{
  "abstract": "Objectives This cohort study aimed to examine the natural history of prediabetes and the related factors based on a nationwide sample of middle-aged and elderly people in China, which could inform the development of individualized management strategies for prediabetes.Method Participants who were ≥45 years old and with prediabetes at baseline and did not receive glucose-lowering drug treatment during follow-up were identified from a longitudinal cohort of Chinese adults with multiple waves of follow-up. Prediabetes was defined by fasting plasma glucose(100–125mg/dL) and/or hemoglobin A1c(5.7%-6.4%) according to the American Diabetes Association standards. The outcomes of interest included regression to normoglycemia and progression to diabetes. Rates of the two outcomes were calculated, and factors associated with them were investigated by multinomial logistic regression analysis using the participants with persistent prediabetes as the reference group.Results A total of 2532 participants with prediabetes at baseline were included, of which 21.9% participants regressed to normoglycemia and 15.7% progressed to diabetes while the other 62.4% remained in the prediabetic state during the 4-year follow-up. Older age (for every 1-year increase: OR=1.02, 95% CI 1.004–1.035), hypertension (OR=1.36, 95%CI 1.04–1.80), dyslipidemia (OR=1.83, 95% CI 1.29–2.60) and overweight/obesity (OR=1.81, 95% CI 1.38–2.38) were associated with a higher probability of progression to diabetes. Largely consistent with this, older age (for every 1-year increase: OR=0.97, 95% CI 0.96–0.98) and overweight/obesity (OR=0.74, 95% CI 0.59–0.94) were associated with a lower probability of regression to normoglycemia.Conclusions In this cohort of middle-aged and elderly Chinese people with prediabetes, 84% remained in the prediabetic state or even regressed to normoglycemia in the absence of drug treatment over a 4-year period. The rate of regression to normoglycemia was 1.4 times that of progression to diabetes. These findings suggest that majority of people with prediabetes can be managed with less aggressive strategies. Individualized management is warranted.",
  "authors": [
    {
      "affiliations": [
        "Macau University of Science and Technology, Macao, Macao"
      ],
      "name": "Jiayue Zhang"
    },
    {
      "affiliations": [
        "The Chinese University of Hong Kong, Hong Kong, Hong Kong"
      ],
      "name": "Shuting Wang"
    },
    {
      "affiliations": [
        "The Chinese University of Hong Kong, Hong Kong, Hong Kong"
      ],
      "name": "Ying Huang"
    },
    {
      "affiliations": [
        "The Chinese University of Hong Kong, Hong Kong, Hong Kong"
      ],
      "name": "Wenxiao Zheng"
    },
    {
      "affiliations": [
        "Macau University of Science and Technology, Macao, Macao"
      ],
      "name": "Ying Xiao"
    },
    {
      "affiliations": [
        "The Chinese University of Hong Kong, Hong Kong, Hong Kong"
      ],
      "name": "Zuyao Yang"
    }
  ],
  "title": "028 Rates and determinants of regression to normoglycemia and progression to diabetes in Chinese adults with prediabetes who did not receive glucose-lowering drug treatment: evidence from a cohort study",
  "uid": "e6a85863-f771-5d14-8fd1-c401d3e01859"
}