Aims: To assess the clinical utility of different available measures for determining risk of Type 2 diabetes mellitus (T2DM) and differences in treatment effects in an overweight/obese clinical sample undergoing a lifestyle intervention.
Methods: This was a secondary analysis investigating T2DM risk in a 12 month randomised controlled lifestyle intervention (the HealthTrack study). Recruitment of participants was conducted between May 2014 and April 2015. 377 participants residing in the Illawarra region with a BMI 25-40kg/m2, and 25-54 years were randomised. 161 completers were included in this analysis. Participants provided risk measures for TyG index and HbA1c at 0, 3, and 12 months, and AUSDRISK at 0 and 12 months. Participants were randomised to interdisciplinary lifestyle intervention ± 30g walnuts from dietitians or general advice from nurse practitioners (control). The main outcome measures were T2DM risk assessed by TyG index, HbA1c and the AUSDRISK tool.
Results: The AUSDRISK score at baseline indicated n=83 (51.5%) participants were at a high risk of T2DM within 5 years (≥12 points). After 12 months the proportion scoring high risk in the walnut group significantly decreased (51.5% vs 33.3%; p=0.005). HbA1c measures indicated high risk in n=24 (17%) of participants at baseline but the TyG index did not identify any participants at risk. There were no significant differences in TyG index or HbA1c over time.
Conclusions: The AUSDRISK tool was able to identify T2DM risk and differentiate between treatment groups in overweight/obese volunteers attending a lifestyle intervention over 12 months