TY - JOUR T1 - Development of a 5-year risk prediction model for type 2 diabetes in individuals with incident HbA1c-defined pre-diabetes in Denmark JF - BMJ Open Diabetes Research & Care JO - BMJ Open Diab Res Care DO - 10.1136/bmjdrc-2022-002946 VL - 10 IS - 5 SP - e002946 AU - Sia K Nicolaisen AU - Reimar W Thomsen AU - Cathrine J Lau AU - Henrik T Sørensen AU - Lars Pedersen Y1 - 2022/09/01 UR - http://drc.bmj.com/content/10/5/e002946.abstract N2 - Introduction Pre-diabetes increases the risk of type 2 diabetes, but data are sparse on predictors in a population-based clinical setting. We aimed to develop and validate prediction models for 5-year risks of progressing to type 2 diabetes among individuals with incident HbA1c-defined pre-diabetes.Research design and methods In this population-based cohort study, we used data from the Danish National Health Survey (DNHS; n=486 495), linked to healthcare registries and nationwide laboratory data in 2012–2018. We included individuals with a first HbA1c value of 42–47 mmol/mol (6.0%–6.4%), without prior indications of diabetes. To estimate individual 5-year cumulative incidences of type 2 diabetes (HbA1c ≥48 mmol/mol (6.5%)), Fine-Gray survival models were fitted in random 80% development samples and validated in 20% validation samples. Potential predictors were HbA1c, demographics, prescriptions, comorbidities, socioeconomic factors, and self-rated lifestyle.Results Among 335 297 (68.9%) participants in DNHS with HbA1c measurements, 26 007 had pre-diabetes and were included in the study. Median HbA1c was 43.0 mmol/mol (IQR 42.0–44.0 mmol/mol, 6.1% (IQR 6.0%–6.2%)), median age was 69.6 years (IQR 61.0–77.1 years), and 51.9% were women. During a median follow-up of 2.7 years, 11.8% progressed to type 2 diabetes and 10.1% died. The final prediction model included HbA1c, age, sex, body mass index (BMI), any antihypertensive drug use, pancreatic disease, cancer, self-reported diet, doctor’s advice to lose weight or change dietary habits, having someone to talk to, and self-rated health. In the validation sample, the 5-year area under the curve was 72.7 (95% CI 71.2 to 74.3), and the model was well calibrated.Conclusions In addition to well-known pre-diabetes predictors such as age, sex, and BMI, we found that measures of self-rated lifestyle, health, and social support are important and modifiable predictors for diabetes. Our model had an acceptable discriminative ability and was well calibrated.Data may be obtained from a third party and are not publicly available. The data used in this study are owned and managed by Statistics Denmark. In accordance with the Danish law and data protection policies, the data used in this study were anonymized, and stored and analyzed on a secure server. The data are available to researchers from research environments preapproved by Statistics Denmark upon project approval by the Danish Data Protection Agency and Statistics Denmark. Researchers can apply for access to data when the request is approved by the Danish Data Protection Agency (https://www.datatilsynet.dk). ER -