title: Incidental Risk of Type 2 Diabetes Mellitus among Patients with Confirmed and Unconfirmed Prediabetes.
abstract: OBJECTIVE
  To determine the risk of type 2 diabetes (T2DM) diagnosis among patients with confirmed and unconfirmed prediabetes (preDM) relative to an at-risk group receiving care from primary care physicians over a 5-year period.
  
  
  METHODS
  Utilizing data from the Intermountain Healthcare (IH) Enterprise Data Warehouse (EDW) from 2006-2013, we performed a prospective analysis using discrete survival analysis to estimate the time to diagnosis of T2DM among groups.
  
  
  METHODS
  Adult patients who had at least one outpatient visit with a primary care physician during 2006-2008 at an IH clinic and subsequent visits through 2013. Patients were included for the study if they were (a) at-risk for diabetes (BMI ≥ 25 kg/m2 and one additional risk factor: high risk ethnicity, first degree relative with diabetes, elevated triglycerides or blood pressure, low HDL, diagnosis of gestational diabetes or polycystic ovarian syndrome, or birth of a baby weighing >9 lbs); or (b) confirmed preDM (HbA1c ≥ 5.7-6.49% or fasting blood glucose 100-125 mg/dL); or (c) unconfirmed preDM (documented fasting lipid panel and glucose 100-125 mg/dL on the same day).
  
  
  RESULTS
  Of the 33,838 patients who were eligible for study, 57.0% were considered at-risk, 38.4% had unconfirmed preDM, and 4.6% had confirmed preDM. Those with unconfirmed and confirmed preDM tended to be Caucasian and a greater proportion were obese compared to those at-risk for disease. Patients with unconfirmed and confirmed preDM tended to have more prevalent high blood pressure and depression as compared to the at-risk group. Based on the discrete survival analyses, patients with unconfirmed preDM and confirmed preDM were more likely to develop T2DM when compared to at-risk patients.
  
  
  CONCLUSIONS
  Unconfirmed and confirmed preDM are strongly associated with the development of T2DM as compared to patients with only risk factors for disease.
authors.affiliation: Institute for Healthcare Delivery Research, Intermountain Healthcare, Salt Lake City, Utah, United States of America.|Division of Public Health, School of Medicine, University of Utah, Salt Lake City, Utah, United States of America.|Primary Care Clinical Program, Intermountain Healthcare, Salt Lake City, Utah, United States of America.|Office of Research, Intermountain Healthcare, Salt Lake City, Utah, United States of America.
authors.forename: Kimberly D
authors.initials: KD
authors.lastname: Brunisholz
authors.affiliation: Office of Research, Intermountain Healthcare, Salt Lake City, Utah, United States of America.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Joy
authors.affiliation: Division of Public Health, School of Medicine, University of Utah, Salt Lake City, Utah, United States of America.
authors.forename: Mia
authors.initials: M
authors.lastname: Hashibe
authors.affiliation: Division of Public Health, School of Medicine, University of Utah, Salt Lake City, Utah, United States of America.
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Gren
authors.affiliation: Institute for Healthcare Delivery Research, Intermountain Healthcare, Salt Lake City, Utah, United States of America.
authors.forename: Lucy A
authors.initials: LA
authors.lastname: Savitz
authors.affiliation: Primary Care Clinical Program, Intermountain Healthcare, Salt Lake City, Utah, United States of America.
authors.forename: Sharon
authors.initials: S
authors.lastname: Hamilton
authors.affiliation: Primary Care Clinical Program, Intermountain Healthcare, Salt Lake City, Utah, United States of America.
authors.forename: Wayne
authors.initials: W
authors.lastname: Cannon
authors.affiliation: Division of Public Health, School of Medicine, University of Utah, Salt Lake City, Utah, United States of America.
authors.forename: Jaewhan
authors.initials: J
authors.lastname: Kim
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology*; D016640:Diabetes, Gestational / Q000175:diagnosis; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications / Q000175:diagnosis; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000175:diagnosis; D011236:Prediabetic State / Q000150:complications* / Q000175:diagnosis; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose