title: Is there a link between components of health-related functioning and incident impaired glucose metabolism and type 2 diabetes? The Australian Diabetes Obesity and Lifestyle (AusDiab) study.
abstract: OBJECTIVE
  To determine the longitudinal association of components of health-related functioning (HRF) with incident impaired glucose metabolism and type 2 diabetes.
  
  
  METHODS
  The Australian Diabetes Obesity and Lifestyle (AusDiab) study is a national, longitudinal study of adults aged > or =25 years from 42 randomly selected areas of Australia. Diabetes status was defined using the World Health Organization criteria, and HRF was assessed using the SF-36 questionnaire in 1999-2000 and 2004-2005.
  
  
  RESULTS
  Incident impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and newly diagnosed type 2 diabetes were associated with increased bodily pain at baseline compared with those with normal glucose tolerance (NGT) (IFG P = 0.005, IGT P < 0.004, and newly diagnosed type 2 diabetes P = 0.005), after adjustment. In addition, those with incident IGT and newly diagnosed type 2 diabetes had significantly reduced physical functioning, general health, mental health, and vitality at baseline compared with those with NGT. After we controlled for factors associated with incident diabetes, those in the lowest quartile of the physical component summary scale at baseline had at least a 50% higher risk of progression to impaired glucose metabolism and diabetes 5 years later.
  
  
  CONCLUSIONS
  These findings show that incident IFG, IGT, and newly diagnosed type 2 diabetes are associated with reduced HRF independent of cardiovascular disease and that this is evident before the onset of these conditions. If future health promotion campaigns are to effectively target those at high risk of developing diabetes, an understanding of the process of declining health before onset of the disease is essential.
authors.affiliation: Department of Medicine, Monash Medical Centre Southern Clinical School, Monash University, Victoria, Australia. robyn.tapp@med.monash.edu.au
authors.forename: Robyn J
authors.initials: RJ
authors.lastname: Tapp
authors.forename: Adrienne
authors.initials: A
authors.lastname: O'Neil
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Shaw
authors.forename: Paul Z
authors.initials: PZ
authors.lastname: Zimmet
authors.forename: Brian F
authors.initials: BF
authors.lastname: Oldenburg
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology*; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology / Q000503:physiopathology; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology
chemical_list: D001786:Blood Glucose