Asking the Right Questions May Lead to Earlier Intervention in Pre-Diabetes

Could Reduce Rate of Transition to Type 2 Diabetes, According to SHIELD Study

SAN DIEGO--(BUSINESS WIRE)-- Predictors for type 2 diabetes are easily identifiable, according to a large community study undertaken to understand diabetes and the disease burden, and may lead to earlier intervention for people at risk. The findings were presented today at the American Diabetes Association’s 71st Annual Scientific Sessions.

SHIELD (The Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes) is the largest non-governmental study of its kind1. AstraZeneca (NYSE: AZN) sponsored the study.

SHIELD data demonstrated that simple, easily available information, e.g., age, family history, obesity -- characteristics adults can self-identify -- are strong predictors for developing type 2 diabetes. The presence of these factors significantly boosts risk of transition, by as much as 300%-500%. Furthermore, clinicians may not need any other patient-reported symptom besides excessive thirst to further screen for type 2 diabetes. Active understanding of these pre-diabetes risk factors and early intervention may reduce transition to type 2 diabetes.

“We need to slow down the rate of transition to type 2 diabetes, said Helena W. Rodbard, MD, Endocrine and Metabolic Consultants in Rockville, MD and SHIELD study investigator. “SHIELD data can, ideally, be used to simplify the process by which clinicians identify and screen patients at risk of progressing, and help those in need get required support earlier.”

Risk Predictor Data Findings

The most significant predictor for developing type 2 diabetes, confirmed SHIELD, was increasing age, boosting risk by 300%-500% and was highest for those between the ages of 55-64. The presence of high blood sugar without diabetes increased risk of transitioning to type 2 diabetes by 400%. Obesity and carrying excess abdominal fat boosted risk by 50%-100%. Excessive thirst increased risk by 50% and family history increased risk of transitioning to type 2 diabetes by 40%.


SHIELD (The Study to Help Improve Early Evaluation and management of risk factors Leading to Diabetes) was a 5-year longitudinal population-based survey conducted from 2004 to 2009 to better understand the risk for the development of diabetes mellitus, as well as disease burden. The objectives of SHIELD have been to assess:

  • Prevalence and incidence of diabetes mellitus and cardiovascular disease (CVD)
  • Disease burden
  • Disease progression and transition from pre-disease to diagnosed disease
  • Risk predictors of transitioning from pre-disease to diagnosed disease
  • Knowledge, attitudes and behaviors regarding health

Of the 200,000 households that received the screening questionnaire in 2004, 127,420 households (containing a total of 211,097 adults) returned completed questionnaires.1 The follow-up baseline survey was mailed to 22,001 respondents to be followed over the subsequent five years with annual surveys.

The evaluation of transition to type 2 diabetes was analyzed from 11,238 respondents who had no diagnosis of diabetes at baseline and completed at least one or more follow-up surveys.

About AstraZeneca

AstraZeneca is a global, innovation-driven biopharmaceutical business with a primary focus on the discovery, development and commercialization of prescription medicines for gastrointestinal, cardiovascular, neuroscience, respiratory and inflammation, oncology and infectious disease. AstraZeneca operates in over 100 countries and its innovative medicines are used by millions of patients worldwide.

For more information about AstraZeneca in the U.S. or our AZ&Me™ Prescription Savings programs, please visit: or call 1-800-AZandMe (292-6363).

1 Bays et al. Prevalence of self-reported diagnosis of diabetes mellitus and associated risk factors in a national survey in a US population: SHIELD (Study to Help Improve Early Evaluation and Management of Risk Factors Leading to Diabetes). BMC Public Health. 2007. 7:2-7

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