Colorectal adenomas and diabetes: implications for disease prevention

AIM: The study assessed the baseline type II diabetes mellitus (T2DM) risk status among overweight patients with screen-detected colorectal adenomas and explored the implications of the findings for preventative practice.

METHOD: Participants, aged 50-74 years (73% male) recruited from four Scottish health boards were assessed for diabetes risk. Participants were categorised as at 'high' diabetes risk if HbA_1c ranged between 6.0 to 6.4% or fasting plasma glucose (FPG) ranged from 5.5 to 6.9mmol/l and as potentially undiagnosed T2DM when HbA1c ≥6.5% or FPG ≥7mmol/l. Secondary outcome measures included anthropometric measurements, blood pressure and plasma lipid profile. The tests were repeated at 12 months and diabetes risk categories were re-assessed following intervention procedures.

RESULTS: Of the 329 participants, a pre-existing diagnosis of T2DM had been made in 47(14.3%). Of the remainder with complete biochemistry results (n=250), 19 (7.6%) were classified as having potentially undiagnosed T2DM and 125 (50.0%) as being at high risk of developing diabetes. More than a quarter of participants in all categories had raised waist circumference, hypertension and plasma lipids indicative of raised cardiovascular risk. At 12 months follow up, diabetes risk category diminished in 20% of the intervention group versus 11% in control [OR 2.26 (95%CI 1.03 - 4.96)].

CONCLUSION: Results suggest that an diagnosis of adenoma in overweight patients provides a health service opportunity for diabetes assessment, prevention and management in a high risk population at a potentially teachable moment. This article is protected by copyright. All rights reserved.