Transition between prediabetic and diabetic stages in an urban community in india: a decade-long retrospective cohort...

The rising prevalence of prediabetes has increased the risk of diabetes, particularly among younger populations, if timely interventions are not implemented. In India, the limited availability of cohort-based incidence studies underscores the need for retrospective analyses using hospital-based electronic medical information systems (EMIS). This study estimates the transition probabilities and duration of stay in the prediabetic state before progression to type 2 diabetes in a cohort of normoglycemic individuals.

Data from 1,670 diabetes-free individuals aged 30 years and above were extracted from a government hospital's electronic medical records spanning a 10-year period. Incidence rates of type II diabetes were calculated separately for individuals with baseline normoglycemia and prediabetes. A multistate model was employed to estimate transition probabilities between normoglycemia, prediabetes, and diabetes over time.

The overall incidence of type II diabetes was 20.94 per 1,000 person-years, with higher rates among individuals with baseline prediabetes (41.74 vs. 15.89 per 1,000 PYs in normoglycemic individuals). The probability of progressing from prediabetes to diabetes reached ~ 30%, while normoglycemia to prediabetes reached ~ 25%. Reversion from prediabetes to normoglycemia peaked at around 60% within the first 2-3 years and later declined. Males had a higher likelihood of progressing to diabetes, whereas females showed higher prediabetic reversal.

The study underscores the critical importance of early detection and timely intervention during the prediabetic phase to prevent progression to diabetes and associated complications.