ArticlePreventive medicine reports2026
Association of socioeconomic status and lifestyle factors with incident diabetes among individuals with prediabetes: a prospective cohort study from UK Biobank.
Article in Preventive medicine reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To examine how socioeconomic status (SES) affects diabetes incidence in prediabetic adults, quantifying the mediating role of modifiable lifestyle factors in SES-related disparities to guide interventions. Methods: A prospective cohort of 34,669 adults with prediabetes from UK Biobank (2006-2010) with follow-up through 31 October 2022. From 27 SES indicators based on the social determinants of health framework, education, employment, and income were selected for latent class analysis. Lifestyle was assessed using a composite score (0-5) including smoking, diet, sleep duration, body mass index (BMI), and sedentary behavior. Cox models estimated associations; mediation analysis quantified the proportion mediated by lifestyle, and population-attributable fractions estimated preventable burden. Results: Over a median 13.22-year follow-up, 6904 incident diabetes cases were identified. Compared with the high SES group, the hazard ratios for incident diabetes were 1.36 (95% confidence interval (CI): 1.25, 1.48) and 1.91 (95% CI: 1.75, 2.09) for medium and low SES, respectively. Lifestyle factors mediated 33.71% and 31.44% of the SES-diabetes association in the medium and low SES, respectively. The population-attributable fractions were 24.05% for lifestyle and 34.50% for SES. Conclusions: Lower SES is associated with elevated diabetes progression risk, with about one-third mediated by lifestyle factors, particularly BMI.
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