Prediabetes and its associations with depressive symptoms, health behaviours, and clinical factors in an English community sample
Bibliographic record
Abstract
Background: Prediabetes is a state in which blood glucose levels are higher than normal, but lower than those required for a diagnosis of diabetes. Adults with prediabetes are at a high risk of developing type 2 diabetes and its associated complications. The prevalence of prediabetes is increasing and is more common among older adults. However, there are gaps in the literature concerning characteristics of older adults with prediabetes as well as risk factors for type 2 diabetes among people with prediabetes. Aims: This thesis aims to 1) provide a detailed description of older adults with prediabetes, including demographic, lifestyle, and health-related characteristics, 2) identify unique characteristics among older adults with prediabetes compared to older adults with normal glucose levels or diabetes, and 3) examine the relationship between depressive symptoms and diabetes incidence among older adults with prediabetes compared to those with normal glucose levels.Methods: This thesis includes two manuscripts. Both manuscripts use data from the English Longitudinal Study of Ageing (ELSA), a nationally-representative sample of English adults aged 50 and above. The first manuscript used data from ELSA Wave 2 only (2004/2005) and included 4180 participants. Design-based F-statistics and t-tests tested differences in individual demographic, lifestyle, and health-related characteristics between people with prediabetes, normal glucose levels, and diagnosed diabetes. Multinomial logistic regression examined the adjusted associations for all characteristics. The second manuscript used ELSA Wave 2 as baseline and followed 4129 participants every 2 years, with the final data from ELSA Wave 6 (2012/2013). Cox proportional hazards regression estimated hazard ratios of time to diagnosis of diabetes in people with no/low depressive symptoms, mild symptoms, and high symptoms and either normal glucose levels or prediabetes. This analysis included adjustment for demographic, lifestyle, and health-related covariates. Results: The first manuscript provided a comprehensive description of older adults with prediabetes. This manuscript also indicated that older adults with prediabetes were more likely to be employed and were more likely to be current smokers compared to older adults with normal glucose levels or diagnosed diabetes. The mean BMI of people with prediabetes was significantly higher than that of people with normal glucose levels, but lower than that of people with diagnosed diabetes. As well, women were more likely to have prediabetes compared to diagnosed diabetes. The second manuscript indicated that elevated depressive symptoms may be more strongly associated with incident diabetes in older adults with prediabetes compared to those with normal glucose levels. As well, even subclinical depressive symptoms may be a risk factor for diabetes in older adults with prediabetes.Conclusions: Older English adults with prediabetes have a unique profile that should be taken into account when developing intervention or prevention programs for this group. As well, although depressive symptoms have been consistently associated with incident diabetes, this thesis suggests that this relationship may be stronger in older adults with prediabetes compared to those with normal glucose levels. Future research should clarify the relationships between depressive symptoms, prediabetes, and diabetes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".