Awareness of Prediabetes Status and Subsequent Health Behavior, Body Weight, and Blood Glucose Levels

Ibiye Owei, MD, MPH; Nkiru Umekwe, MBBS; Fatoumatta Ceesay, BS; Samuel Dagogo-Jack, MD

Disclosures

J Am Board Fam Med. 2019;32(1):20-27. 

In This Article

Results

Cohort Description

The characteristics at enrollment of study subjects who developed prediabetes and were so informed during POP-ABC and age- and sex-matched participants who maintained normoglycemia during POP-ABC study (control) are shown in Table 1. As previously reported,[17] participants who developed incident prediabetes had higher BMI, waist circumference, FPG, and 2hrPG at enrollment, compared with participants who maintained normoglycemia.

Glycemic, Anthropometric, and Lipidmic Changes

We assessed the interval changes in plasma glucose and other metabolic endpoints when progressors and nonprogressors to prediabetes during POP-ABC study were rescreened for enrollment in the extension study (PROP-ABC). As already noted, the POP-ABC study was an observational, natural history study that did not entail any drug intervention or lifestyle counseling to alter metabolic endpoints. During the 18-month interval between the end of POP-ABC study and rescreening for the PROP-ABC study, FPG levels decreased by 8.01 ± 1.11 mg/dL in the prediabetes group and by 2.02 ± 0.64 mg/dL in the control group (P < .0001). During the same said interval, 2hrPG levels decreased by 8.21 ± 3.34 mg/dL in the prediabetes group but increased by 8.53 ± 3.17 mg/dL in the control group (P = .0004) (Figure 2 and Table 2). The corresponding interval changes (prediabetes group vs control group) were −0.54 ± 0.72 kg versus 2.77 ± 1.25 kg (P = .006) for body weight and −1.07 ± 0.78 cm versus 1.78 ± 0.85 cm (P = .001) for waist circumference (Figure 2 and Table 2). The change in BMI was 0.23 ± 0.29 kg/m2 in the prediabetes group and 1.06 ± 0.46 kg/m2 in control (P = .03). In the regression analyses, the interval changes in FPG were correlated with interval changes in weight (r = 0.18, P = .04) and waist circumference (r = 0.20, P = .01).

Figure 2.

Interval changes in glycemia in prediabetes and control groups (A) and within the prediabetes group by ethnicity (B), and interval changes in weight (C) and waist circumference (D) in the prediabetes and control groups. There were no significant ethnic differences in the interval changes in glycemia. *P = .006, **P = .001, ***P = .0004, ****P < .0001. To convert the values for glucose to millimoles per liter, multiply by 0.0555. FPG, fasting plasma glucose; PG, plasma glucose.

The prediabetes group did not show significant alterations in plasma levels of low-density lipoprotein cholesterol (111 ± 3.61 mg/dL vs 111 ± 3.79 mg/dL), high-density lipoprotein cholesterol (49.2 ± 2.18 mg/dL vs 50.5 ± 1.65 mg/dL), or triglycerides (106 ± 6.71 mg/dL vs 102 ± 5.33 mg/dL) between the end of POP-ABC versus follow-up examination 18 months later, nor did the control group: low-density lipoprotein cholesterol, 106 ± 3.55 mg/dL versus 106 ± 3.31 mg/dL; high-density lipoprotein cholesterol, 54.7 ± 1.73 mg/dL versus 55.1 ± 1.57 mg/dL; and triglycerides, 91.5 ± 5.85 versus 94.2 ± 4.91.

Behavioral Changes

Self-reported FHQ score (lower values indicate healthier eating pattern) decreased from 2.57 ± 0.51 to 2.34 ± 0.55 (−0.23; P = .0003) in the prediabetes group and from 2.51 ± 0.50 to 2.35 ± 0.52 (−0.16; P = .0005) in the control group. The absolute decrease in FHQ score was significantly greater in the prediabetes group versus control group (−0.23 ± 0.05 vs −0.16 ± 0.04, P = .002). Self-reported MAQ score (higher values indicate greater physical activity) increased nominally from 13.8 ± 3.03 MET-hr/wk to 16.5 ± 2.47 MET-hr/wk in the prediabetes group, but decreased nominally from 21.7 ± 3.39 MET-hr/wk to 18.4 ± 2.76 MET-hr/wk in the control group. The absolute change in MAQ score was significantly greater in the prediabetes group versus control group (2.70 ± 3.45 MET-hr/wk vs −3.30 ± 4.20 MET-hr/wk; P = .002) (Table 2).

processing....