Transition from non-diabetes to diabetes: a population-based longitudinal study in Vietnamese individuals

Objective. This study sought to determine the incidence of T2DM and identify risk factors among a Vietnamese urban cohort without previous T2DM diagnoses to support early intervention. Methods . This population-based prospective study included 1971 individuals (1368 women) free of T2DM at baseline. Participants were re-assessed after a median follow-up of 2.0 years. Glycosylated hemoglobin (HbA1c) levels were measured using high-pressure liquid chromatography (HPLC) analyzers (ADAMS A1c HA-8160, Arkray, Kyoto, Japan). T2DM was defined as an HbA1c value ≥ 6.5%, while prediabetes was defined as an HbA1c value between 5.7% and 6.4%. Incident T2DM was identified as newly developed diabetes from a non-diabetic status. The association between potential risk factors and T2DM was analyzed using logistic regression. Results. At baseline, 1137 participants (58%) were classified as 'Normal' and 834 (42%) as 'Pre-diabetes'. Over the follow-up, 16% of initially normal individuals progressed to prediabetes, and 10% of those with prediabetes progressed to diabetes. Overall, 4.3% transitioned to diabetes. Advancing age (OR per year: 1.03; 95% CI, 1.01 to 1.06) and higher BMI (OR per unit: 1.20; 95% CI, 1.12 to 1.27) were significantly associated with an increased risk of developing T2DM. A predictive model incorporating age, body mass index (BMI), and baseline HbA1c resulted in an area under the ROC curve of 0.90. Conclusions. The study revealed a notable 4.3% incidence of T2DM over two years among Vietnamese adults. Significant predictors included age and BMI, underscoring the need for targeted preventive measures focusing on weight management and monitoring in high-risk groups.