Anzeige
10.06.2024 | Original Article
Incidence and predictors of diabetes mellitus: A 7- year community cohort follow-up of urban, adult Sri Lankans
Erschienen in: International Journal of Diabetes in Developing Countries
Einloggen, um Zugang zu erhaltenAbstract
Background
There is limited data on the prevalence and outcome of prediabetes and the incidence of type 2 diabetes in South Asia.
Objective
We conducted a prospective, community-based study involving a cohort of urban adults in Sri Lanka, with a seven-year follow-up period.
Methods
Participants were selected using age-stratified random sampling, initially screened in 2007, and reevaluated in 2014. Structured interviews, anthropometric measurements, liver ultrasound, and biochemical and serological tests were performed on both occasions.
Results
A total of 2985 individuals were recruited in 2007 [54.8% women, median age (IQR) 53(47–59)]; 737 had diabetes [baseline prevalence 24.7% (95%CI:23.1–26.2)] and 525 had prediabetes [baseline prevalence 17.9% (95%CI:16.2–19.6)]. In 2014, 2148(71.6%) persons attended follow-up [57.5% women; median (IQR) 60(54–66) years], which included 1650 who did not have diabetes in 2007. By 2014, 436/1650(27.6%) persons had developed new diabetes [annual incidence 3.9% (95%CI:3.0–4.9)]. Poisson regression analysis showed that prediabetes, central obesity, low HDL, and nonalcoholic fatty liver disease at baseline were significantly associated with new-onset diabetes.
Of the 525 persons with prediabetes in 2007, 365(69.5%) were followed-up in 2014; 147/365(40.3%) remained in prediabetes, 201/365(55.1%) had progressed to diabetes, and 17/365(4.6%) had reverted to normoglycemia. The annual conversion rate of prediabetes to diabetes was 7.9%. An increase in waist circumference and low HDL levels from baseline predicted progression to diabetes.
Conclusions
The presence of prediabetes, central obesity, low HDL, and nonalcoholic fatty liver disease at baseline predicted new-onset diabetes, whereas increase in waist circumference and low HDL predicted conversion of prediabetes to diabetes. Targeted lifestyle interventions are essential for individuals with metabolic risks to prevent future diabetes.