Incidence and Risk Factors for Progression to Diabetes Mellitus: A Retrospective Cohort Study.

Min Kyung Hyun,Seon Mi Ji,Soon-Ki Ahn,Kyoung Hoon Kim,Jong Heon Park

doi:10.3390/ijerph19010123

Abstract

(1) Objective: This study examined the incidence and risk factors contributing to the progression to diabetes mellitus (DM) in a seven-year follow-up study of non-diabetic National Health Examinees. (2) Methods: For this retrospective observational cohort study, we used two national representative databases: the National Health Screening (HEALS) database 2009 and the National Health Insurance Service (NHIS) database 2009–2015. The eligible subjects without DM with blood sugar levels of <126 mg/dL were selected using the HEALS database. The subsequent follow-up and clinical outcomes were evaluated using the NHIS database. Cox proportional hazard regression was applied to examine the effects of the covariates on progression to diabetes. (3) Results: Among those who took part in the national health screening in 2009, 4,205,006 subjects who met the eligibility criteria were selected. Of these, 587,015 were diagnosed with DM during the follow-up by 2015. The incidence of progression from non-diabetes to DM was 14.0%, whereas that from impaired fasting glucose (IFG) to DM was 21.9%. Compared to the normal group, the newly diagnosed DM group was more likely to comprise older, female, currently smoking, and high-risk drinking participants and participants with IFG, hypertension, dyslipidemia, and metabolic syndrome. (4) Conclusions: This epidemiological study in the Republic of Korea found risk factors similar to those of other studies, but the incidence of progression to DM was 22.8 per 1000 person-years, which is higher than that previously reported. Hence, more care is needed to prevent DM.

Highlights

Diabetes mellitus (DM) is one of the world’s leading public health concerns; it has increased steadily in incidence over the past few decades and resulted in complications in multiple organ systems [1]
Prediabetes is defined when the glucose levels do not meet the criteria for DM but are too high to be considered normal, including impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) [2]
This is because males are more likely to participate in the national health screening [21]

Summary

Introduction

Diabetes mellitus (DM) is one of the world’s leading public health concerns; it has increased steadily in incidence over the past few decades and resulted in complications in multiple organ systems [1]. Prediabetes is defined when the glucose levels do not meet the criteria for DM but are too high to be considered normal, including impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) [2]. IFG is diagnosed when the blood glucose levels are between 100 and 125 mg/dL (5.6 to 7.0 mmol/L), and it is highly associated with the development of DM [2]. IFG increases the risk of progression to DM, and the annual rate of conversion to DM is 6–9% [3,4,5]. The prevalence of IFG ranges from 1%

Results

Discussion

Conclusion