***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background A simple diabetes risk tool that does not require laboratory tests would be beneficial in screening individuals at higher risk . Few studies have evaluated the ability of these tools to identify new cases of pre-diabetes . This study aim ed to assess the ability of the American Diabetes Association Risk Tool ( ADART ) to predict the 3-year incidence of pre-diabetes and diabetes in Taiwanese . Methods This was a 3-year prospect i ve study of 1021 residents with normoglycemia at baseline , gathered from a r and om sample of residents aged 40–88 years in a metropolitan city in Taiwan . The areas under the curve ( AUCs ) of three models were compared : ADART only , ADART plus lifestyle behaviors at baseline , and ADART plus lifestyle behaviors and biomarkers at baseline . The performance of ADART was compared with that of 16 tools that had been reported in the literature . Results The AUCs and their 95 % confidence intervals ( CIs ) were 0.60 ( 0.54–0.66 ) for men and 0.72 ( 0.66–0.77 ) for women in model 1 ; 0.62 ( 0.56–0.68 ) for men and 0.74 ( 0.68–0.80 ) for women in model 2 ; and 0.64 ( 0.58–0.71 ) for men and 0.75 ( 0.69–0.80 ) for women in model 3 . The AUCs of these three models were all above 0.7 in women , but not in men . No significant difference in either women or men ( p = 0.268 and 0.156 , respectively ) was observed in the AUC of these three models . Compared to 16 tools published in the literature , ADART had the second largest AUC in both men and women . Conclusions ADART is a good screening tool for predicting the three-year incidence of pre-diabetes and diabetes in females of a Taiwanese population . The performance of ADART in men was similar to the results with other tools published in the literature . Its performance was one of the best among the tools reported in the literature BACKGROUND The aim of this study was to develop a risk score to predict the 4-year risk of  diabetes  in a middle-aged Korean cohort . METHODS AND RESULTS Participants without diabetes ( 6,342 participants , aged 40 - 69 years ) were included and biennial follow ups were conducted . A logistic regression analysis was used to construct the models . The basic model was based on simple information such as age , parental or sibling history of diabetes , smoking status , body mass index , and hypertension , while clinical model 1 was constructed by adding biochemical tests such as fasting plasma glucose , high-density lipoprotein-cholesterol and triglycerides to the basic model ; clinical model 2 further added glycated hemoglobin ( HbA(1c ) ) to clinical model 1 . The model accuracy was assessed using area under a receiver operating characteristic ( AROC ) curve and the Hosmer-Lemeshow statistics . Both net reclassification improvement ( NRI ) and integrated discrimination improvement ( IDI ) were calculated to determine the contribution of HbA(1c ) . Two clinical models improved model discrimination ( AROC=0.75 and 0.77 ) when compared with the basic model ( AROC=0.65 ) . The addition of HbA(1c ) to clinical model 1 increased AROC by only 0.02 despite its high impact on the prediction of diabetes ( odds ratio=2.66 ) . However , the NRI and IDI were significantly improved with the addition of HbA(1c ) Therefore , a risk score system was developed to estimate the 4-year risk of diabetes based on clinical model 2 . CONCLUSIONS A risk score derived from simple biochemical examinations including HbA(1c ) can help identify those at a high risk of diabetes in a middle-aged Korean cohort OBJECTIVE To create a simple prediction rule that could perform as well as the 2-h postchallenge plasma glucose ( PCPG ) test to predict those at risk for diabetes . We created a prediction rule in one sample and prospect ively vali date d it for incident diabetes in a separate cohort . RESEARCH DESIGN AND METHODS A cross-sectional analysis with data from the Rancho Bernardo Study ( age 67 + /- 11 years ) to derive a rule predicting abnormal PCPG > /=140 mg/dl , using demographic , clinical , and laboratory data of nondiabetic