Khalili Davood, Dehghani Zohreh, Asgari Samaneh, Hadaegh Farzad, Azizi Fereidoun
Prevention of Metabolic Disorders Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, PO Box 19395-4763, Yaman St, Tehran, Iran.
Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Diabetes Metab Disord. 2024 May 29;23(2):1863-1870. doi: 10.1007/s40200-023-01370-7. eCollection 2024 Dec.
The incidence of prediabetes has been on the rise, indicating a growing public health concern, as individuals with prediabetes are at higher risk of developing type 2 diabetes. This study aimed to determine the effects of simple interventions on the regression of pre-diabetes status into normoglycemia and also prevent progression to diabetes in a pragmatic community trial.
A total of 2073 (761 intervention; 1,312 controls) participants with pre-diabetes were included in the present secondary data analysis; cases with diabetes or normoglycemia were identified during nine years of follow-up. We utilized multinomial logistic regression to calculate relative risk reductions (RRR, 95% CIs) for educational interventions targeting lifestyle changes in both men and women. Additionally, we employed a linear regression model that considered the ordinal outcomes ranging from normal to prediabetes and diabetes.
In men, after adjusting for confounders, the intervention group had a 53% (95% CI = 1.11-2.10) more significant chance of returning to normoglycemia than the control group after three years of follow-up. In addition, men in the intervention group also had an increased risk of developing type 2 diabetes than men in the control group (RRR = 1.53, 95% CI = 1.02-2.31) after three years of follow-up. These findings among men remained consistent even after a six-year follow-up period. In women, after adjusting for age, the chance of returning to normoglycemia after three years in the intervention group was 1.30 times higher than in women in the control group (95% CI = 1.00-1.69), which disappeared after adjusting for other covariates or after six years of follow-up. The results of the regression analysis showed that the intervention had no effect on changing the status of the outcome from normal to prediabetes and diabetes.
We could not demonstrate any effect of a simple intervention in improving prediabetes. This high-risk population may require more gender-specific intensive interventions and attention.
糖尿病前期的发病率一直在上升，这表明公众健康问题日益严重，因为糖尿病前期个体患2型糖尿病的风险更高。本研究旨在通过一项务实的社区试验，确定简单干预措施对糖尿病前期状态恢复正常血糖以及预防进展为糖尿病的影响。
本二次数据分析纳入了总共2073名（761名干预组；1312名对照组）糖尿病前期参与者；在九年的随访期间识别出糖尿病或血糖正常的病例。我们使用多项逻辑回归来计算针对男性和女性生活方式改变的教育干预的相对风险降低率（RRR，95%置信区间）。此外，我们采用了一个线性回归模型，该模型考虑了从正常到糖尿病前期和糖尿病的有序结果。
在男性中，调整混杂因素后，随访三年后干预组恢复正常血糖的可能性比对照组高53%（95%置信区间=1.11 - 2.10）。此外，随访三年后，干预组男性患2型糖尿病的风险也高于对照组男性（RRR = 1.53，95%置信区间=1.02 - 2.31）。即使在六年的随访期后，男性中的这些发现仍然一致。在女性中，调整年龄后，干预组三年后恢复正常血糖的可能性比对照组女性高1.30倍（95%置信区间=1.00 - 1.69），在调整其他协变量后或六年随访后这种差异消失。回归分析结果表明，干预对改变结果状态从正常到糖尿病前期和糖尿病没有影响。
我们未能证明简单干预对改善糖尿病前期有任何效果。这个高危人群可能需要更具性别针对性的强化干预和关注。
