Diabetes Metab J.  2023 Nov;47(6):859-868. 10.4093/dmj.2022.0377.

Prediabetes Progression and Regression on Objectively- Measured Physical Function: A Prospective Cohort Study

• Qiu S
• Zhu Y
• Xie B
• Chen W
• Wang D
• Cai X
• Sun Z
• Wu T

• KMID: 2548162
• DOI: http://doi.org/10.4093/dmj.2022.0377

Abstract

Background
Prediabetes leads to declines in physical function in older adults, but the impact of prediabetes progression or regression on physical function is unknown. This study assessed this longitudinal association, with physical function objectivelymeasured by grip strength, walking speed, and standing balance, based on the Health and Retirement Study enrolling United States adults aged >50 years.
Methods
Participants with prediabetes were followed-up for 4-year to ascertain prediabetes status alteration (maintained, regressed, or progressed), and another 4-year to assess their impacts on physical function. Weak grip strength was defined as <26 kg for men and <16 kg for women, slow walking speed was as <0.8 m/sec, and poor standing balance was as an uncompleted fulltandem standing testing. Logistic and linear regression analyses were performed.
Results
Of the included 1,511 participants with prediabetes, 700 maintained as prediabetes, 306 progressed to diabetes, and 505 regressed to normoglycemia over 4 years. Grip strength and walking speed were declined from baseline during the 4-year followup, regardless of prediabetes status alteration. Compared with prediabetes maintenance, prediabetes progression increased the odds of developing weak grip strength by 89% (95% confidence interval [CI], 0.04 to 2.44) and exhibited larger declines in grip strength by 0.85 kg (95% CI, –1.65 to –0.04). However, prediabetes progression was not related to impairments in walking speed or standing balance. Prediabetes regression also did not affect any measures of physical function.
Conclusion
Prediabetes progression accelerates grip strength decline in aging population, while prediabetes regression may not prevent physical function decline due to aging.

Keyword

Aging; Follow-up studies; Hand strength; Prediabetic state

Figure

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  Fig. 1. Study design and flowchart. (A) Study design: considering the 4-year turn-around time in the Health and Retirement Study surveys, three sequential datasets were created, namely the pre-evaluation (data combined from 2008 and 2010 waves), baseline (data combined from 2012 and 2014 waves), and follow-up (data combined from 2016 and 2018 waves) datasets. The pre-evaluation dataset was used to identify participants with prediabetes, the baseline dataset was to ascertain prediabetes status alteration, and the follow-up dataset was to assess the impact of prediabetes status alteration on physical function. (B) Study flowchart: A total of 1,511 prediabetes participants aged >50 years from the pre-evaluation dataset were included. Among them, 1,227 participants with adequately functioning grip strength, 406 with adequately functioning walking speed, and 961 with adequately functioning standing balance were finally used for analyses on physical function during a 4-year follow-up. HbA1c, glycosylated hemoglobin.

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