The heterogeneity of reversion to normoglycemia according to prediabetes type is not explained by lifestyle factors
Authors: Giráldez-García Carolina , Cea-Soriano Lucía , Albaladejo Romana , Franch-Nadal Josep , Mata-Cases Manel , Díez-Espino Javier , Artola Sara , Serrano Rosario , Regidor Enrique ,   for the PREDAPS Study Group, Alonso Margarita , Álvarez Beatriz , Álvarez Fernando , Álvarez J Carlos , del Mar Álvarez Mª , Antón J Joaquín , Armengol Oriol , Ávila Luis , Babace Carmen , Barutell Lourdes , Bedoya Mª Jesús , Benito Belén , Bilbeny Beatriz , Birules Marti , Blanco Concepción , Bobé Mª Isabel , Boente Carmen , Borras Antonia , Bosch Remei , Brito Mª Jesús , Buil Pilar , Cabré J José , Cambra Ainoha , Carbonell Francisco , Carramiñana Francisco , Carrillo Lourdes , Casorrán Ana , Colas Rafael , Cordero Blanca , Cos Xavier , Cuatrecasas Gabriel , De Castro Cristina , De la Flor Manuel , De la Sen Carlos , De Miguel Rosa Mar , De Santiago A María , Del Castillo Mercedes , Durán Mª Carmen , Ezkurra Patxi , Gabriel Paula , Gamarra Javier , García Francisco , García-Giralda Luis , García-Soidán F Javier , Gijón Mª Teresa , Goday Albert , Gómez Ángel , del Carmen Gómez María , González J Carles , González María , Granero Esteban , Gutiérrez Ángela Trinidad , Gutiérrez Félix , Gutiérrez Luisa , Gutiérrez M Ángel , Hernández Ana Mª , Ibáñez Mercedes , Iglesias Rosario , Igual Dimas , Innenaraty Jaime , Iriarte Yon , Jurado Ángeles , Llanes Rafael , López Flora , López Riánsares , Lorenzo Ángela , Losada Carmen , Macía Ramón , Malo Fernando , Mancera José , Mansilla Mª José , Marín Mª Teresa , Martín José Luis , Martínez F Javier , Martínez Juan , Martínez Rosario , Mayayo Mª Soledad , Mediavilla J Javier , Mendo Luis , Millaruelo J Manuel , Monzón Alicia , Moreno Ana , Muñoz Pedro , Mundet Xavier , Mur Teresa , Navarro Emma , Navarro Jorge , Nogales Pedro , Obaya J Carlos , Ortega Francisco Javier , Paniagua Francisca , Pardo José Luis , Pérez Francisco Carlos , Pérez Pedro P , Piulats Neus , Plana Raquel , Porta Nuria , Poveda Santiago , Prieto Luis , Pujol Ramón , Ripoll Jazmín , Rodríguez Antonio , Rodríguez J José , Rollán Mª Angeles , Romera Laura , Rubio Jóse Félix , Ruiz Antonio , Ruiz Irene , Ruiz Manuel Antonio , Sáenz Isabel , Sagredo Julio , Salanova Alejandro , Sánchez L Gabriel , Sánchez Manuel , Sanz Gloria , Seguí Mateu , Suárez Dulce , Tarragó Eduard , Torrecilla Jesús , Torres José Luis , Villaró Merè , Yuste Carmen 
Published: May 2021

Healthy lifestyle interventions and drug therapies are proven to have a positive preventative influence on normal glucose regulation in prediabetes. However, little is known on the specific role that these factors play on reversion to normal glycemia according to type of prediabetes. We used data from the Observational prospective cohort study, The Cohort study in Primary Health Care on the Evolution of Patients with Prediabetes from 2012 to 2015. A total of 1184 individuals aged 30–74 years old were included and classified based on the ADA in three mutually exclusive groups using either fasting plasma glucose (FPG) levels (from 100 to 125 mg/dl, FPG group), HbA1c (5.7–6.4%, HbA1c group) or both impaired parameters. Information on lifestyle factors and biochemical parameters were collected at baseline. Reversion to normal glucose regulation was calculated at third year of follow-up. Relationship of lifestyle factor and type of prediabetes with reversion were estimated using odds ratios (ORs) with 95% confidence intervals (95% CIs) adjusting by different groups of confounders. Proportion of reversion rates were 31% for FPG group, 31% for HbA1c group and 7.9% for both altered parameters group, respectively. Optimal life style factors such as BMI < 25 kg/m2[OR (95% CI): 1.90 (1.20–3.01)], high adherence to Mediterranean diet 1.78 (1.21–2.63) and absence of abdominal obesity 1.70 (1.19–2.43) were the strongest predictors for reversion to normal glucose. However, those did not modify the ORs of reversion to normal glucose. Taking as reference those with both impaired parameters, subjects with FPG impairment (FPG group) had an OR of 4.87 (3.10–7.65) and 3.72 (2.39–5.78) for HbA1c group. These estimates remained almost the same after further adjustment for biochemical parameters and lifestyle factors (4.55(2.84–7.28) and 3.09 (1.92–4.97), respectively). Optimal lifestyle factors showed to be a positive predictor for reversion to normal glucose regulation however, the differences of reversion risk according type of prediabetes are not explained by lifestyle factors.