participants with fasting plasma glucose ( FPG ) < 126 mg/dl . Data from the Health , Aging and Body Composition study ( age 74 + /- 3 years ) were used to prospect ively vali date this rule for incident diabetes and compare it with the predictive ability of the PCPG test . RESULTS Of 1,549 RBS participants , 514 ( 33 % ) had PCPG > /=140 mg/dl . Female sex , age , triglycerides , and FPG were most significantly associated with abnormal PCPG . Based on st and ardized beta-coefficients , we allotted 1 point for female sex , triglycerides > /=150 mg/dl , or FPG 95 - 104 mg/dl . Age > /=70 years or FPG 105 - 115 mg/dl were given 2 points , and FPG 116 - 125 mg/dl received 3 points . In the validation cohort , this simple prediction rule was as good as the 2-h PCPG test for predicting incident diabetes ( C-statistic : 0.71 for both ) . CONCLUSIONS Advanced age , female sex , FPG , and triglycerides were able to predict adults at risk for diabetes equally well as the 2-h PCPG test . Using this rule , clinicians may better identify older persons who should receive intensive lifestyle intervention to prevent type 2 diabetes OBJECTIVE Hemoglobin A1c ( HbA1c ) can be used to assess type 2 diabetes ( T2D ) risk . We asked whether HbA1c was associated with T2D risk in four scenarios of clinical information availability : 1 ) HbA1c alone , 2 ) fasting laboratory tests , 3 ) clinic data , and 4 ) fasting laboratory tests and clinic data . RESEARCH DESIGN AND METHODS We studied a prospect i ve cohort of white ( N = 11,244 ) and black ( N = 2,294 ) middle-aged participants without diabetes in the Framingham Heart Study and Atherosclerosis Risk in Communities study . Association of HbA1c with incident T2D ( defined by medication use or fasting glucose [ FG ] ≥126 mg/dL ) was evaluated in regression models adjusted for 1 ) age and sex ( demographics ) ; 2 ) demographics , FG , HDL , and triglycerides ; 3 ) demographics , BMI , blood pressure , and T2D family history ; or 4 ) all preceding covariates . We combined results from cohort and race analyses by r and om-effects meta-analyses . Subsidiary analyses tested the association of HbA1c with developing T2D within 8 years or only after 8 years . RESULTS Over 20 years , 3,315 individuals developed T2D  . With adjustment for demographics , the odds of T2D increased fourfold for each percentage-unit increase in HbA1c . The odds ratio ( OR ) was 4.00 ( 95 % CI 3.14 , 5.10 ) for blacks and 4.73 ( 3.10 , 7.21 ) for whites , result ing in a combined OR of 4.50 ( 3.35 , 6.03 ) . After adjustment for fasting laboratory tests and clinic data , the combined OR was 2.68 ( 2.15 , 3.34 ) over 20 years , 5.79 ( 2.51 , 13.36 ) within 8 years , and 2.23 ( 1.94 , 2.57 ) after 8 years . CONCLUSIONS HbA1c predicts T2D in different common scenarios and is useful for identifying individuals with elevated T2D risk in both the short- and long-term OBJECTIVE To evaluate the incidence and relative risk of type 2 diabetes  defined by the newly proposed HbA1c diagnostic criteria in groups categorized by different baseline HbA1c levels . RESEARCH DESIGN AND METHODS Using data from the European Prospect i ve Investigation of Cancer (EPIC)-Norfolk cohort with repeat HbA1c measurements , we estimated the prevalence of known and previously undiagnosed diabetes at baseline ( baseline HbA1c ≥6.5 % ) and the incidence of diabetes over 3 years . We also examined the incidence and corresponding odds ratios ( ORs ) by different levels of baseline HbA1c . Incident diabetes was defined clinical ly ( self-report at follow-up , prescribed diabetes medication , or inclusion on a diabetes register ) or biochemically ( HbA1c ≥6.5 % at the second health assessment ) , or both . RESULTS The overall prevalence of diabetes was 4.7 % ; 41 % of prevalent cases were previously undiagnosed . Among 5,735 participants without diabetes at baseline ( identified clinical ly or using HbA1c criteria , or both ) , 72 developed diabetes over 3 years ( 1.3 % [ 95 % CI 1.0–1.5 ] ) , of which 49 % were identified using the HbA1c criteria . In 6 % of the total population , the baseline