Regidor Enrique, Cea-Soriano Lucía, Ruiz Antonio, Goday Albert, Carabantes David, Díez-Espino Javier, Artola Sara, Franch-Nadal Josep
Department of Public Health and Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
Scand J Prim Health Care. 2021 Sep;39(3):355-363. doi: 10.1080/02813432.2021.1958497. Epub 2021 Aug 4.
Information about prognostic outcomes can be of great help for people with prediabetes and for physicians in the face of scientific controversy about the cutoff point for defining prediabetes. We aimed to estimate different prognostic outcomes in people with prediabetes.
Prospective cohort of subjects with prediabetes according to American Diabetes Association guidelines.
The probabilities of diabetes onset versus non-onset, the odds against diabetes onset, and the probability of reverting to normoglycemia according to different prediabetes categories were calculated.
The odds against diabetes onset ranged from 29:1 in individuals with isolated FPG of 100-109 mg/dL to 1:1 in individuals with FPG 110-125 mg/dL plus HbA1c 6.0-6.4%. The probability of reversion to normoglycemia was 31.2% (95% CI 24.0-39.6) in those with isolated FPG 100-109 mg/dL and 6.2% (95% CI 1.4-10.0) in those with FPG 110-125 mg/dL plus HbA1c 6.0-6.4%. Of every 100 participants in the first group, 97 did not develop diabetes and 31 reverted to normoglycemia, while in the second group those figures were 52 and 6.
Using odds of probabilities and absolute numbers might be useful for people with prediabetes and physicians to share decisions on potential interventions.Key pointsCommunicating knowledge on the course of the disease to make clinical decisions is not always done appropriately.Prediabetes is an example where risk communication is important because the prognosis of subjects with prediabetes is very heterogeneous.Depending on fasting plasma glucose and HbA1c levels, the odds of probabilities against diabetes onset ranged from 29: 1 to 1: 1.Depending on fasting plasma glucose and HbA1c levels, the number of subjects in 100 who revert to normoglycemia ranged from 31 to 6.Using probabilities and number absolutes on the prognosis of prediabetes may be useful for people with prediabetes and physicians to share decisions on potential interventions.
面对关于糖尿病前期定义切点的科学争议，糖尿病前期患者的预后信息对他们自身以及医生都有很大帮助。我们旨在评估糖尿病前期患者的不同预后情况。
根据美国糖尿病协会指南对糖尿病前期患者进行前瞻性队列研究。
计算根据不同糖尿病前期类别发生糖尿病与未发生糖尿病的概率、糖尿病发病的比值比以及恢复正常血糖的概率。
糖尿病发病的比值比范围从单纯空腹血糖（FPG）为100 - 109mg/dL的个体的29:1到FPG为110 - 125mg/dL加上糖化血红蛋白（HbA1c）为6.0 - 6.4%的个体的1:1。单纯FPG为100 - 109mg/dL的个体恢复正常血糖的概率为31.2%（95%置信区间24.0 - 39.6），FPG为110 - 125mg/dL加上HbA1c为6.0 - 6.4%的个体恢复正常血糖的概率为6.2%（95%置信区间1.4 - 10.0）。在第一组的每100名参与者中，97人未患糖尿病，31人恢复正常血糖，而在第二组中，这两个数字分别为52人和6人。
对于糖尿病前期患者和医生来说，使用概率比值和绝对数字可能有助于就潜在干预措施达成共识。要点通过传达疾病发展过程的知识来做出临床决策并非总是恰当的。糖尿病前期就是一个风险沟通很重要的例子，因为糖尿病前期患者的预后差异很大。根据空腹血糖和HbA1c水平，糖尿病发病的概率比值范围从29:1到1:1。根据空腹血糖和HbA1c水平，每100名恢复正常血糖的受试者人数范围从31人到6人。使用糖尿病前期预后的概率和绝对数字可能有助于糖尿病前期患者和医生就潜在干预措施达成共识。
