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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...

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Autores principales: Kawahara, Tetsuya, Imawatari, Ryuichiro, Kawahara, Chie, Inazu, Tetsuya, Suzuki, Gen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
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.
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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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