Prediabetes Progression to Diabetes among Veterans

Prevalence of diabetes and prediabetes, as well as cardiovascular disease is very high among Veterans. The aim of the study is to evaluate the rate of progression of prediabetes and the factors associated with progression to diabetes. This is an observational, retrospective data-base study of progression of prediabetes to diabetes at Veterans Health Administration at Columbia, South Carolina, diagnosed between 2008 and 2019 based on HbA1C (5.7 to 6.4). We calculated the time interval to progress to diabetes from the date of baseline data, and then the percentage of subjects progressed to diabetes is calculated as 1st year, 2nd year and so on. Statistical analysis included descriptive statistics and correlation of parameters with progression to diabetes. Subjects with prediabetes identified include 72,604 with mean age 66 and mean HbA1C of 5.9. Among the study population, only 8% were women. Association of hypertension was 55% and atherosclerotic coronary artery disease was 13%. Among the study population, 10,710 subjects did not have follow up. Among 61,894 prediabetics 21,954 (35%) progressed to diabetes, while 39,940 (65%) remained as prediabetic. Those progressed to diabetes had relatively higher HbA1C and associated with higher prevalence of atherosclerotic cardiovascular disease, hypertension and are older by age. About 60% of those progressed to diabetes are within 2 years from baseline. We conclude that aggressive measures are necessary to prevent progression to diabetes to decrease the morbidity associated with diabetes and health care burden. It is essential to identify those progress to diabetes, such as biomarker evaluation.

Prediabetes Progression to Diabetes among Veterans with Post Traumatic Stress Disorder

Prevalence of diabetes and prediabetes, post-traumatic stress disorder (PTSD) as well as atherosclerotic cardiovascular disease is very high among veterans. The primary aim of this study is to compare the rate of progression of prediabetes to diabetes among veterans with or without PTSD and associated conditions and or risk factors for that. This retrospective observational database study included all subjects with prediabetes based on HbA1C (5.7 to 6.4), after exclusion criteria between 2008 and 2019 at Veterans Health Administration at Columbia, South Carolina. PTSD codes were used to identify veterans with PTSD. Subjects with prediabetes identified include 72,604 with mean age of 66 and mean HbA1C of 5.9% and 29% of them had PTSD. Follow-up data is available for 62,184 subjects. Among those who had follow-up, 35% progressed to diabetes, while 65% remained as prediabetic. Progression to diabetes negatively is correlated with HbA1C (r = 0.34;p < 0.001). Associated other risks include obesity, hypertension and atherosclerotic cardiovascular disease. The rate of progression was higher among subjects with PTSD though much younger than those without PTSD.