Frailty tied to prediabetes progression to diabetes and risk of CVD and mortality

There is a continual increase in diabetes patients, and it is expected to reach 300 million globally by 2025. In people with diabetes, cardiovascular diseases and death are attributed to classical risk factors, including dyslipidemia, hypertension, and smoking habits. In recent years, fragility has gained attention concerning diabetes. Frailty is a condition associated with reduced physical and mental activities with age resulting in psychological and physical weakness. However, with appropriate intervention, quality of life (QOL) and activities of daily living can be maintained.

Examining the relationship of frailty with cardiovascular diseases, mortality, and hospitalization in diabetes patients is essential in medical economics and clinical.

Against the above background, Qing Chen and the research team from China conducted the study to assess the impacts of frailty on the progression of prediabetes to diabetes, CVD and all-cause mortality in people with prediabetes and diabetes.

For this purpose, the researchers included 7,933 subjects with prediabetes and diabetes from the ELSA (English Longitudinal Study of Ageing) and the CHARLS (China Health and Retirement Longitudinal Study). The frailty index assessed frailty status, and the status was classified as robust, pre-frail, and frail. Risks of progression to diabetes were also calculated through logistic regression. Cox regression provided risks of all-cause mortality and cardiovascular disease.

The study led to the following findings:

· Frail subjects with prediabetes compared with robust subjects were at significantly elevated risks of advancement to diabetes (CHARLS, OR=1.55; ELSA, OR=1.86).

· Frail subjects with prediabetes were also at significantly increased risks of CVD (CHARLS: HR=1.90; ELSA: HR=1.94) and all-cause mortality (CHARLS: HR=2.45; ELSA: HR=2.13) compared to robust subjects with prediabetes.

· Frailty still increased risks of cardiovascular disease (CHARLS, HR=2.72; ELSA, HR=2.41) and all-cause mortality (CHARLS, HR=2.28; ELSA, HR=2.28) in diabetes.

To conclude, frailty promotes the progression of prediabetes to diabetes. Moreover, it increases the risks of all-cause mortality and cardiovascular diseases in prediabetes and diabetes.

"Frailty improves the risk predictions for all-cause mortality and CVD in prediabetes and diabetes," the researchers wrote.

Reference:

The study, "Frailty is associated with the progression of prediabetes to diabetes and elevated risks of cardiovascular disease and all-cause mortality in individuals with prediabetes and diabetes: evidence from two prospective cohorts," was published in Diabetes Research and Clinical Practice.

DOI: https://doi.org/10.1016/j.diabres.2022.110145