(45) Incidence of First-Time HbA1c-Defined Prediabetes in Denmark 2012-2018 and Risk of Progression to Type 2 Diabetes: A Nationwide Study Based on Routine Care Laboratory Data

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1090

Presenting Author(s)

Sia Nicolaisen
– Aarhus University, Aarhus N, Midtjylland, Denmark

Co-Author(s)

Reimar W. Thomsen, MD, PhD
– Professor, Aarhus University, Aarhus N, Midtjylland, Denmark
Cathrine Juel Lau
– Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region of Denmark, Denmark, Denmark
Daniel Witte
– Steno Diabetes Center Aarhus, Aarhus, Denmark. Department of Public Health, Aarhus University, Aarhus, Denmark., Denmark
Henrik Toft Sørensen, MD, PhD, DMSc, DSc
– Professor & Chair, Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark, Midtjylland, Denmark
Lars Pedersen, MSc, PhD
– Professor, Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark, Denmark

Background: Since glycated hemoglobin (HbA1c) became a diagnostic tool for diabetes in 2011, HbA1c testing has increasingly been used. Population-based routine clinical care laboratory databases may therefore be a valuable research tool in prediabetes research.

Objectives: To describe HbA1c measurement patterns in the entire Danish population, to characterize individuals with first-time incident HbA1c-defined prediabetes, and to examine their risk of progression to diabetes.

Methods: All HbA1c measurements in the Danish nationwide laboratory databases during 2012-2018 were characterized. The general population incidence rate of prediabetes (HbA1c 42-47 mmol/mol) was calculated. Among individuals with prediabetes, the 5-year cumulative incidence of diabetes (HbA1c >=48 mmol/mol) was assessed.

Results: Among 5,483,467 Danish residents, 13,107,797 HbA1c measurements from 3,183,880 (58%) individuals were available in the database for the 2012-2018 period. A total of 373,628 individuals were identified with first-time incident HbA1c-defined prediabetes, corresponding to an incidence rate of 15.5 (95% CI 15.5-15.6) per 1,000 person-years. The median HbA1c at prediabetes diagnosis was 43 mmol/mol (IQR 42-44), median age was 67.8 years (IQR 57.9-76.4), and 52.0% were women. During a median follow-up of 2.7 years, 46,821 (12.5%) developed HbA1c-defined diabetes, yielding an estimated cumulative 5-year diabetes incidence of 20.1% (95% CI 19.9-20.3).

Conclusions: More than half of the Danish entire nation had at least one HbA1c measurement registered during 2012-2018. The incidence rate of prediabetes was 15.5 per 1000 person-years, and likely due to extensive testing, persons were identified at an early stage of prediabetes. Within 5 years, one in five individuals with prediabetes will progress to diabetes.