , pregnancy , endocrinology , gestation , biology , genetics
Objective 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. Study Design 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. Population Studied 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). Principal Findings 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. Conclusions Unconfirmed and confirmed preDM are strongly associated with the development of T2DM as compared to patients with only risk factors for disease.