Real-world predictors of progression to type 2 diabetes among adults with prediabetes.

aimsAssess predictors of progression to type 2 diabetes (T2D) among patients with prediabetes. MATERIALS AND

methodsThis case-control study assessed adults with prediabetes using US claims and EMR-linked data from January 1, 2016, through January 31, 2024. T2D cases were patients with prediabetes who progressed to T2D (index: date of first T2D diagnosis); controls had prediabetes but did not progress to T2D. Control index dates were randomly assigned from cases. Demographic and clinical characteristics in the year before progression to T2D were assessed to identify progression predictors.

resultsThe study included 39 281 T2D cases and 58 751 controls. Data on race/ethnicity (White, Black, Hispanic, Asian-Other) were available for 62% of the study sample. Demographic characteristics for cases and controls were similar in the overall population, by sex, and by race/ethnicity. During the 1-year baseline, T2D cases had a higher prevalence of obesity, cardiovascular disease (CVD), and obstructive sleep apnea (OSA) than controls. Comorbidity patterns varied by sex and race/ethnicity. Compared with patients aged 18-34 years, patients aged 35-44 (OR, 1.37), 45-54 (OR, 1.49), and 55-64 (OR, 1.33) had higher odds of progression. Obesity (OR, 1.45), CVD (OR, 1.64), OSA (OR, 1.36), metabolic dysfunction-associated steatohepatitis (MASH; OR, 1.37), and neuropathy (OR, 1.19) were associated with T2D progression. Black (OR, 1.27) and Hispanic (OR, 1.21) patients had higher odds of progression than White patients (all p < 0.0001).

conclusionsAmong patients with prediabetes, age 35-64 years, obesity, CVD, OSA, MASH, and neuropathy in the year before progression are associated with progression to T2D. PLAIN LANGUAGE SUMMARY: What is the context and purpose of this research study? This research study looked at why some adults with prediabetes were more likely than others to develop type 2 diabetes (T2D). The researchers wanted to know if factors like age, sex, race, history of health conditions (such as obesity, heart disease, and sleep disorders), and abnormal lab tests (like elevated blood sugar levels) could predict who will get T2D. What was done? The researchers conducted a study using a US database of insurance and medical records from 2016 to 2024. The researchers compared two groups: 39 281 adults with prediabetes who developed T2D and 58 751 adults with prediabetes who did not develop T2D. The researchers looked for patterns in these groups and used statistics to identify risk factors. What were the main results? The study found that middle-aged adults (35-64 years old) and those with health problems like obesity, heart disease, sleep apnea, neuropathy, and liver disease were more likely to get T2D. These patterns were similar across patients of different races and genders. However, Black and Hispanic patients had a higher risk of T2D compared to White patients. There was no difference in the risk of developing T2D between patients with Asian or Other ethnicities and White patients. What is the originality and relevance of this study? This study is important because it identifies factors that increase the risk of developing T2D in people with prediabetes. It suggests that age, certain health conditions, and race can affect this risk. These findings can help doctors create better treatment and prevention plans for high-risk patients.