Quantifying the duration of pre-diabetes

Aust N Z J Public Health. 2010 Jun;34(3):311-4. doi: 10.1111/j.1753-6405.2010.00532.x.


Objective: Interventions for individuals with pre-diabetes are efficacious, however, identification of people with pre-diabetes does not occur in Australia. This study aims to calculate the duration of pre-diabetes, in order to provide supporting evidence for a screening program.

Methods: We carried out a systematic review and random effects meta-analysis to identify if an increased risk of mortality is present in people with pre-diabetes. The result of this meta-analysis as well as information on prevalence, remission of pre-diabetes and transition to diabetes from an Australian cohort study, were used in the software program DisMod to calculate duration.

Results: From 2,578 articles identified, 11 studies met the inclusion criteria. The pooled relative risk of all-cause mortality was 1.26 (1.17-1.34) with no sign of heterogeneity between the studies. The average duration of pre-diabetes was 8.5 years in males aged 30+ and 10.3 years in females aged 30+.

Conclusions: The duration of pre-diabetes in Australia is long enough to warrant a screening program. The finding is robust to sensitivity testing of very large variations in the epidemiological parameters.

Implications: If the interventions following screening are shown to be cost-effective, a strong rationale for the implementation of a screening program exists.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Australia / epidemiology
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Evidence-Based Medicine
  • Female
  • Glucose Intolerance / mortality*
  • Humans
  • Male
  • Middle Aged
  • Prediabetic State / mortality*
  • Risk
  • Sex Factors
  • Time Factors