TOPLINE:

Adults with prediabetes had higher odds of progressing to type 2 diabetes (T2D) if they were aged 35-64 years vs 18-34 years or had specific comorbidities such as obesity, cardiovascular disease, obstructive sleep apnea, metabolic dysfunction-associated steatohepatitis or steatotic liver disease (MASH/MASLD), or neuropathy in the year before progression.

METHODOLOGY:

• Reportedly, 5%-10% of people with prediabetes experience progression to T2D each year. Because the risk for progression varies by age, sex, ethnicity, and socioeconomic status, there is a need for improved understanding of real-world, patient-level determinants.
• Researchers conducted a case-control study using real-world data to identify predictors of progression to T2D among 98,032 adults with prediabetes.
• Cases were those who experienced progression to T2D (n = 39,281; mean age, 55.8 years; 53.1% women), and control participants were those who did not (n = 58,751; mean age, 56.8 years; 50.8% women); all had continuous medical and pharmacy claims coverage during the previous year.
• T2D was identified either by a medical claim with a diabetes diagnosis code or by a lab result indicating the condition.
• Demographic and clinical characteristics, including age, sex, race/ethnicity, comorbidities, laboratory values, and the use of antidiabetic medications, were assessed during the year before progression to T2D for cases and for a comparable period for control participants.

TAKEAWAY:

• Adults aged 35-44, 45-54, and 55-64 years had higher odds of progression to T2D (odds ratio [OR] range, 1.33-1.49) than those aged 18-34 years.
• A higher comorbidity burden was linked to higher odds of progression to T2D; specific comorbidities associated with higher odds of progression included obesity (OR, 1.45), cardiovascular disease (OR, 1.64), obstructive sleep apnea (OR, 1.36), MASH/MASLD (OR, 1.37), and neuropathy (OR, 1.19).
• Among patients with laboratory data available, a higher baseline A1c level (≥ 5.7% to < 6.0% and ≥ 6.0% to < 6.5%) predicted progression.
• Among those with race/ethnicity data available, Black and Hispanic patients had higher odds of progression to T2D than White patients.

IN PRACTICE:

“The study findings can inform treatment planning and decision-making to mitigate progression in patients with prediabetes,” the authors wrote.

SOURCE:

This study was led by Tyler Dunn, PhD, Novo Nordisk Inc in Plainsboro, New Jersey. It was published online in Diabetes, Obesity and Metabolism.

LIMITATIONS:

This study could not establish causality between the predictors and progression to T2D. The datasets lacked information on behavioral, lifestyle, and socioeconomic factors. Moreover, the sample primarily included insured patients, which may have limited generalizability.

DISCLOSURES:

This study was funded by Novo Nordisk Inc. Four authors disclosed employment with Novo Nordisk Inc and shareholdings in Novo Nordisk A/S; another disclosed serving as a speaker and being on Novo Nordisk’s advisory board. Some authors disclosed employment with IQVIA, which received funding from Novo Nordisk to conduct the study.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.