Diabetes, obesity, and cardiometabolic CARE · 2026
Predictors of Glycemic Worsening in the Next Year in Adults With Screen-Detected Type 2 Diabetes.
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Schneider Aguirre Rebecca, Hannon Tamara S, Considine Robert V, Patel Yash, Kirkman M Sue, Mather Kieren J
Аннотация
OBJECTIVE: Predicting which individuals with mild dysglycemia will progress to frank type 2 diabetes is challenging. Identifying simple markers for impending worsening glucose can allow clinicians to target therapeutic interventions for those at highest risk. We aimed to determine which routine clinical measures herald near-term glycemic worsening in early type 2 diabetes.
RESEARCH DESIGN AND METHODS: The Early Diabetes Intervention Program (EDIP) was a clinical trial in individuals with asymptomatic, screen-detected type 2 diabetes (HbA1c 6.3 ± 0.63% [45 ± 5 mmol/mol]). We investigated the time course of fasting blood glucose (FBG), HbA1c, weight, and other clinical factors to determine predictors of glycemic worsening over the next year.
RESULTS: Of 219 participants, 62 (28.5%) progressed. Progressors had higher FBG than nonprogressors at baseline (130 vs. 118 mg/dL [7.2 vs. 6.6 mmol/L]; P < 0.001). FBG remained stable until the year of progression, when progressors exhibited a large 1-year rise (mean change 14.2 mg/dL [0.79 mmol/L]). Current FBG and antecedent year change in FBG were associated with progression (P < 0.01), although the magnitude of change was not clinically useful (0.19 mg/dL [0.01 mmol/L]). Neither current nor antecedent year change in HbA1c, weight, triglycerides, or HDL were associated with progression. In the year of glycemic worsening, rising glucose was strongly associated with a concurrent increase in weight (P < 0.001).
CONCLUSIONS: Elevated FBG, but not HbA1c, identified individuals at risk for imminent glycemic worsening; the subsequent large rise in glucose was associated with a short-term increase in weight. Weight maintenance (even without weight loss) is associated with favorable glycemic patterns and may provide an actionable goal for managing early diabetes.
RESEARCH DESIGN AND METHODS: The Early Diabetes Intervention Program (EDIP) was a clinical trial in individuals with asymptomatic, screen-detected type 2 diabetes (HbA1c 6.3 ± 0.63% [45 ± 5 mmol/mol]). We investigated the time course of fasting blood glucose (FBG), HbA1c, weight, and other clinical factors to determine predictors of glycemic worsening over the next year.
RESULTS: Of 219 participants, 62 (28.5%) progressed. Progressors had higher FBG than nonprogressors at baseline (130 vs. 118 mg/dL [7.2 vs. 6.6 mmol/L]; P < 0.001). FBG remained stable until the year of progression, when progressors exhibited a large 1-year rise (mean change 14.2 mg/dL [0.79 mmol/L]). Current FBG and antecedent year change in FBG were associated with progression (P < 0.01), although the magnitude of change was not clinically useful (0.19 mg/dL [0.01 mmol/L]). Neither current nor antecedent year change in HbA1c, weight, triglycerides, or HDL were associated with progression. In the year of glycemic worsening, rising glucose was strongly associated with a concurrent increase in weight (P < 0.001).
CONCLUSIONS: Elevated FBG, but not HbA1c, identified individuals at risk for imminent glycemic worsening; the subsequent large rise in glucose was associated with a short-term increase in weight. Weight maintenance (even without weight loss) is associated with favorable glycemic patterns and may provide an actionable goal for managing early diabetes.