Prediabetes Progression and Reversion: Social Factors and Racial/Ethnic Differences

Area of Science:

• Endocrinology and Metabolism
• Health Disparities Research
• Social Determinants of Health

Background:

• Racial and ethnic minorities experience disproportionately higher rates of diabetes.
• Social characteristics like family structure, social support, and loneliness may exacerbate these health disparities.
• Understanding longitudinal changes in glucose metabolism (prediabetes to diabetes or normoglycemia) across diverse populations is crucial.

Purpose of the Study:

• To evaluate longitudinal rates of progression from prediabetes to diabetes and reversion to normoglycemia in a diverse older adult population.
• To examine the influence of race/ethnicity and social variables on these glycemic transitions.
• To identify potential targets for culturally specific interventions to reduce diabetes disparities.

Main Methods:

• Analysis of the longitudinal Health and Retirement Study (2006-2014) with 2229 individuals and 2625 follow-up intervals.
• Assessment of 4-year progression and reversion rates using HbA1c levels and physician-diagnosed diabetes status.
• Application of chi-square and logistic regression models, controlling for comorbidities and demographics, to analyze race/ethnicity and social factors.

Main Results:

• Overall, reversion from prediabetes to normoglycemia (36%) was more common than progression to diabetes (17%).
• Hispanic/Latino individuals exhibited higher odds of progression compared to Whites, while Black individuals showed lower odds of reversion.
• Social variables, particularly family reliance and lower loneliness among Hispanics/Latinos, reduced progression odds, but did not impact Black reversion rates.

Conclusions:

• Distinct transition pathways and social profiles exist for Hispanic/Latinos and Black individuals regarding diabetes development.
• Social factors significantly influence diabetes progression in Hispanic/Latinos, but not reversion in Black individuals.
• Culturally tailored interventions addressing social determinants are essential for mitigating diabetes disparities.