Department of Nursing and Physiotherapy, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears, Spain.
Prevention of Occupational Risks in Health Services, Balearic Islands Health Service, C/ Reina Esclaramunda, 9, 07003 Palma, Illes Balears, Spain.
Nutrients. 2020 May 25;12(5):1538. doi: 10.3390/nu12051538.
People with prediabetes have an increased risk of developing type 2 diabetes (T2D). Few studies have evaluated the influence of lifestyle factors on the risk of progression to diabetes and reversion to normoglycemia. The aim of this study was to determine the incidence of T2D in a large cohort of workers with prediabetes, and to evaluate the influence of sociodemographic, clinical, metabolic, and lifestyle factors that affect the persistence of prediabetes and the progression to T2D.
A cohort study of 27,844 adult workers (aged 20 to 65 years) from Spain who had prediabetes based on an occupational medical examination from 2012 to 2013. Prediabetes was defined as fasting plasma glucose (FPG) between 100 and 125 mg/dL. At the baseline evaluation, sociodemographic, anthropometric, metabolic, and lifestyle data were collected. At the 5-year follow-up, incident T2D was defined as an FPG of at least 126 mg/dL or initiation of an antidiabetic medication.
Among 235,995 initially screened workers, the prevalence of T2D was 14.19% (95% confidence interval (CI) 14.05 to 14.33) and the prevalence of prediabetes was 11.85% (95% CI 11.71 to 11.99). Follow-up data were available for 23,293 individuals with prediabetes. Among them, 36.08% (95% CI 35.46 to 36.70) returned to normoglycemia, 40.92% (95% CI 40.29 to 41.55) had persistent prediabetes, and 23.00% (95% CI 22.46 to 23.54) progressed to T2D. The risk for persistence of prediabetes and for progression to T2D increased with age, body mass index (BMI), triglyceride level, and less than 150 min/week of physical activity. An HbA1c level of 6% or greater was the strongest individual predictor of progression to T2D.
Physical activity, diet, smoking, and BMI are modifiable factors that are associated with the persistence of prediabetes and the progression to T2D. The workplace is a feasible setting for the early detection of prediabetes and the promotion of lifestyles that can prevent progression to T2D.
患有前驱糖尿病的人群发生 2 型糖尿病（T2D）的风险增加。很少有研究评估生活方式因素对进展为糖尿病和恢复正常血糖水平的风险的影响。本研究旨在确定大规模前驱糖尿病患者队列中 T2D 的发生率，并评估影响前驱糖尿病持续存在和进展为 T2D 的社会人口学、临床、代谢和生活方式因素。
这是一项对西班牙 27844 名成年工人（年龄 20 至 65 岁）进行的队列研究，他们在 2012 年至 2013 年期间的职业体检中被诊断为前驱糖尿病。前驱糖尿病的定义为空腹血糖（FPG）在 100 至 125mg/dL 之间。在基线评估时，收集了社会人口统计学、人体测量学、代谢和生活方式数据。在 5 年随访时，将新诊断的 T2D 定义为 FPG 至少 126mg/dL 或开始使用抗糖尿病药物。
在最初筛选的 235995 名工人中，T2D 的患病率为 14.19%（95%置信区间[CI]为 14.05%至 14.33%），前驱糖尿病的患病率为 11.85%（95%CI 为 11.71%至 11.99%）。有 23293 名前驱糖尿病患者可获得随访数据。其中，36.08%（95%CI 为 35.46%至 36.70%）恢复正常血糖，40.92%（95%CI 为 40.29%至 41.55%）持续存在前驱糖尿病，23.00%（95%CI 为 22.46%至 23.54%）进展为 T2D。前驱糖尿病持续存在和进展为 T2D 的风险随着年龄、体重指数（BMI）、甘油三酯水平和每周体力活动少于 150 分钟而增加。HbA1c 水平为 6%或更高是进展为 T2D 的最强个体预测因素。
体力活动、饮食、吸烟和 BMI 是与前驱糖尿病持续存在和进展为 T2D 相关的可改变因素。工作场所是早期发现前驱糖尿病和促进可预防 T2D 进展的生活方式的可行场所。
