(225) Evaluation of Factors Associated with Transition from Pre-diabetes to Diabetes among Residents of Low-income Communities

Objective : More than one-third of the United States (US) population has prediabetes, characterized by hemoglobin A1C levels (HbA1c) ranging from 5.7 ≤ to < 6.5. Prediabetes exposes individuals to an elevated risk of developing type 2 diabetes, heart disease, and stroke. Although prediabetes predominates among rural communities, no study has evaluated the factors associated with transitioning from prediabetes to diabetes among low-income patients residing in the US. The aim of the study is to identify factors associated with the progression from prediabetes to diabetes among rural patients. The goal is to identify targeted interventions for enhancing diabetes management and prevention among patients with prediabetes.

Methods: We retrospectively studied adult patients’ electronic health records (EHR) with a diabetes history from January 2012 to September 2022. Data came from Community Health Northwest Florida—a Federally Qualified Health Center. Patients aged at least 18 years with a prediabetes diagnosis (baseline HbA1c = 5.7 – 6.4%) were included. They were categorized based on subsequent progression to diabetes [HbA1c > 6.4%] or the absence of progression (HbA1c < 5.7%). Patients with one data point or type-1 diabetes were excluded. Analysis used stepwise logistic regression. The study was approved by IRB.

Results: Our analysis included 1,910 patients with prediabetes - male= 746, Female = 1164. Results showed that a higher BMI (OR= 1.018, 95% Confidence Interval {CI} [1.005 – 1.031; P-value = 0.0057) was associated with an increased risk of diabetes. Conversely, patients who received dietary counseling had a reduced risk of diabetes (OR= 0.531, 95% CI [0.419 – 0.672], p < 0.001).

Conclusions: Our study highlights the importance of focusing prediabetes education on dietary counseling and implementing interventions to address BMI (obesity) among at-risk patients.