Prediabetes and risk of mortality, diabetes-related complications and comorbidities: umbrella review of meta-analyses of prospective studies

Aims/hypothesis The term prediabetes is used for individuals who have impaired glucose metabolism whose glucose or HbA 1c levels are not yet high enough to be diagnosed as diabetes. Prediabetes may already be associated with an increased risk of chronic ‘diabetes-related’ complications. This umbrell...

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Veröffentlicht in:Diabetologia Jg. 65; H. 2; S. 275 - 285
Hauptverfasser: Schlesinger, Sabrina, Neuenschwander, Manuela, Barbaresko, Janett, Lang, Alexander, Maalmi, Haifa, Rathmann, Wolfgang, Roden, Michael, Herder, Christian
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2022
Springer Nature B.V
Schlagworte:
Breast cancer
Cardiovascular Diseases - mortality
Cause of Death
Cognitive ability
Comorbidity
Congestive heart failure
Dementia
Dementia - mortality
Dementia disorders
Diabetes
Diabetes Complications - mortality
Diabetes mellitus
Diabetic neuropathy
Fibrillation
Glucose
Glucose Intolerance - complications
Glucose metabolism
Glucose tolerance
Hepatocellular carcinoma
Human Physiology
Humans
Internal Medicine
Kidney diseases
Kidney Diseases - mortality
Liver cancer
Medicine
Medicine & Public Health
Meta-analysis
Metabolic Diseases
Mortality
Neoplasms - mortality
Prediabetic State - mortality
Reviews
Risk Factors
Stroke
Systematic review
Prediabetes
Complications
Mortality
Umbrella review
Meta-analysis
ISSN:0012-186X, 1432-0428, 1432-0428
Online-Zugang:Volltext
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Zusammenfassung:Aims/hypothesis The term prediabetes is used for individuals who have impaired glucose metabolism whose glucose or HbA 1c levels are not yet high enough to be diagnosed as diabetes. Prediabetes may already be associated with an increased risk of chronic ‘diabetes-related’ complications. This umbrella review aimed to provide a systematic overview of the available evidence from meta-analyses of prospective observational studies on the associations between prediabetes and incident diabetes-related complications in adults and to evaluate their strength and certainty. Methods For this umbrella review, systematic reviews with meta-analyses reporting summary risk estimates for the associations between prediabetes (based on fasting or 2 h postload glucose or on HbA 1c ) and incidence of diabetes-related complications, comorbidities and mortality risk were included. PubMed, Web of Science, the Cochrane Library and Epistemonikos were searched up to 17 June 2021. Summary risk estimates were recalculated using a random effects model. The certainty of evidence was evaluated by applying the GRADE tool. This study is registered with PROSPERO, CRD42020153227. Results Ninety-five meta-analyses from 16 publications were identified. In the general population, prediabetes was associated with a 6–101% increased risk for all-cause mortality and the incidence of cardiovascular outcomes, CHD, stroke, heart failure, atrial fibrillation and chronic kidney disease, as well as total cancer, total liver cancer, hepatocellular carcinoma, breast cancer and all-cause dementia with moderate certainty of evidence. No associations between prediabetes and incident depressive symptoms and cognitive impairment were observed (with low or very low certainty of evidence). The association with all-cause mortality was stronger for prediabetes defined by impaired glucose tolerance than for prediabetes defined by HbA 1c . Conclusions/interpretation Prediabetes was positively associated with risk of all-cause mortality and the incidence of cardiovascular outcomes, CHD, stroke, chronic kidney disease, cancer and dementia. Further high-quality studies, particularly on HbA 1c -defined prediabetes and other relevant health outcomes (e. g. neuropathy) are required to support the evidence. Graphical abstract
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ISSN:0012-186X
1432-0428
1432-0428
DOI:10.1007/s00125-021-05592-3