PMID- 36621941
OWN - NLM
STAT- MEDLINE
DCOM- 20230110
LR  - 20230208
IS  - 1365-2060 (Electronic)
IS  - 0785-3890 (Print)
IS  - 0785-3890 (Linking)
VI  - 55
IP  - 1
DP  - 2023 Dec
TI  - Risk factors associated with glycated hemoglobin A1c trajectories progressing to 
      type 2 diabetes.
PG  - 371-378
LID - 10.1080/07853890.2022.2164347 [doi]
AB  - BACKGROUND AND OBJECTIVE: The notion of prediabetes, defined by the ADA as 
      glycated hemoglobin A1c (HbA1c) of 5.7-6.4%, implies increased vascular 
      inflammatory and immunologic processes and higher risk for developing diabetes 
      mellitus and major cardiovascular events. We aimed to determine the risk factors 
      associated with rapid progression of normal and prediabetes patients to type 2 
      diabetes mellitus (T2DM). METHODS: Retrospective cohort study in a single 
      8-hospital health system in southeast Michigan, between 2006 and 2020. All 
      patients with HbA1c <6.5% at baseline and at least 2 other HbA1c measurements 
      were clustered in five trajectories encompassing more than 95% of the study 
      population. Multivariate linear regression analysis was performed to examine the 
      association of demographic and comorbidities with HbA1c trajectories progressing 
      to diabetes. RESULTS: A total of 5,347 prediabetic patients were clustered based 
      on their HbA1c progression (C1: 4,853, C2: 253, C66: 102, C12: 85, C68: 54). The 
      largest cluster (C1) had a baseline median HbA1c value of 6.0% and exhibited 
      stable HbA1c levels in prediabetic range across all subsequent years. The 
      smallest cluster (C68) had the lowest median baseline HbA1c value and also 
      remained stable across subsequent years. The proportion of normal HbA1c in each 
      of the pre-diabetic trajectories ranged from 0 to 12.7%, whereas 81.5% of the 
      reference cluster (C68) were normal HbA1c at baseline. The C2 (steady rising) 
      trajectory was significantly associated with BMI (adj OR 1.10, 95%CI 1.03-1.17), 
      and family history of DM (adj OR 2.75, 95%CI 1.32-5.74). With respect to the late 
      rising trajectories, baseline BMI was significantly associated with both C66 and 
      C12 trajectory (adj OR 1.10, 95%CI 1.03-1.18) and (adj OR 1.13, 95%CI 1.05-1.23) 
      respectively, whereas, the C12 trajectory was also significantly associated with 
      age (adj OR 1.62, 95%CI 1.04-2.53) and history of MACE (adj OR 3.20, 95%CI 
      1.14-8.93). CONCLUSIONS: We suggest that perhaps a more aggressive preventative 
      approach should be considered in patients with a family history of T2DM who have 
      high BMI and year-to-year increase in HbA1c, whether they have normal hemoglobin 
      A1c or they have prediabetes.KEY MESSAGESProgression to diabetes from normal or 
      prediabetic hemoglobin A1c within four years is associated with baseline BMI.A 
      steady rise in HbA1c during a four-year period is associated with age and family 
      history of T2DM, whereas age and personal history of MACE are associated with a 
      rapid rise in HbA1c.A more aggressive preventative approach should be 
      considered in patients with a family history of T2DM who have high BMI and 
      year-to-year increase in HbA1c.
FAU - Halalau, Alexandra
AU  - Halalau A
AD  - Department of Internal Medicine, Beaumont Hospital, Royal Oak, MI, USA.
AD  - Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
FAU - Roy, Sujoy
AU  - Roy S
AD  - Department of Foundational Medical Studies, Oakland University William Beaumont 
      School of Medicine, Rochester, MI, USA.
FAU - Hegde, Arpitha
AU  - Hegde A
AD  - Department of Electrical and Computer Engineering, Oakland University, Rochester, 
      MI, USA.
FAU - Khanal, Sumesh
AU  - Khanal S
AD  - Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA.
FAU - Langnas, Emily
AU  - Langnas E
AD  - Department of Internal Medicine, Beaumont Hospital, Royal Oak, MI, USA.
FAU - Raja, Maidah
AU  - Raja M
AD  - Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
FAU - Homayouni, Ramin
AU  - Homayouni R
AD  - Department of Foundational Medical Studies, Oakland University William Beaumont 
      School of Medicine, Rochester, MI, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Ann Med
JT  - Annals of medicine
JID - 8906388
RN  - 0 (Glycated Hemoglobin)
SB  - IM
MH  - Humans
MH  - *Diabetes Mellitus, Type 2/epidemiology/etiology
MH  - Glycated Hemoglobin
MH  - *Prediabetic State/epidemiology/complications
MH  - Retrospective Studies
MH  - Risk Factors
PMC - PMC9833406
OTO - NOTNLM
OT  - Prediabetes
OT  - hemoglobin A1c
OT  - risk factors
OT  - trajectory
OT  - type 2 diabetes mellitus
COIS- No potential conflict of interest was reported by the author(s).
EDAT- 2023/01/10 06:00
MHDA- 2023/01/11 06:00
PMCR- 2023/01/09
CRDT- 2023/01/09 07:13
PHST- 2023/01/09 07:13 [entrez]
PHST- 2023/01/10 06:00 [pubmed]
PHST- 2023/01/11 06:00 [medline]
PHST- 2023/01/09 00:00 [pmc-release]
AID - 2164347 [pii]
AID - 10.1080/07853890.2022.2164347 [doi]
PST - ppublish
SO  - Ann Med. 2023 Dec;55(1):371-378. doi: 10.1080/07853890.2022.2164347.