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Incidence of Type 2 Diabetes in Pre-Diabetic Japanese Individuals Categorized by HbA(1c) Levels: A Historical Cohort Study
OBJECTIVE: Reported incidence of type 2 diabetes estimated at the pre-diabetic stage differs widely (2.3–18.1% per year). Because clinicians need to know the risk of incident diabetes after a diagnosis of pre-diabetes, our objective was to estimate precise incidence of diabetes using baseline HbA(1c...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4390315/ https://www.ncbi.nlm.nih.gov/pubmed/25853519 http://dx.doi.org/10.1371/journal.pone.0122698 |
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author | Kawahara, Tetsuya Imawatari, Ryuichiro Kawahara, Chie Inazu, Tetsuya Suzuki, Gen |
author_facet | Kawahara, Tetsuya Imawatari, Ryuichiro Kawahara, Chie Inazu, Tetsuya Suzuki, Gen |
author_sort | Kawahara, Tetsuya |
collection | PubMed |
description | OBJECTIVE: Reported incidence of type 2 diabetes estimated at the pre-diabetic stage differs widely (2.3–18.1% per year). Because clinicians need to know the risk of incident diabetes after a diagnosis of pre-diabetes, our objective was to estimate precise incidence of diabetes using baseline HbA(1c) levels. METHODS: A historical cohort study using electronic medical record data obtained between January 2008 and December 2013. A total of 52,781 individuals with HbA(1c) < 6.5% were assigned to one of six groups categorized by baseline HbA(1c) level: ≤ 5.5% (n=34,616), 5.6–5.7% (n=9,388), 5.8–5.9% (n=4,664), 6.0–6.1% (n= 2,338), 6.2–6.3% (n=1,257), and 6.4% (n=518). Participants were tracked until a subsequent diagnosis of diabetes or end of follow-up during a period of 5 years. RESULTS: During the follow-up period (mean 3.7 years), 4,369 participants developed diabetes. The incidence of diabetes in the first year was 0.7, 1.5, 2.9, 9.2, 30.4, and 44.0% in the six HbA(1c) groups, respectively. At five years the incidence was 3.6, 8.9, 13.8, 27.5, 51.6, and 67.8%, respectively (p < 0.0001 comparing the HbA(1c) ≤5.5% group to the other groups). After adjustment for confounding factors, the hazard ratios compared with the HbA(1c) ≤5.5% group were significantly elevated: 2.3 (95%CI 2.0–2.5), 3.4 (95%CI 2.9–3.7), 8.8 (95%CI 8.0–10.1), 26.3 (95%CI 23.3–30.1), and 48.7 (95%CI 40.8–58.1) in the five HbA(1c) groups (p < 0.0001). CONCLUSION: By fractionating baseline HbA(1c) levels into narrower HbA(1c) range groups, accuracy of estimating the incidence of type 2 diabetes in subsequent years was increased. The risk of developing diabetes increased with increasing HbA(1c) levels, especially with the HbA(1c) level ≥ 6.2% in the first follow-up year. |
format | Online Article Text |
id | pubmed-4390315 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-43903152015-04-21 Incidence of Type 2 Diabetes in Pre-Diabetic Japanese Individuals Categorized by HbA(1c) Levels: A Historical Cohort Study Kawahara, Tetsuya Imawatari, Ryuichiro Kawahara, Chie Inazu, Tetsuya Suzuki, Gen PLoS One Research Article OBJECTIVE: Reported incidence of type 2 diabetes estimated at the pre-diabetic stage differs widely (2.3–18.1% per year). Because clinicians need to know the risk of incident diabetes after a diagnosis of pre-diabetes, our objective was to estimate precise incidence of diabetes using baseline HbA(1c) levels. METHODS: A historical cohort study using electronic medical record data obtained between January 2008 and December 2013. A total of 52,781 individuals with HbA(1c) < 6.5% were assigned to one of six groups categorized by baseline HbA(1c) level: ≤ 5.5% (n=34,616), 5.6–5.7% (n=9,388), 5.8–5.9% (n=4,664), 6.0–6.1% (n= 2,338), 6.2–6.3% (n=1,257), and 6.4% (n=518). Participants were tracked until a subsequent diagnosis of diabetes or end of follow-up during a period of 5 years. RESULTS: During the follow-up period (mean 3.7 years), 4,369 participants developed diabetes. The incidence of diabetes in the first year was 0.7, 1.5, 2.9, 9.2, 30.4, and 44.0% in the six HbA(1c) groups, respectively. At five years the incidence was 3.6, 8.9, 13.8, 27.5, 51.6, and 67.8%, respectively (p < 0.0001 comparing the HbA(1c) ≤5.5% group to the other groups). After adjustment for confounding factors, the hazard ratios compared with the HbA(1c) ≤5.5% group were significantly elevated: 2.3 (95%CI 2.0–2.5), 3.4 (95%CI 2.9–3.7), 8.8 (95%CI 8.0–10.1), 26.3 (95%CI 23.3–30.1), and 48.7 (95%CI 40.8–58.1) in the five HbA(1c) groups (p < 0.0001). CONCLUSION: By fractionating baseline HbA(1c) levels into narrower HbA(1c) range groups, accuracy of estimating the incidence of type 2 diabetes in subsequent years was increased. The risk of developing diabetes increased with increasing HbA(1c) levels, especially with the HbA(1c) level ≥ 6.2% in the first follow-up year. Public Library of Science 2015-04-08 /pmc/articles/PMC4390315/ /pubmed/25853519 http://dx.doi.org/10.1371/journal.pone.0122698 Text en © 2015 Kawahara et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Kawahara, Tetsuya Imawatari, Ryuichiro Kawahara, Chie Inazu, Tetsuya Suzuki, Gen Incidence of Type 2 Diabetes in Pre-Diabetic Japanese Individuals Categorized by HbA(1c) Levels: A Historical Cohort Study |
title | Incidence of Type 2 Diabetes in Pre-Diabetic Japanese Individuals Categorized by HbA(1c) Levels: A Historical Cohort Study |
title_full | Incidence of Type 2 Diabetes in Pre-Diabetic Japanese Individuals Categorized by HbA(1c) Levels: A Historical Cohort Study |
title_fullStr | Incidence of Type 2 Diabetes in Pre-Diabetic Japanese Individuals Categorized by HbA(1c) Levels: A Historical Cohort Study |
title_full_unstemmed | Incidence of Type 2 Diabetes in Pre-Diabetic Japanese Individuals Categorized by HbA(1c) Levels: A Historical Cohort Study |
title_short | Incidence of Type 2 Diabetes in Pre-Diabetic Japanese Individuals Categorized by HbA(1c) Levels: A Historical Cohort Study |
title_sort | incidence of type 2 diabetes in pre-diabetic japanese individuals categorized by hba(1c) levels: a historical cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4390315/ https://www.ncbi.nlm.nih.gov/pubmed/25853519 http://dx.doi.org/10.1371/journal.pone.0122698 |
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