Type 2 diabetes in the Russian population: the contribution of socio-demographic, behavioral, and cardiometabolic factors to new cases (data from the ESSE-RF and ESSE-RF2 prospective cohort studies)
Abstract
Aim . To investigate the incidence of new-onset type 2 diabetes (T2D) and identify prognostic factors for its development in the Russian population aged 25-64 years. Material and methods . A cohort was formed based on the ESSE-RF and ESSE-RF2 studies (14 regions, n=20738, median follow-up 10,5 years). The examination included questionnaires and paraclinical tests. T2D was defined by a self-reported diagnosis and/or fasting plasma glucose (FPG) ≥7,0 mmol/L; such participants were excluded from the analysis. Prediabetes was defined as an FPG level of 6,1-6,99 mmol/L in individuals without T2D. Vital status was updated biennially. Information on fatal and non-fatal events, including cardiovascular ones and new cardiovascular diseases, was collected. In 2025, data on new T2D cases (type and date of diagnosis) were collected for the entire follow-up period. Statistical analysis was performed using the R programming language (version 4.1). Results. During the follow-up period, 665 (3,2%) new cases of T2D were identified, with a statistically significantly higher incidence in women. The risk of T2D increased 5-fold in the presence of prediabetes (12,8% vs 2,4%). Independent predictors of T2D included age >45 years, lack of higher education, prediabetes (hazard ratio (HR) =3,02; p<0,001), abdominal obesity (HR =1,89; p<0,001), hypertriglyceridemia, low high-density lipoprotein cholesterol, hyperuricemia, elevated C-reactive protein levels, and a history of hypertension. Male sex was associated with a lower risk. Conclusion . This prospective study, involving over 20000 participants without T2D, established that the incidence of new-onset T2D is higher among women. Key prognostic factors include age and prediabetes. These findings underscore the necessity of active screening and management of these risk factors to reduce the incidence of T2D.
