Toward targeted prevention: risk factors for prediabetes defined by impaired fasting glucose, impaired glucose tolerance and increased HbA1c in the population-based KORA study from Germany

Gregory G. Greiner, Karl M.F. Emmert-Fees, Jana Becker, Wolfgang Rathmann, Barbara Thorand, Annette Peters, Anne S. Quante, Lars Schwettmann, Michael Laxy

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Aims: To identify socioeconomic, behavioral and clinical factors that are associated with prediabetes according to different prediabetes definition criteria. Methods: Analyses use pooled data of the population-based Cooperative Health Research in the Region of Augsburg (KORA) studies (n = 5312 observations aged ≥ 38 years without diabetes). Prediabetes was defined through either impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or elevated HbA1c according to thresholds of the American Diabetes Association. Explanatory variables were regressed on prediabetes using generalized estimating equations. Results: Mean age was 58.4 years; 50% had prediabetes (33% had IFG, 16% IGT, and 26% elevated HbA1c, 10% fulfilled all three criteria). Age, obesity, hypertension, low education, unemployment, statutory health insurance, urban residence and physical inactivity were associated with prediabetes. Male sex was a stronger risk factor for IFG (OR = 2.5; 95%–CI: 2.2–2.9) than for IGT or elevated HbA1c, and being unemployed was a stronger risk factor for IGT (OR = 3.2 95%–CI: 2.6–4.0) than for IFG or elevated HbA1c. Conclusions: The overlap of people with IFG, IGT and elevated HbA1c is small, and some factors are associated with only one criterion. Knowledge on sociodemographic and socioeconomic risk factors can be used to effectively target interventions to people at high risk for type 2 diabetes.

Original languageEnglish
Pages (from-to)1481-1491
Number of pages11
JournalActa Diabetologica
Volume57
Issue number12
DOIs
StatePublished - 1 Dec 2020
Externally publishedYes

Keywords

  • Epidemiology
  • IFG
  • IGT
  • Increased HbA1c
  • Prediabetes
  • Prevention

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