Estimating Transition Probabilities and Duration of Pre-Diabetes: A Retrospective Multistate Analysis

Palak Sharma, International Institute for Population Sciences
T R. Dilip, International Institute for Population Sciences
Vikas Sharma, Mediacorp Pte. Ltd.
Anjali Kulkarni, Homi Bhabha National Institute

The rising prevalence of prediabetes has elevated the risk of diabetes, especially among younger populations, if timely interventions are not implemented. In India, limited cohort-based incidence studies emphasize the need for retrospective analysis using hospital-based electronic medical information systems (EMIS). This study estimates the transition probabilities and duration of stay in the prediabetic state before progressing to Type 2 diabetes in a cohort of normoglycemic individuals. Data from 1,669 diabetes-free individuals were extracted from a government hospital’s EMIS over 10 years. A multistate model was applied to assess transitions between normoglycemia, prediabetes, and diabetes. Of the 1,669 individuals, 873 were prediabetic in 2011. Over the 10-year period, 43% (373) progressed to diabetes, while 35% reverted to normoglycemia. The transition probability from normoglycemia to prediabetes was approximately 42% over 10 years. The average duration in the prediabetic state before developing diabetes was 48 months. While males had a higher likelihood of developing diabetes, females spent slightly longer in the prediabetic state (50 months vs. 46 months). The study highlights the critical importance of early detection and timely intervention during the prediabetic phase to prevent progression to diabetes and associated complications.

Keywords: Health and Morbidity, Longitudinal studies , Population and Development, Data and Methods

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