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Incident Type 2 diabetes and the effect of early regression to normoglycaemia in a population with impaired glucose regulation

journal contribution
posted on 04.04.2016, 11:04 by Danielle H. Bodicoat, Kamlesh Khunti, BT Srinivasan, S Mostafa, Laura J. Gray, Melanie J. Davies, David R. Webb
AIMS: To report contemporary regression rates from impaired glucose regulation to normal glucose tolerance, identify modifiable factors associated with early regression, and establish whether it affects subsequent diabetes risk in a population-based cohort. METHODS: Participants with impaired glucose regulation (impaired fasting glucose and/or impaired glucose tolerance on a 75-g oral glucose tolerance test) at baseline in the UK-based ADDITION-Leicester study had annual Type 2 diabetes re-screens for 5 years or until diabetes diagnosis. Logistic regression models investigated modifiable risk factors for regression to normal glucose tolerance at 1 year (n=817). Cox regression models estimated subsequent diabetes risk (n=630). RESULTS: At 1 year, 54% of participants had regressed to normal glucose tolerance, and 6% had progressed to diabetes. Regression to normal glucose tolerance was associated with weight loss of 0.1-3% [adjusted odds ratio 1.81 (95% CI 1.08, 3.03) compared with maintaining or gaining weight] and a waist circumference reduction of >3cm [adjusted odds ratio 1.78 (95% CI 1.03, 3.06) compared with maintaining or increasing waist circumference]. Those with normal glucose tolerance at 1 year subsequently had lower diabetes risk than those who remained with impaired glucose regulation [adjusted hazard ratio 0.19 (95% CI 0.10, 0.37)]. CONCLUSIONS: Early regression to normal glucose tolerance was associated with reduced diabetes incidence, and might be induced by small reductions in weight or waist circumference. If confirmed in experimental research, this could be a clear and achievable target for individuals diagnosed with impaired glucose regulation. This article is protected by copyright. All rights reserved.

History

Citation

Diabet Medicine, 2016 (Early View)

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cardiovascular Sciences

Version

AM (Accepted Manuscript)

Published in

Diabet Medicine

Publisher

Wiley for Diabetes UK

issn

0742-3071

eissn

1464-5491

Acceptance date

09/02/2016

Copyright date

2016

Available date

03/03/2017

Publisher version

http://onlinelibrary.wiley.com/doi/10.1111/dme.13091/abstract

Notes

The file associated with this record is under a 12-month embargo from publication in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.

Language

en

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