title: Quantifying the duration of pre-diabetes.
abstract: OBJECTIVE
  Interventions for individuals with pre-diabetes are efficacious, however, identification of people with pre-diabetes does not occur in Australia. This study aims to calculate the duration of pre-diabetes, in order to provide supporting evidence for a screening program.
  
  
  METHODS
  We carried out a systematic review and random effects meta-analysis to identify if an increased risk of mortality is present in people with pre-diabetes. The result of this meta-analysis as well as information on prevalence, remission of pre-diabetes and transition to diabetes from an Australian cohort study, were used in the software program DisMod to calculate duration.
  
  
  RESULTS
  From 2,578 articles identified, 11 studies met the inclusion criteria. The pooled relative risk of all-cause mortality was 1.26 (1.17-1.34) with no sign of heterogeneity between the studies. The average duration of pre-diabetes was 8.5 years in males aged 30+ and 10.3 years in females aged 30+.
  
  
  CONCLUSIONS
  The duration of pre-diabetes in Australia is long enough to warrant a screening program. The finding is robust to sensitivity testing of very large variations in the epidemiological parameters.
  
  
  CONCLUSIONS
  If the interventions following screening are shown to be cost-effective, a strong rationale for the implementation of a screening program exists.
authors.affiliation: Centre for Burden of Disease and Cost-Effectiveness, School of Population Health, Edith Cavell Building, Herston Rd, Herston QLD 4006. m.bertram@sph.uq.edu.au
authors.forename: Melanie Y
authors.initials: MY
authors.lastname: Bertram
authors.forename: Theo
authors.initials: T
authors.lastname: Vos
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D005260:Female; D018149:Glucose Intolerance / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000401:mortality*; D012306:Risk; D012737:Sex Factors; D013997:Time Factors