Trudy Gaillard1, Haiying Chen2, Valery S Effoe3, Adolfo Correa4, Mercedes Carnethon5, Rita R Kalyani6, Justin B Echouffo-Tcheugui6, Joshua J Joseph7, Alain G Bertoni8,9. 1. Florida International University, Miami, FL. 2. Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston Salem, NC. 3. Division of Cardiology, Morehouse School of Medicine, Atlanta, GA. 4. Department of Medicine, University of Mississippi Medical Center, Jackson, MS. 5. Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL. 6. Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. 7. Division of Endocrinology, Diabetes and Metabolism, The Ohio State University Wexner Medical Center, Columbus, OH. 8. Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, NC. 9. Maya Angelou Center for Health Equity, Wake Forest School of Medicine, Winston-Salem NC.
Abstract
Background: Diabetes and prediabetes are common among African Americans (AA), but the frequency and predictors of transition between normal, impaired glucose metabolism, and diabetes are not well-described. The aim of this study was to examine glucometabolic transitions and their association with the development of type 2 diabetes (T2D). Methods: AA participants of the Jackson Heart Study who attended baseline exam (2000-2004) and at least one of two subsequent exams (2005-2008 and 2009-2013, ~8 years) were classified according to glycemic status. Transitions were defined as progression (deterioration) or remission (improvement) of glycemic status. Multinomial logistic regression models with repeated measures were used to estimate the odds ratios (OR) for remission and progression with adjustment for demographic, anthropometric, behavioral, and biochemical factors. Results: Among 3353 participants, (mean age 54.6±12.3 years), 43% were normoglycemic, 32% were prediabetes, and 25% had diabetes at baseline. For those with normal glucose at a visit, the probability at the next visit (~4years) of having prediabetes or diabetes was 38.5% and 1.8%, respectively. For those with prediabetes, the probability was 9.9% to improve to normal and 19.9% to progress to diabetes. Progression was associated with baseline BMI, diabetes status, triglycerides, family history of diabetes, and weight gain (OR 1.04 kg, 95% CI:1.03-1.06, P=<.0001). Remission was strongly associated with weight loss (OR .97 kg, 95%CI: .95-.98, P<.001). Conclusions: In AAs, glucometabolic transitions were frequent and most involved deterioration. From a public health perspective additional emphasis should be placed on weight control to preserve glucometabolic status and prevent progression to T2D.
Background: Diabetes and prediabetes are common among African Americans (AA), but the frequency and predictors of transition between normal, impaired glucose metabolism, and diabetes are not well-described. The aim of this study was to examine glucometabolic transitions and their association with the development of type 2 diabetes (T2D). Methods: AA participants of the Jackson Heart Study who attended baseline exam (2000-2004) and at least one of two subsequent exams (2005-2008 and 2009-2013, ~8 years) were classified according to glycemic status. Transitions were defined as progression (deterioration) or remission (improvement) of glycemic status. Multinomial logistic regression models with repeated measures were used to estimate the odds ratios (OR) for remission and progression with adjustment for demographic, anthropometric, behavioral, and biochemical factors. Results: Among 3353 participants, (mean age 54.6±12.3 years), 43% were normoglycemic, 32% were prediabetes, and 25% had diabetes at baseline. For those with normal glucose at a visit, the probability at the next visit (~4years) of having prediabetes or diabetes was 38.5% and 1.8%, respectively. For those with prediabetes, the probability was 9.9% to improve to normal and 19.9% to progress to diabetes. Progression was associated with baseline BMI, diabetes status, triglycerides, family history of diabetes, and weight gain (OR 1.04 kg, 95% CI:1.03-1.06, P=<.0001). Remission was strongly associated with weight loss (OR .97 kg, 95%CI: .95-.98, P<.001). Conclusions: In AAs, glucometabolic transitions were frequent and most involved deterioration. From a public health perspective additional emphasis should be placed on weight control to preserve glucometabolic status and prevent progression to T2D.
Authors: David M Nathan; Mayer B Davidson; Ralph A DeFronzo; Robert J Heine; Robert R Henry; Richard Pratley; Bernard Zinman Journal: Diabetes Care Date: 2007-03 Impact factor: 19.112
Authors: Joshua J Joseph; Justin B Echouffo-Tcheugui; Rita R Kalyani; Hsin-Chieh Yeh; Alain G Bertoni; Valery S Effoe; Ramon Casanova; Mario Sims; Adolfo Correa; Wen-Chih Wu; Gary S Wand; Sherita H Golden Journal: J Clin Endocrinol Metab Date: 2016-02-23 Impact factor: 5.958
Authors: J Tuomilehto; J Lindström; J G Eriksson; T T Valle; H Hämäläinen; P Ilanne-Parikka; S Keinänen-Kiukaanniemi; M Laakso; A Louheranta; M Rastas; V Salminen; M Uusitupa Journal: N Engl J Med Date: 2001-05-03 Impact factor: 91.245
Authors: William C Knowler; Elizabeth Barrett-Connor; Sarah E Fowler; Richard F Hamman; John M Lachin; Elizabeth A Walker; David M Nathan Journal: N Engl J Med Date: 2002-02-07 Impact factor: 91.245
Authors: Edward W Gregg; Haiying Chen; Lynne E Wagenknecht; Jeanne M Clark; Linda M Delahanty; John Bantle; Henry J Pownall; Karen C Johnson; Monika M Safford; Abbas E Kitabchi; F Xavier Pi-Sunyer; Rena R Wing; Alain G Bertoni Journal: JAMA Date: 2012-12-19 Impact factor: 56.272