Glucose indices, health behaviors, and incidence of diabetes in Australia: the Australian Diabetes, Obesity and Lifestyle Study

Dianna J Magliano, Elizabeth L M Barr, Paul Z Zimmet, Adrian J Cameron, David W Dunstan, Stephen Colagiuri, Damien Jolley, Neville Owen, Patrick Phillips, Robyn J Tapp, Tim A Welborn, Jonathan E Shaw

Research output: Contribution to journalArticle

157 Citations (Scopus)

Abstract

OBJECTIVE: This national, population-based study reports diabetes incidence based on oral glucose tolerance tests (OGTTs) and identifies risk factors for diabetes in Australians.

RESEARCH DESIGN AND METHODS: The Australian Diabetes, Obesity and Lifestyle Study followed-up 5,842 participants over 5 years. Normal glycemia, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes were defined using World Health Organization criteria.

RESULTS: Age-standardized annual incidence of diabetes for men and women was 0.8% (95% CI 0.6-0.9) and 0.7% (0.5-0.8), respectively. The annual incidence was 0.2% (0.2-0.3), 2.6% (1.8-3.4), and 3.5% (2.9-4.2) among those with normal glycemia, IFG, and IGT, respectively, at baseline. Among those with IFG, the incidence was significantly higher in women (4.0 vs. 2.0%), while among those with IGT, it was significantly higher in men (4.4 vs. 2.9%). Using multivariate logistic regression, hypertension (odds ratio 1.64 [95% CI 1.17-2.28]), hypertriglyceridemia (1.46 [1.05-2.02]), log fasting plasma glucose (odds ratio per 1 SD 5.25 [95% CI 3.98-6.92]), waist circumference (1.26 [1.08-1.48]), smoking (1.70 [96% CI 1.11-2.63]), physical inactivity (1.56 [1.12-2.16]), family history of diabetes (1.82 [1.30-2.52]), and low education level (1.85 [1.04-3.31]) were associated with incident diabetes. In age- and sex-adjusted models, A1C was a predictor of diabetes in the whole population, in those with normal glycemia, and in those with IGT or IFG.

CONCLUSIONS: Diabetes incidence is 10-20 times greater in those with IGT or IFG than those with normal glycemia. Measures of glycemia, A1C, metabolic syndrome components, education level, smoking, and physical inactivity are risk factors for diabetes.

Original languageEnglish
Pages (from-to)267-272
Number of pages6
JournalDiabetes Care
Volume31
Issue number2
DOIs
Publication statusPublished - Feb 2008
Externally publishedYes

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Australia/epidemiology
  • Blood Glucose/analysis
  • Cross-Sectional Studies
  • Diabetes Mellitus/epidemiology
  • Exercise
  • Female
  • Glucose Intolerance/epidemiology
  • Glucose Tolerance Test
  • Health Behavior
  • Health Surveys
  • Humans
  • Hypertriglyceridemia/epidemiology
  • Incidence
  • Life Style
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prevalence
  • Risk Factors
  • Smoking Cessation
  • Surveys and Questionnaires

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