Prediabetes negatively affects physical function

Prediabetes contributes to faster functional decline and disability, irrespective of the future development of diabetes, a study suggests. This association is partly mediated by cardiovascular diseases (CVDs).

The analysis included a cohort of 2,013 participants aged ≥60 from the Swedish National Study on Aging and Care in Kungsholmen. They were followed for up to 12 years. Physical function was measured with chair stand and walking speed tests, while disability was evaluated by adding the scores of impaired basic and instrumental activities of daily living.

At baseline, 650 individuals (32.3 percent) had prediabetes (glycated haemoglobin [HbA1c] ≥5.7 percent to 6.4 percent) and 151 (7.5 percent) had diabetes (HbA1c ≥6.5 percent).

In multivariable mixed-effect models, prediabetes correlated with an increased chair stand time (0.33 s, 95 percent confidence interval [CI], 0.05–0.61), a decreased walking speed (−0.006 m/s, 95 percent CI, −0.010 to −0.002), and an accelerated disability progression (0.05, 95 percent CI, 0.01–0.08). These relationships persisted despite controlling for the future development of diabetes.

As expected, diabetes was associated with faster functional decline than prediabetes.

Further analyses revealed that CVDs mediated 7.1 percent, 7.8 percent, and 20.9 percent of the associations of prediabetes with chair stand, walking speed, and disability progression, respectively.