title: Incidence Rate of Prediabetes: An Analysis of New Zealand Primary Care Data.
abstract: BACKGROUND
  Diabetes is a common disease affecting 9% of the adult population worldwide. People with impaired glucose tolerance ('prediabetes') are at high risk of progressing to type 2 diabetes.
  
  
  METHODS
  To understand prediabetes incidence rate, we analysed the electronic medical records (EMR) from 14 New Zealand general practices regarding patients aged ≥20 years and enrolled with the practices between 2009 and 2012. Prediabetes incidence rate was calculated by the number of patients with an initial HbA1c of 41-49 mmol/mol in 2011 among those who had not been diagnosed or treated for diabetes.
  
  
  RESULTS
  28,192 adults were included in the analysis, 11% of this cohort had diabetes before 2011. 1,276 new cases of prediabetes were identified in 2011, giving a 5.0% incidence rate. The relative risk (RR) for prediabetes was increased for the Māori and Pacific groups versus non-Māori/non-Pacific people, with RR of 1.97 in the younger age groups (&lt;50 years) and RR of 1.42 in the 50+ group. The RR for having uncontrolled HbA1c (highest HbA1c in 2011 ≥65 mmol/mol) among the whole adult population was also increased for the Māori and Pacific groups versus non-Māori/non-Pacific people (RR=3.35 among those &lt;50 years, RR=4.35 in the 50+ group).
  
  
  CONCLUSIONS
  EMR analysis identified an alarming incidence rate of prediabetes, especially among Māori and Pacific groups, highlighting the need to better prevent and manage the condition.
authors.affiliation: University of Auckland, New Zealand.
authors.forename: Yulong
authors.initials: Y
authors.lastname: Gu
authors.affiliation: University of Auckland, New Zealand.
authors.forename: Jim
authors.initials: J
authors.lastname: Warren
authors.affiliation: University of Auckland, New Zealand.
authors.forename: John
authors.initials: J
authors.lastname: Kennelly
authors.affiliation: University of Auckland, New Zealand.
authors.forename: Natalie
authors.initials: N
authors.lastname: Walker
authors.affiliation: University of Auckland, New Zealand.
authors.forename: Matire
authors.initials: M
authors.lastname: Harwood
mesh_terms: D000328:Adult; D017677:Age Distribution; D015415:Biomarkers / Q000097:blood; D057225:Data Mining / Q000379:methods; D020000:Decision Support Systems, Clinical; D057286:Electronic Health Records / Q000145:classification / Q000706:statistics & numerical data*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009323:Natural Language Processing; D009520:New Zealand / Q000453:epidemiology; D011159:Population Surveillance; D011236:Prediabetic State / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human