ABSTRACT
BACKGROUND: Lifestyle intervention decreases diabetes risk in prediabetic subjects, but the impact of passive notification of prediabetes status on glycemia or health behavior is unclear. METHODS: The Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) study followed normoglycemic African American (AA) and European American (EA) offspring of parents with type 2 diabetes mellitus for incident prediabetes. During 5.5 years of follow-up (mean, 2.62 years), 101 of 343 subjects developed prediabetes and were notified, without any interventions. Participants were recalled 18 months poststudy. Here, we compared data from participants with incident prediabetes or normoglycemia (control) during POP-ABC who underwent retesting 18-months poststudy. RESULTS: There were 73 subjects (46 female, 27 male; 36 AA, 37 EA) in the prediabetes group and 73 subjects (48 female, 25 male; 35 AA, 38 EA) in the control group. The mean (± SEM) enrollment age was 48.7 ± 0.96 years versus 48.3 ± 1.06 years (P = .37) and body mass index (BMI) was 31.1 ± 0.70 kg/m2 versus 29.2 ± 0.69 kg/m2 (P = .04) for prediabetes versus control groups, respectively. The 18-month changes (prediabetes vs control) were the following: fasting plasma glucose (FPG), -8.01 ± 1.11 vs 2.02 ± 0.64 mg/dL; 2-hour plasma glucose (2hrPG), -8.21 ± 3.34 vs 8.53 ± 3.17 mg/dL; weight, -0.54 ± 0.72 vs 2.77 ± 1.25 kg; and waist circumference -1.07 ± 0.78 vs 1.78 ± 0.85 (P = .03-<0.0001). The interval changes in FPG were significantly correlated with changes in weight and waist circumference (r = 0.2, P = .01). The prediabetes group reported improved dietary and exercise habits compared with control. CONCLUSION: Communication of prediabetes status is associated with improvements in glucose tolerance, glycemia, and adiposity, probably via self-directed lifestyle modification.
Subject(s)
Behavior Therapy/methods , Diabetes Mellitus, Type 2/prevention & control , Health Behavior , Health Knowledge, Attitudes, Practice , Prediabetic State/therapy , Adolescent , Adult , Black or African American/psychology , Black or African American/statistics & numerical data , Aged , Blood Glucose/analysis , Body Weight , Case-Control Studies , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/etiology , Female , Follow-Up Studies , Healthy Lifestyle , Humans , Incidence , Male , Middle Aged , Prediabetic State/blood , Prediabetic State/complications , Treatment Outcome , White People/psychology , White People/statistics & numerical data , Young AdultABSTRACT
AIMS: We assessed blood pressure (BP) and blood glucose (BG) values in healthy subjects, and examined baseline BP as a predictor of incident prediabetes during follow-up. METHODS: Participants in the Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) study underwent screening assessments (anthropometry, BP, OGTT) and were stratified into normal BP (NBP), prehypertension, or hypertension, and normal glucose regulation (NGR), prediabetes (IFG/IGT), or type 2 diabetes (T2D) status. NGR subjects who met all inclusion criteria were enrolled in a 5-yr prospective study, with the primary outcome of incident prediabetes. RESULTS: We screened 602 adults (341 black, 261 white) and enrolled 343 (193 black, 150 white) for prospective follow-up. Systolic and diastolic BP correlated significantly with fasting and nonfasting BG (P=0.003-<0.0001). Compared to NGR group, more prediabetic subjects had prehypertension (42.5% vs. 36.2%) and fewer had NBP (35.9% vs. 48.6%) (P=0.009). During ~5years of follow-up, 26.3% of NBP and 35.7% of prehypertensive subjects developed prediabetes (P=0.02). Kaplan-Meier analysis showed higher probability of incident prediabetes among participants with prehypertension compared to NBP during ~5years of follow-up (P=0.0012). CONCLUSIONS: In our biracial cohort, BP and BG values were significantly correlated, and BP status predicted incident prediabetes among initially normoglycemic individuals. These findings suggest co-evolution of factors involved in the dysregulation of BP and BG.