HbA1c was 6.0–6.4 % ; 36 % of incident cases arose in this group . The incidence of diabetes in this group was 15 times higher than in those with a baseline HbA1c of < 5.0 % ( OR 15.5 [ 95 % CI 7.2–33.3 ] ) . CONCLUSIONS The cumulative incidence of diabetes defined using a newly proposed HbA1c threshold in this middle-aged British cohort was 1.3 % over 3 years . Targeting interventions to individuals with an HbA1c of 6.0–6.4 % might represent a feasible preventive strategy , although complementary population -based preventive strategies are also needed to reduce the growing burden of diabetes Aims In a population at risk for type 2 diabetes ( T2DM ) , we assessed early physical and metabolic markers that predict progression from normal to impaired glucose tolerance ( IGT ) and T2DM . Methods A total of 388 individuals ( 22 % male , age 46 + 11 years ) at risk for T2DM were r and omized to St and ard ( n = 182 ) or Intervention ( n = 206 ) care and evaluated at baseline and 5 annual follow-up visits , including blood pressure , BMI , A1C , lipids , urine albumin/creatinine ratio , VO2max , fasting glucose , insulin and C-peptide . The St and ard group received results of annual lab tests and quarterly newsletters , while the Intervention group received quarterly newsletters and detailed discussion s of lab results , routine self-directed activities , semi-annual group meetings and monthly telephone calls for ongoing support . Results Overall , 359 ( 93 % ) returned for at least one follow-up visit and 272 ( 70 % ) completed the final 5-year assessment . Return rates , changes in measures and incidence of IGT/T2DM were similar between groups . Low cardiorespiratory fitness ( VO2max ) was the most prevalent baseline abnormality . A1C and BMI were significant predictors of IGT/T2DM after controlling for other factors . The risk of IGT/T2DM within 5 years was 17.16 ( 95 % CL : 6.169 , 47.736 ) times greater for those with baseline A1C>=5.8 % as compared to those < 5.8 % ( p < 0.0001 ) . Conclusion Baseline A1C>=5.8 % was a significant predictor of IGT/T2DM within 5 years in a population at high risk for T2DM . A1C is routinely performed among patients with diabetes , however these data and other evidence suggest that it may also be a useful tool for risk assessment and screening OBJECTIVE Although an excess transmission of type 2 diabetes from mothers has been documented , whether this is an independent trait or whether the effect can be detected early through risk factors for type 2 diabetes remains to be eluci date d. The objective of this study was to investigate the prevalence of and the possible prospect i ve effect of family history on type 2 diabetes incidence adjusted for multiple diabetes risk factors in a 22.5-year follow-up study of healthy men . RESEARCH DESIGN AND METHODS A total of 1,947 apparently healthy nondiabetic men with fasting blood glucose ( FBG ) levels < 110 mg/dl at baseline , in whom an intravenous glucose tolerance test ( IVGTT ) was administered and several conventional risk factors were measured , were followed for 22.5 years . Family history data were obtained at the baseline examination , and morbidity data were obtained from repeated investigations , hospital records , and death certificates . RESULTS A total of 131 men reported maternal diabetes family history only , 65 men reported paternal diabetes family history only and 10 men reported both maternal and paternal diabetes family history . Among the 1,947 men , 143 cases of type 2 diabetes developed during 22.5 years of observation . 
    Output:
    
Taking into account the long-term follow-up of cohort studies , estimation of HRs for time-dependent events like T2DM incidence appeared most reliable .
Overall prognosis of people with IH worsened over time .
T2DM cumulative incidence generally increased over the course of follow-up but varied with IH definition .
Regression from IH to normoglycaemia decreased over time but was observed even after 11 years of follow-up .
The risk of developing T2DM when comparing IH with normoglycaemia at baseline varied by IH definition .