title: Pre-diabetes in adults 45 years and over in Ireland: the Survey of Lifestyle, Attitudes and Nutrition in Ireland 2007.
abstract: OBJECTIVE
  Pre-diabetes is an important indicator of future diabetes burden and many countries are reporting prevalence estimates of pre-diabetes. To date in Ireland, estimates of the prevalence of pre-diabetes were unavailable. Our objectives were to estimate the prevalence of pre-diabetes in a nationally representative sample of Irish adults and to explore determinants of pre-diabetes.
  
  
  METHODS
  The Survey of Lifestyle Attitudes and Nutrition 2007 was a cross-sectional survey on health and lifestyle in a nationally representative sample of Irish adults. Analysis was performed on a subsample of 1132 participants ≥ 45 years who provided blood samples. Determination of pre-diabetes was based on American Diabetes Association HbA1c cut points of 39-46 mmol/mol (5.7-6.4%). To explore determinants, we modelled pre-diabetes prevalence as a function of a set of health system and socio-demographic variables using logistic regression.
  
  
  RESULTS
  The overall weighted prevalence estimate of pre-diabetes in participants ≥ 45 years was 19.8% (95% CI 16.4-23.9). There was no significant difference between age or gender-specific prevalence rates. Obesity was significantly associated with pre-diabetes on univariate and multivariate analysis. Population attributable fraction estimates for excess BMI, physical inactivity and poor diet as causes of pre-diabetes were 31.3% (95% CI -3.9 to 54.5), 10.0% (95% CI -2.7 to 21.3) and 6.1% (95% CI -4.9 to 15.9), respectively.
  
  
  CONCLUSIONS
  The high levels of pre-diabetes detected in this study are worrying. Population level interventions to address diet and lifestyle factors are needed urgently to prevent progression to diabetes in high-risk individuals.
authors: Department of General Practice, University College Cork (UCC), Cork, Ireland; Department of Epidemiology and Public Health, University College Cork (UCC), Cork, Ireland.
authors: C M
authors: CM
authors: Buckley
authors: J
authors: J
authors: Madden
authors: K
authors: K
authors: Balanda
authors: S
authors: S
authors: Barron
authors: L
authors: L
authors: Fahy
authors: J
authors: J
authors: Harrington
authors: I J
authors: IJ
authors: Perry
authors: P
authors: P
authors: M Kearney
mesh_terms: D000368:Aged; D001290:Attitude; D001786:Blood Glucose; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D018450:Disease Progression; D005247:Feeding Behavior; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D015438:Health Behavior; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D011159:Population Surveillance; D011236:Prediabetic State / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control; D015995:Prevalence; D057185:Sedentary Behavior
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human