Prediabetes raises Mexicans’ risk of dying prematurely of heart or kidney disease

Prediabetes increases the risk of dying before age 75, particularly due to heart disease, kidney disease and acute diabetic complications, according to a new study presented Saturday at ENDO 2024, the Endocrine Society’s annual meeting in Boston, Mass.

“Prediabetes is well known to increase the risk of developing diabetes; however, information about other complications of prediabetes in Latin America was limited before this study,” said study researcher Carlos Fermin-Martinez, M.D., of the National Autonomous University of Mexico in Mexico City, Mexico. He is also with the National Institute of Geriatrics in Mexico City, which funded this project. “Our results are particularly relevant for the population of Mexico, where the prevalence of prediabetes is rising at an alarming rate.”

The researcher studied data from 115,919 adults ages 35 to 74 without diabetes who participated in the Mexico City Prospective Study (MCPS). Participants entered the study between 1998 and 2004 and received follow up until January 1, 2021. The MCPS received funding primarily from the Mexican Health Ministry and from the United Kingdom’s Wellcome Trust foundation.

More than one in four study participants (26%) had prediabetes as defined by the American Diabetes Association (ADA), Fermin-Martinez reported. The ADA defines prediabetes as a hemoglobin A1C concentration of 5.7 to 6.4 percent. An A1C test measures average blood sugar levels over three months.

When Fermin-Martinez evaluated prevalence using a stricter definition of prediabetes as an A1C of 6% to 6.4%, only 7% of participants had the precursor to diabetes. This definition came from the International Experts Committee, appointed by widely recognized diabetes associations in 2008 to give a consensus about A1C use for diagnosing diabetes.

Compared with participants whose blood sugar levels were normal, participants with the stricter definition of prediabetes had 2.6 times the risk of dying of acute complications of diabetes at ages 40 to 74. They also had 1.6 times, or 60%, increased risk of dying prematurely due to kidney disease. Although the risk of dying of heart disease increased when the researcher used the international committee’s A1C cutoff for prediabetes, there was no significant difference with the ADA cutoff, Fermin-Martinez said.

“Eventual development of diabetes most likely accounts for a large percentage of deaths for people with prediabetes,” he said. “We could significantly reduce premature mortality in the Mexican population by identifying and treating prediabetes early on.”

Approximately 80% of persons with prediabetes do not know they have it, according to the U.S. Centers for Disease Control and Prevention (CDC). In the U.S., up to 35% of Hispanic adults have prediabetes, the CDC estimates.

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