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Identification of impaired fasting glucose, healthcare utilization and progression to diabetes in the UK using the Clinical Practice Research Datalink (CPRD).
Pharmacoepidemiol Drug Saf 2016; 25(12):1375-1386PD

Abstract

PURPOSE

Few studies have examined patients with prediabetes in usual, "real-world" clinical practice settings. Among patients with impaired fasting glucose (IFG), we aimed to describe the rates of progression to diabetes and to examine the long-term reduction in diabetes risk associated with regression to normoglycemia at 1 year.

METHODS

The UK-based study included 120 055 non-diabetic patients in Clinical Practice Research Datalink from 2001 to 2012 aged 25+ years and with ≥1 fasting plasma glucose (FPG) test between ≥6.1 and <7.0 mmol/l indicating IFG who were followed for progression to diabetes. In a subgroup of 45 167 patients with IFG with subsequent FPG results 1 year later, we assessed the 1-year glycemic status change and estimated the relative hazard of diabetes comparing patients with regression to normoglycemia (IFG-normoglycemia) to those who remained in IFG (IFG-IFG) using a multivariable Cox model.

RESULTS

Among patients with IFG with over 414 649 person-years of follow-up, 52% received a subsequent FPG test, and 10% developed diabetes within 1 year after recognition of IFG. The incidence rate of diabetes was 5.86 (95% CI: 5.78 to 5.93) per 100 person-years. In the subgroup analysis, 31% of these patients remained in IFG, while 53% and 16% converted to normoglycemia or diabetes, respectively. The adjusted hazard ratio of developing diabetes was 0.33 (95% CI: 0.31 to 0.35) comparing IFG-normoglycemia to IFG-IFG.

CONCLUSIONS

IFG is a high-risk state for diabetes. Regression to normoglycemia from IFG strongly reduces the long-term risk of developing diabetes. Our study also shows the feasibility of identifying patients with IFG in the Clinical Practice Research Datalink. Copyright © 2016 John Wiley & Sons, Ltd.

Authors+Show Affiliations

Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Department of Epidemiology, Merck & Co., Inc., Kenilworth, NJ, USA.Department of Epidemiology, Merck & Co., Inc., Kenilworth, NJ, USA.Department of Epidemiology, Merck & Co., Inc., Kenilworth, NJ, USA.Department of Epidemiology, Merck & Co., Inc., Kenilworth, NJ, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27193175

Citation

Hong, Jin-Liern, et al. "Identification of Impaired Fasting Glucose, Healthcare Utilization and Progression to Diabetes in the UK Using the Clinical Practice Research Datalink (CPRD)." Pharmacoepidemiology and Drug Safety, vol. 25, no. 12, 2016, pp. 1375-1386.
Hong JL, McNeill AM, He J, et al. Identification of impaired fasting glucose, healthcare utilization and progression to diabetes in the UK using the Clinical Practice Research Datalink (CPRD). Pharmacoepidemiol Drug Saf. 2016;25(12):1375-1386.
Hong, J. L., McNeill, A. M., He, J., Chen, Y., & Brodovicz, K. G. (2016). Identification of impaired fasting glucose, healthcare utilization and progression to diabetes in the UK using the Clinical Practice Research Datalink (CPRD). Pharmacoepidemiology and Drug Safety, 25(12), pp. 1375-1386. doi:10.1002/pds.4007.
Hong JL, et al. Identification of Impaired Fasting Glucose, Healthcare Utilization and Progression to Diabetes in the UK Using the Clinical Practice Research Datalink (CPRD). Pharmacoepidemiol Drug Saf. 2016;25(12):1375-1386. PubMed PMID: 27193175.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Identification of impaired fasting glucose, healthcare utilization and progression to diabetes in the UK using the Clinical Practice Research Datalink (CPRD). AU - Hong,Jin-Liern, AU - McNeill,Ann Marie, AU - He,Jinghua, AU - Chen,Yong, AU - Brodovicz,Kimberly G, Y1 - 2016/05/19/ PY - 2015/09/22/received PY - 2016/03/01/revised PY - 2016/03/14/accepted PY - 2016/5/20/pubmed PY - 2017/8/2/medline PY - 2016/5/20/entrez KW - Clinical Practice Research Datalink KW - diabetes KW - impaired fasting glucose KW - pharmacoepidemiology KW - prediabetes SP - 1375 EP - 1386 JF - Pharmacoepidemiology and drug safety JO - Pharmacoepidemiol Drug Saf VL - 25 IS - 12 N2 - PURPOSE: Few studies have examined patients with prediabetes in usual, "real-world" clinical practice settings. Among patients with impaired fasting glucose (IFG), we aimed to describe the rates of progression to diabetes and to examine the long-term reduction in diabetes risk associated with regression to normoglycemia at 1 year. METHODS: The UK-based study included 120 055 non-diabetic patients in Clinical Practice Research Datalink from 2001 to 2012 aged 25+ years and with ≥1 fasting plasma glucose (FPG) test between ≥6.1 and <7.0 mmol/l indicating IFG who were followed for progression to diabetes. In a subgroup of 45 167 patients with IFG with subsequent FPG results 1 year later, we assessed the 1-year glycemic status change and estimated the relative hazard of diabetes comparing patients with regression to normoglycemia (IFG-normoglycemia) to those who remained in IFG (IFG-IFG) using a multivariable Cox model. RESULTS: Among patients with IFG with over 414 649 person-years of follow-up, 52% received a subsequent FPG test, and 10% developed diabetes within 1 year after recognition of IFG. The incidence rate of diabetes was 5.86 (95% CI: 5.78 to 5.93) per 100 person-years. In the subgroup analysis, 31% of these patients remained in IFG, while 53% and 16% converted to normoglycemia or diabetes, respectively. The adjusted hazard ratio of developing diabetes was 0.33 (95% CI: 0.31 to 0.35) comparing IFG-normoglycemia to IFG-IFG. CONCLUSIONS: IFG is a high-risk state for diabetes. Regression to normoglycemia from IFG strongly reduces the long-term risk of developing diabetes. Our study also shows the feasibility of identifying patients with IFG in the Clinical Practice Research Datalink. Copyright © 2016 John Wiley & Sons, Ltd. SN - 1099-1557 UR - https://www.unboundmedicine.com/medline/citation/27193175/Identification_of_impaired_fasting_glucose_healthcare_utilization_and_progression_to_diabetes_in_the_UK_using_the_Clinical_Practice_Research_Datalink__CPRD__ L2 - https://doi.org/10.1002/pds.4007 DB - PRIME DP - Unbound Medicine ER -