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Prevalence of pre-diabetes and undiagnosed diabetes in the Mollerussa prospective observational cohort study in a semi-rural area of Catalonia.

Primary Health Care Centre Cervera, Gerència d'Atenció Primaria, Institut Català de la Salut, Lleida, Spain. Department of Medicine, University of Lleida & Biomedical Research Institute of Lleida, Lleida, Spain. Primary Health Care Centre Igualada Nord, Gerència d'Atenció Primaria, Institut Català de la Salut, Lleida, Spain. Department of Nutrition and Dietetics, Avantmedic, Lleida, Spain. Department of Endocrinology & Nutrition, University Hospital Germans Trias I Pujol & Health Sciences Research Institute, Badalona, Spain. Unitat de Suport a la Recerca Lleida, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), & CIBER of Epidemiology and Public Health (CIBERESP), Lleida, Spain. Department of Cardiovascular, Vall d'Hebron Research Institute, Barcelona, Spain. Primary Health Care Centre Tàrrega, Gerència d'Atenció Primaria, Institut Català de la Salut, Lleida, Spain. Primary Health Care Centre Mollerussa, Gerència d'Atenció Primaria, Institut Català de la Salut, Lleida, Spain. Primary Health Care Centre Guissona, Gerència d'Atenció Primaria, Institut Català de la Salut, Lleida, Spain. DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), & CIBER on Diabetes and Associated Metabolic Diseases (CIBERDEM), Barcelona, Spain. Primary Health Care Centre Raval Sud, Gerència d'Atenció Primaria Barcelona, Institut Català de la Salut, Barcelona, Spain. Primary Health Care Centre La Mina, Gerència d'Atenció Primària Barcelona, Institut Català de la Salut, Barcelona, Spain. DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain didacmauricio@gmail.com esmeraldacas@gmail.com. Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau & Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), & CIBER on Diabetes and Associated Metabolic Diseases (CIBERDEM), Barcelona, Spain. Department of Medicine, University of Lleida & Biomedical Research Institute of Lleida, Lleida, Spain didacmauricio@gmail.com esmeraldacas@gmail.com.

BMJ open. 2020;(1):e033332
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Abstract

OBJECTIVES To assess the prevalence of undiagnosed diabetes and pre-diabetes in the healthy population in the Mollerussa cohort. As a secondary objective, to identify the variables associated with these conditions and to describe the changes in glycaemic status after 1 year of follow-up in subjects with pre-diabetes. DESIGN Prospective observational cohort study. SETTING General population from a semi-rural area. PARTICIPANTS The study included 583 participants without a diagnosis of diabetes recruited between March 2011 and July 2014. RESULTS The prevalence of undiagnosed diabetes was 20, 3.4% (95% CI 2.6 to 4.2) and that of pre-diabetes was 229, 39.3% (37.3 to 41.3). Among those with pre-diabetes, 18.3% had isolated impaired fasting plasma glucose (FPG) (FPG: 100 to <126 mg/dL), 58.1% had isolated impaired glycated haemoglobin (HbA1c) (HbA1c 5.7 to <6.5) and 23.6% fulfilled both criteria. Follow-up data were available for 166 subjects; 41.6%(37.8 to 45.4) returned to normoglycaemia, 57.6% (57.8 to 61.4) persisted in pre-diabetes and 0.6% (0 to 1.2) progressed to diabetes. Individuals with pre-diabetes had worse cardiometabolic risk profiles and sociodemographic features than normoglycaemic subjects. In the logistic regression model, variables significantly associated with pre-diabetes were older age (OR; 95% CI) (1.033; 1.011 to 1.056), higher physical activity (0.546; 0.360 to 0.827), body mass index (1.121; 1.029 to 1.222) and a family history of diabetes (1.543; 1.025 to 2.323). The variables significantly associated with glycaemic normalisation were older age (0.948; 0.916 to 0.982) and body mass index (0.779; 0.651 to 0.931). CONCLUSIONS Among adults in our region, the estimated prevalence of undiagnosed diabetes was 3.4% and that of pre-diabetes was 39.3%. After a 1-year follow-up, a small proportion of subjects (0.6%) with pre-diabetes progressed to diabetes, while a high proportion (41.6%) returned to normoglycaemia. Individuals with pre-diabetes who returned to normoglycaemia were younger and had a lower body mass index.

Methodological quality

Publication Type : Multicenter Study ; Observational Study

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