Transition between prediabetic and diabetic stages in an urban community in india: a decade-long retrospective cohort study.

Purpose: The rising prevalence of prediabetes has increased the risk of diabetes, particularly among younger populations, if timely interventions are not implemented. In India, the limited availability of cohort-based incidence studies underscores the need for retrospective analyses using hospital-based electronic medical information systems (EMIS). This study estimates the transition probabilities and duration of stay in the prediabetic state before progression to type 2 diabetes in a cohort of normoglycemic individuals. Methods: Data from 1,670 diabetes-free individuals aged 30 years and above were extracted from a government hospital's electronic medical records spanning a 10-year period. Incidence rates of type II diabetes were calculated separately for individuals with baseline normoglycemia and prediabetes. A multistate model was employed to estimate transition probabilities between normoglycemia, prediabetes, and diabetes over time. Results: The overall incidence of type II diabetes was 20.94 per 1,000 person-years, with higher rates among individuals with baseline prediabetes (41.74 vs. 15.89 per 1,000 PYs in normoglycemic individuals). The probability of progressing from prediabetes to diabetes reached ~ 30%, while normoglycemia to prediabetes reached ~ 25%. Reversion from prediabetes to normoglycemia peaked at around 60% within the first 2-3 years and later declined. Males had a higher likelihood of progressing to diabetes, whereas females showed higher prediabetic reversal. Conclusion: The study underscores the critical importance of early detection and timely intervention during the prediabetic phase to prevent progression to diabetes and associated complications.