title: Colorectal adenomas and diabetes: implications for disease prevention.
abstract: OBJECTIVE
  This study assessed the baseline type II diabetes mellitus (T2DM) risk status among overweight patients with screen-detected colorectal adenomas and explored the implications of the findings for preventative practice.
  
  
  METHODS
  Participants aged between 50 and 74 years (73% of whom were men) were recruited from four Scottish health boards and assessed for diabetes risk. Participants were categorized as at 'high' diabetes risk if glycated haemoglobin (HbA1c) was between 6.0 and 6.4% or fasting plasma glucose (FPG) was between 5.5 and 6.9 mmol/l and as potentially undiagnosed T2DM when HbA1c ≥ 6.5% or FPG ≥ 7 mmol/l. Secondary outcome measures included anthropometric measurements, blood pressure and the plasma lipid profile. The tests were repeated at 12 months and diabetes risk categories were reassessed following intervention procedures.
  
  
  RESULTS
  Forty-seven (14.3%) of the 329 participants had a preexisting diagnosis of T2DM. Of the remainder with complete biochemistry results (n = 250), 19 (7.6%) were classified as having potentially undiagnosed T2DM and 125 (50.0%) as being at high risk of developing diabetes. More than a quarter of participants in all categories had raised waist circumference, hypertension and plasma lipids, indicative of raised cardiovascular risk. At 12 months' follow-up, the diabetes risk category diminished in 20% of the intervention group vs 11% in the controls [OR 2.26 (95% CI 1.03-4.96)].
  
  
  CONCLUSIONS
  Our results suggest that a diagnosis of adenoma in overweight patients provides a health service opportunity for diabetes assessment, prevention and management in a high-risk population at a potentially teachable moment.
authors.affiliation: Centre for Research into Cancer Prevention and Screening, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.
authors.forename: R J C
authors.initials: RJ
authors.lastname: Steele
authors.affiliation: Centre for Research into Cancer Prevention and Screening, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.
authors.forename: A S
authors.initials: AS
authors.lastname: Anderson
authors.affiliation: Centre for Research into Cancer Prevention and Screening, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.
authors.forename: M
authors.identifier: http://orcid.org/0000-0002-7536-8198
authors.initials: M
authors.lastname: Macleod
authors.affiliation: Centre for Research into Cancer Prevention and Screening, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.
authors.forename: A M
authors.initials: AM
authors.lastname: Craigie
authors.affiliation: Centre for Research into Cancer Prevention and Screening, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.
authors.forename: S
authors.initials: S
authors.lastname: Caswell
authors.affiliation: Vascular Diseases Research Unit, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.
authors.forename: J
authors.initials: J
authors.lastname: Belch
authors.affiliation: Health Services Research Unit, University of Aberdeen, Aberdeen, UK.
authors.forename: S
authors.initials: S
authors.lastname: Treweek
mesh_terms: D000236:Adenoma / Q000150:complications*; D000368:Aged; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications; D015179:Colorectal Neoplasms / Q000097:blood / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000517:prevention & control*; D005215:Fasting / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D050177:Overweight / Q000097:blood / Q000150:complications / Q000628:therapy; D012307:Risk Factors; D012606:Scotland; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008055:Lipids; C517652:hemoglobin A1c protein, human
keywords: Adenoma; cardiovascular; diabetes; obesity; screening