Regression from prediabetes to normal glucose levels is more frequent than progression towards diabetes: The CRONICAS Cohort Study

Maria Lazo-Porras, Antonio Bernabe-Ortiz, Andrea Ruiz-Alejos, Liam Smeeth, Robert H. Gilman, William Checkley, German Málaga, J. Jaime Miranda

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Aims: This study aimed to (1) estimate the prevalence of prediabetes according to different definitions, (2) evaluate regression to normal glucose levels and progression towards T2DM, and (3) determine factors associated with regression and progression across four diverse geographical settings in a Latin American country. Methods: The CRONICAS Cohort Study was conducted in four different areas in Peru. Enrollment started in September 2010 and follow-up was conducted in 2013. Prediabetes, T2DM and normal glucose levels were determined according to definitions from the World Health Organization (WHO), American Diabetes Association (ADA), and National Institute for Health and Care Excellence (NICE). The main outcomes were regression to normal glucose levels and incidence of T2DM. Prevalence estimates and 95% confidence intervals (95% CI) were calculated. Crude and adjusted models using Poisson regression were performed and relative risk ratios (RRR) and 95% CI were calculated. Results: At baseline, the prevalence of prediabetes varied markedly by definition used: 6.5%(95% CI 5.6−7.6%), 53.6% (95% CI 51.6−55.6%), and 24.6% (95% CI 22.8−26.4%) according to WHO, ADA and NICE criteria, respectively. After 2.2 years of follow-up, in those with prediabetes, the cumulative incidence of regression to euglycemia ranged between 31.4% and 68.9%, whereas the incidence of T2DM varied from 5.5% to 28.8%. Factors associated with regression to normal glucose levels and progression to diabetes were age, body mass index, and insulin resistance. Conclusions: Regression from pre-diabetes back to euglycemia was much more common than progression to diabetes.

Original languageEnglish
Article number107829
JournalDiabetes Research and Clinical Practice
Volume163
DOIs
StatePublished - May 2020
Externally publishedYes

Keywords

  • Diabetes
  • Disease progression
  • Insulin resistance
  • Longitudinal studies
  • Low-and middle-income countries
  • Normal glucose levels
  • Peru
  • Prediabetes

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