Incidence of Prediabetes and Diabetes in a European Longitudinal General Population Cohort and Its Associated Factors—Results From the Austrian LEAD Study

Abstract

Aims: This study evaluates the incidence of (pre)diabetes in an Austrian population over a broad age span and addresses whether alterations in lifestyle, blood markers, and body composition are associated with the development of (pre)diabetes. Material and Methods: Data from the first and second phases of the Austrian LEAD study, a longitudinal population–based cohort study, were used. Inclusion criteria were a valid glycaemic status (i.e., normoglycaemia, prediabetes, and diabetes) at both phases using American Diabetes Association criteria. Besides blood samples, body composition parameters and an interviewer-administered questionnaire were assessed. A binary logistic regression was performed to answer the research question. Results: In total, 7822 individuals (51% females, 46 ± 19 years with 9.6% aged < 18 years, median follow-up time 4.1 [3.9–4.5] years) were included. The overall incidence rate was estimated at 63.0 (95% CI [59.7; 66.3]) and 8.4 (95% CI [7.4; 9.5]) per 1000 person-years for prediabetes and diabetes, respectively. In the 6–<10-, 10–<20-, and 20–<30-year age bins, an incidence rate of, respectively, 30.2, 16.3, and 13.4 per 1000 person-years (prediabetes) and 2.0, 3.5, and 1.3 (diabetes) was observed. Further, 38.3% of diabetic individuals at Visit 2 were undiagnosed and thus untreated. Factors identified as being significantly associated with progression towards (pre)diabetes included changes in triglycerides, high-density lipoprotein cholesterol, total cholesterol, and visceral adipose tissue mass, besides male sex, older age, low education level, and urban residence. Conclusions: The overall incidence of (pre)diabetes in the Austrian population is high and highlights the need for screening from a young age and on a regular basis so that preventive and treatment strategies can be implemented at an early stage. Trial Registration: ClinicalTrials.gov identifier: NCT01727518.