Associations Between Modifiable Risk Factors and Changes in Glycemic Status Among Individuals With Prediabetes

Objective: To examine the associations between modifiable risk factors and glycemic status changes in individuals with prediabetes.

Research design and methods: A total of 10,358 individuals with prediabetes defined by their fasting blood glucose and HbA1c levels from the Health Examinees-Gem (HEXA-G) study were included. Modifiable factors, including BMI, abdominal obesity, smoking status, physical activity, alcohol consumption, diet quality, hypertension, and dyslipidemia, were examined to determine their associations with changes in glycemic status during follow-up. In addition, modifiable factor scores were calculated, and their association with changes in glycemic status was also analyzed. 

Results: The median follow-up time for this study was four years (range, one–seven years). BMI ≥25 kg/m2 (adjusted odds ratio 0.71 [95% confidence interval 0.63–0.79]), abdominal obesity (0.76 [0.68–0.86]), heavy drinking (0.74 [0.60–0.91]), hypertension (0.71 [0.64–0.79]), and dyslipidemia (0.78 [0.70–0.85]) were observed to have lower possibility of normoglycemia reversion. BMI ≥25 kg/m2 (1.58 [1.29–1.94]), abdominal obesity (1.31 [1.11–1.55]), current smoking (1.43 [1.07–1.91]), and hypertension (1.26 [1.07–1.49]) were found to have higher probability of type 2 diabetes progression. Having more favorable modifiable factors was also associated with normoglycemia reversion (1.46 [1.30–1.64]) and type 2 diabetes progression (0.62 [0.49–0.77]).

Conclusions: More favorable modifiable factors were related to a higher probability of returning to normoglycemia and a lower probability of progression to type 2 diabetes.