1608-P: Life Years Lost Associated with Prediabetes in a 40-Year Follow-Up Study

Background: The prevalence of prediabetes is gradually increasing and its association with life years lost (LYL) is yet to be determined.

Objective: to examine LYL associated with prediabetes as compared to normoglycemia, by age, sex, country of origin, smoking status, BMI, and blood pressure, using data of the Israel Study of Glucose Intolerance, Obesity and Hypertension (GOH) 40-year follow-up.

Methods: The population of the current study included 2,844 men and women (mean age 52±8.2 years) who underwent OGTT and anthropometric measurements, during 1976-1982, and were followed for mortality until May 2019. Normoglycemia, Prediabetes and diabetes were defined according to fasting plasma glucose, 2-hour post OGTT plasma glucose, reporting of having diabetes or use of antidiabetes medications. By the end of follow-up 27.7% remained alive and multiple imputation procedures were used for missing mortality dates.

Results: At baseline, 35.8%, 48.8% and 15.4% individuals were found with normoglycemia, prediabetes, and diabetes, respectively. Using multiple regression mixed models, the average difference in LYL associated with prediabetes as compared to normoglycemia was 4.3 years (95%CI 3.3-5.2; p<0.001). LYL were higher in prediabetic women than in prediabetic men 4.4 (95%CI 3.0-5.7) vs. 3.3 (95%CI 1.9-4.8). These differences persisted mainly in individuals younger than 60 years, with BMI<25 kg/m², never smokers, and normotensives at baseline. Significant reductions of 9.9 years (95%CI 8.6-11.2) were observed for diabetes as compared to prediabetes and 14.2 years on average (95%CI 12.8-15.5) as compared to normoglycemic individuals.

Conclusions: This study reveals that life expectancy of middle-aged individuals with prediabetes is more than 4 years shorter than of normoglycemic individuals. As expected, diabetes was associated with the greatest LYL in this long-term cohort study.