Prevalence of prediabetes in England from 2003 to 2011: population-based, cross-sectional study

Objective: Prediabetes is a high-risk state for developing diabetes and associated complications. The purpose of this paper was to report trends in prevalence of prediabetes for individuals aged 16 and older in England without previously diagnosed diabetes. Setting: Data collected by the Health Survey for England (HSE) in England in the years 2003, 2006, 2009 and 2011. Participants: Individuals aged 16 and older who participated in the HSE and provided a blood sample. Primary outcome variable: Individuals were classified as having prediabetes if glycated haemoglobin was between 5.7% and 6.4% and were not previously diagnosed with diabetes. Results: The prevalence rate of prediabetes increased from 11.6% to 35.3% from 2003 to 2011. By 2011, 50.6% of the population who were overweight (body mass index (BMI)>25) and >= 40 years of age had prediabetes. In bivariate relationships, individuals with greater socioeconomic deprivation were more likely to have prediabetes in 2003 (p=0.0008) and 2006 (p=0.0246), but the relationship was not significant in 2009 (p=0.213) and 2011 (p=0.3153). In logistic regressions controlling for age, sex, race/ethnicity, BMI and high blood pressure, the second most socioeconomically deprived had a significantly elevated risk of having prediabetes (2011, OR=1.45; 95% CI 1.26 to 1.88). Conclusions: There has been a marked increase in the proportion of adults in England with prediabetes. The socioeconomically deprived are at substantial risk. In the absence of concerted and effective efforts to reduce risk, the number of people with diabetes is likely to increase steeply in coming years.