Variation in effectiveness of the NHS Diabetes Prevention Programme in people diagnosed with non-diabetic hyperglycaemia by age, sex, BMI, and deprivation: A matched cohort analysis of 69,801 people

IF 3.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2025-04-18 DOI:10.1111/dme.70037

Rathi Ravindrarajah, Matt Sutton, Peter Bower, Evangelos Kontopantelis

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Abstract

Aims

The NHS Diabetes Prevention Programme (DPP) is a behaviour-change programme aimed at adults diagnosed with non-diabetic hyperglycaemia (NDH), who are at higher risk of developing type 2 diabetes mellitus (Diabetes). This paper explores the heterogeneity in the effectiveness of the DPP by age, sex, BMI, and practice location deprivation (IMD).

Methods

Matched cohort analysis with random-effects parametric survival models, evaluating the association between referral to the DPP and conversion to diabetes, with interactions fitted for age, sex, BMI, and IMD.

Results

18,470 patients referred to the programme were matched to 51,331 controls. None of the interactions of patient characteristics with referrals were statistically significant. For women, the difference in the HR of conversion to diabetes, compared to men, was HR = 0.94 (95% CI: 0.81, 1.08, p = 0.38); For those aged [18–34], HR = 0.79 (95% CI: 0.34, 1.84, p = 0.58) and aged [75–84] HR = 0.86 (95% CI:0.66, 1.12, p = 0.26) compared to those aged [55–64]. The HR for conversion was 0.88 (95% CI:0.62, 1.26, p = 0.49) for those with a BMI ≥ (25–29.9) kg/m² and HR = 0.76 (95% CI:0.54, 1.06, p = 0.10) in those with a BMI ≥ 30 kg/m² compared to BMI < 25 kg/m². Finally, for the most deprived IMD quintile, compared to the least deprived, the difference in the conversion was HR = 1.31 (95% CI: 0.98, 1.73, p = 0.06).

Conclusions

The DPP was effective in reducing conversion rates from NDH to diabetes as shown in our previous study results. The intervention appeared to be similarly effective by age, sex, BMI, and deprivation.

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根据年龄、性别、BMI和剥夺程度，NHS糖尿病预防计划在诊断为非糖尿病性高血糖患者中的有效性变化：一项69,801人的匹配队列分析

NHS糖尿病预防计划（DPP）是一项行为改变计划，针对被诊断为非糖尿病性高血糖（NDH）的成年人，这些成年人发展为2型糖尿病（糖尿病）的风险较高。本文探讨了年龄、性别、身体质量指数和实践地点剥夺（IMD）对DPP效果的异质性。方法采用随机效应参数生存模型进行匹配队列分析，评估转诊至DPP与转化为糖尿病之间的关系，并根据年龄、性别、BMI和IMD进行拟合。结果18,470例患者与51,331例对照相匹配。患者特征与转诊的相互作用均无统计学意义。对于女性，与男性相比，转化为糖尿病的HR差异为HR = 0.94 (95% CI: 0.81, 1.08, p = 0.38)；年龄[18-34]与年龄[55-64]相比，HR = 0.79 (95% CI: 0.34, 1.84, p = 0.58)，年龄[75-84]与HR = 0.86 （95% CI:0.66, 1.12, p = 0.26）。BMI≥(25 - 29.9)kg/m2与BMI≤25 kg/m2相比，BMI≥30 kg/m2的HR为0.88 (95% CI:0.62, 1.26, p = 0.49), HR = 0.76 （95% CI:0.54, 1.06, p = 0.10）。最后，对于最缺乏IMD的五分之一，与最缺乏IMD的五分之一相比，转换的差异HR = 1.31 （95% CI: 0.98, 1.73, p = 0.06）。结论DPP可有效降低NDH向糖尿病的转换率，如我们之前的研究结果所示。干预似乎在年龄、性别、BMI和剥夺方面同样有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”