A landmark study published in JAMA Network Open has unveiled crucial insights into diabetes risk prediction, establishing fasting plasma glucose (FPG) as a primary indicator for diabetes development, even when initial readings fall within normal ranges.
The research, conducted through the Rochester Epidemiology Project (REP) in Olmsted County, Minnesota, analyzed data from nearly 45,000 adults aged 18 to 65 years, tracking their health outcomes between 2005 and 2017. The study population comprised a diverse group, with 87.1% White, 4.1% Asian, 4.3% Black, and 4.5% identifying as other races or ethnicities.
Key Risk Factors and Their Impact
The investigation revealed that 8.6% of participants developed diabetes during the median follow-up period of 6.8 years. Notably, men showed a significantly higher risk, with 10.7% developing diabetes compared to 7.1% of women. The overall Kaplan-Meier 10-year cumulative risk stood at 12.8%.
Both elevated and reduced FPG levels showed increased diabetes risk compared to the reference range of 80-94 mg/dL. Body Mass Index (BMI) emerged as another crucial factor, with any deviation from the normal range (19.5-24.9) correlating with increased diabetes risk. Age also played a significant role, with individuals over 60 showing heightened risk.
Cumulative Risk Assessment
The study's most striking finding was the additive effect of multiple risk factors. For example, researchers documented a dramatic risk escalation in women aged 55-59:
- 7% risk with normal BMI (18.5-24.9) and FPG of 95-99 mg/dL
- 13% risk when BMI increased to 30-34.9
- 28% risk with elevated FPG (105-109 mg/dL)
Clinical Implications and Future Directions
These findings represent a significant advancement in diabetes risk assessment, offering healthcare providers more precise tools for identifying high-risk patients. The study suggests that early intervention strategies, including lifestyle modifications and pharmacological treatments, could be more effectively targeted based on these risk profiles.
The research team emphasizes the need for validation studies in diverse populations to confirm the broader applicability of these risk assessment tools. This work could fundamentally change how healthcare providers approach diabetes prevention, allowing for more personalized and proactive intervention strategies.
