REVERSION FROM TYPE-2 DIABETES TO NONDIABETIC STATUS

OBJECTIVE - To determine the incidence and the rate of reversion of ty pe 2 diabetes to a nondiabetic status in the 7- to 8-year follow-up of the San Antonio Heart Study, and to determine the influence of the re cent 1997 American Diabetes Association (ADA) criteria for diabetes on these rates. Individuals who revert have been problematic for those d eveloping criteria for the diagnosis of type 2 diabetes. Few studies h ave addressed this issue using 1979 National Diabetes Data Group/1980 World Health Organization (WHO) criteria. RESEARCH DESIGN AND METHODS - We studied 3,682 Mexican-American and non-Hispanic white men and non pregnant women who completed both the baseline and follow-up examinati on of the San Antonio Heart Study. Incidence and reversion rates were calculated using both the 1980 WHO and the 1997 ADA criteria. Risk fac tors for reversion were identified, and the best fitting model using m ultiple logistic regression was determined using both the 1980 WHO and the 1997 ADA criteria. RESULTS - Using the 1997 ADA criteria, the age -adjusted incidences of type 2 diabetes for Mexican-American men and w omen were 10.8 and 12.2%, respectively. For non-Hispanic white men and women, the age-adjusted incidence rates were 5.5 and 5.1%, respective ly. Similar age-adjusted incidences were recorded using the 1980 WHO c riteria. The reversion rate for individuals with type 2 diabetes was 1 1.5% using the 1980 WHO criteria and 12.5% using the 1997 ADA criteria . These rates were not significantly different. Numerous risk factors for reversion were identified. The best fitting model, after controlli ng for age, sex, and ethnicity, included baseline 2-h glucose level, b aseline HDL cholesterol, and previous diagnosis of diabetes. The model s were the same for both the 1980 WHO and the 1997 ADA criteria. CONCL USIONS - There was no significant difference in the incidence or the r eversion rates for diabetic subjects using either 1980 WHO or 1997 ADA criteria. In addition, the risk factors for reversion were very simil ar using either set of criteria. The revision of the ADA criteria did not have a significant influence on reversion in this study.