Abstract
Introduction:
There is limited data on longitudinal assessments of diabetes incidence according to baseline glycemic status among Hispanics/Latinos in the US.
Hypothesis:
We hypothesized that diabetes risk in Hispanics/Latino adults varies by baseline glycemic status.
Methods:
We examined the progression to diabetes among Hispanic/Latinos enrolled in HCHS/SOL; a population-based longitudinal study of 16,415 individuals of varying Hispanic/Latino background aged 18 - 74. We used Poisson regression models that accounted for the complex sampling strategy in HCHS/SOL to compare the rates of diabetes incidence by baseline prediabetes criteria [impaired glycated hemoglobin (IA1c, 5.7-6.4%), impaired fasting glucose (IFG, 100-125 mg/dl), and impaired glucose tolerance (IGT, 140-199 mg/dl on OGTT)], as well as any of these two criteria, or all prediabetes criteria, compared to normoglycemia.
Results:
A total of 8014 individuals attended both Visit 1 (2008-2011) and Visit 2 (2014-2017) and were free of diabetes at Visit 1. Persons who developed diabetes were older, had lower education and had higher blood pressure, adiposity (waist circumference, BMI), dyslipidemia, HOMA-IR, and C-reactive protein (all p<0.001). The proportion of participants who developed diabetes on visit 2 varied significantly according to baseline prediabetes categories (IFG 7.4±1.5%, IGT=10.6±2.0%, impaired A1c=9.0±1.1%, two criteria=23.9±1.8%, all prediabetes criteria=43.1±3.7%). After adjusting for potential confounders, including demographics and risk factors for diabetes, meeting more prediabetes criteria was associated with a significantly higher risk of diabetes compared to baseline normoglycemic status, (Table).
Conclusions:
Diabetes incidence among Hispanic/Latino adults varied markedly by glycemic category at baseline. Each additional criterion of prediabetes magnified in a dose-response relationship the risk of diabetes in this population.