Classifying and communicating risks in prediabetes according to fastingglucose and/or glycated hemoglobin: PREDAPS cohort study

Abstract

Objective: Information about prognostic outcomes can be of great help for people with prediabetes and for physicians in the face of scientific controversy about the cutoff point for definingprediabetes. We aimed to estimate different prognostic outcomes in people with prediabetes. Design: Prospective cohort of subjects with prediabetes according to American Diabetes Association guidelines. Main Outcome measures: The probabilities of diabetes onset versus non-onset, the oddsagainst diabetes onset, and the probability of reverting to normoglycemia according to different prediabetes categories were calculated. Results: The odds against diabetes onset ranged from 29:1 in individuals with isolated FPG of100–109mg/dL to 1:1 in individuals with FPG 110–125mg/dL plus HbA1c 6.0–6.4%. The probability of reversion to normoglycemia was 31.2% (95% CI 24.0–39.6) in those with isolated FPG100–109mg/dL and 6.2% (95% CI 1.4–10.0) in those with FPG 110–125mg/dL plus HbA1c6.0–6.4%. Of every 100 participants in the first group, 97 did not develop diabetes and 31reverted to normoglycemia, while in the second group those figures were 52 and 6. Conclusions: Using odds of probabilities and absolute numbers might be useful for people with prediabetes and physicians to share decisions on potential interventions.