School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
School of Nursing, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.
J Adv Nurs. 2020 Dec;76(12):3329-3345. doi: 10.1111/jan.14557. Epub 2020 Oct 3.
To assess the overall relative risk of diabetes in individuals with prediabetes based on updated diagnostic criteria, as compared with individuals with normoglycaemia; and to identify the study characteristics associated with the heterogeneity between studies.
Meta-analysis, meta-regression.
PubMed, CINAHL, British Nursing Index. Search time frame: December 1998-December 2018.
The pooled relative risk of developing diabetes among individuals with prediabetes compared with those with normoglycaemia was calculated under a random effects model. Studies reported the natural progression from prediabetes to diabetes were included in this review. Sources of study heterogeneity were examined by a meta-regression.
Fifty-nine eligible studies were systematically identified. The pooled relative risk for diabetes among individuals with prediabetes as compared with normoglycaemia was 5.88 (95% CI: 5.02-6.89). The annualized incidence rate (per 1,000 person-year) for diabetes among individuals with prediabetes defined by different criteria varied from 2.20-212.15, with high heterogeneity between studies (I = 96.64%, Q test: p < .001). In the multivariable meta-regression analysis, Asian population significantly increased RR compare to Caucasians. Besides, people with 'elevated glycated haemoglobin A1c or impaired fasting glucose' had highest relative risk compare to people with other types of prediabetes.
Individuals with prediabetes had higher risk of developing diabetes than those with normoglycaemia. Races and diagnostic criteria of prediabetes were associated with the magnitude of the estimated risk.
Prediabetes is a precursor of diabetes. To screen people with prediabetes as early as possible, practitioners could consider haemoglobin A1c test as an alternative to fasting plasma glucose test. Nurses should educate people especially Asians with prediabetes for the prevention of progression to diabetes.
根据最新的诊断标准，评估基于更新诊断标准的个体中糖尿病的总体相对风险，与血糖正常个体相比；并确定与研究间异质性相关的研究特征。
荟萃分析，荟萃回归。
PubMed、CINAHL、英国护理索引。搜索时间范围：1998 年 12 月-2018 年 12 月。
采用随机效应模型计算糖尿病前期个体与血糖正常个体相比发生糖尿病的相对风险。本综述纳入了报告从糖尿病前期自然进展为糖尿病的研究。通过荟萃回归检查研究异质性的来源。
系统地确定了 59 项符合条件的研究。与血糖正常个体相比，糖尿病前期个体的糖尿病相对风险为 5.88（95%CI：5.02-6.89）。不同标准定义的糖尿病前期个体的年糖尿病发病率（每 1000 人年）从 2.20-212.15 不等，研究间存在高度异质性（I 2 = 96.64%，Q 检验：p<0.001）。在多变量荟萃回归分析中，与白种人相比，亚洲人群的 RR 显著增加。此外，与其他类型的糖尿病前期患者相比，“糖化血红蛋白升高或空腹血糖受损”的人群具有最高的相对风险。
与血糖正常者相比，糖尿病前期患者发生糖尿病的风险更高。种族和糖尿病前期的诊断标准与估计风险的大小有关。
糖尿病前期是糖尿病的前驱期。为了尽早筛查糖尿病前期患者，临床医生可以考虑糖化血红蛋白检测作为空腹血糖检测的替代方法。护士应教育糖尿病前期患者，特别是亚洲患者，以预防病情进展为糖尿病。
