A recent Chinese study suggests that a simple clinical measure, the estimated glucose disposal rate (eGDR), could predict which women with prediabetes are most likely to progress to type 2 diabetes, highlighting potential for sex-specific risk assessment.
A new prospective cohort study suggests that a simple measure of insulin sensitivity may help identify which women with prediabetes are most likely to develop type 2 diabetes within four years. The research, published in BMC Endocrine Disorders and led by investigators at Nanchang Medical College, focused on the estimated glucose disposal rate, or eGDR, a score calculated from routine clinical measures including waist circumference, blood pressure and glycated haemoglobin.
Prediabetes affects hundreds of millions of adults worldwide and marks the precarious stage between normal blood sugar regulation and diabetes. Because the gold-standard method for measuring insulin sensitivity is too cumbersome for everyday practice, researchers have long looked for easier substitutes. The eGDR is designed to fill that gap by estimating how efficiently the body disposes of glucose using information already gathered in a standard consultation.
The Chinese team analysed data from the China Health and Retirement Longitudinal Study, a large nationally representative survey of middle-aged and older adults. They identified 2,630 people with prediabetes at the outset and tracked their outcomes over four years. By the end of follow-up, 382 had progressed to diabetes, 617 had returned to normal fasting glucose, and 1,631 remained in the prediabetic range.
The results were notably different for women and men. Among women, higher eGDR scores, which indicate better insulin sensitivity, were linked to a lower risk of progressing to diabetes and a greater chance of reverting to normal glucose levels. The pattern was close to linear, suggesting that even modest improvements in the score were associated with more favourable outcomes. In men, however, the score did not show a meaningful relationship with either progression or recovery.
The authors explored whether blood lipids might help explain the association in women. High-density lipoprotein cholesterol and triglycerides accounted for a small part of the link between eGDR and diabetes progression, while low-density lipoprotein cholesterol and total cholesterol explained a modest share of the pathway towards recovery. That points to a connection between insulin resistance and lipid metabolism, although most of the relationship remained unexplained.
Even so, the researchers urged caution. The statistical test for a sex difference came close to, but did not cross, the usual threshold for significance, meaning the finding should be treated as suggestive rather than definitive. The study was also limited to Chinese adults, so it is not clear whether the same pattern would appear in other populations. As with all observational research, factors such as diet, exercise and medication use could still have influenced the results.
The findings add to a wider body of research suggesting that eGDR may have prognostic value beyond diabetes alone. Other studies have linked lower eGDR to greater risks of cardiovascular disease and mortality, with several reporting that its predictive value may also vary by sex. Together, that work strengthens the case for eGDR as a low-cost marker of broader metabolic risk, even if its role in routine care is not yet established.
For now, the main implication is that a score built from ordinary clinic data may help identify women with prediabetes who are most in need of close follow-up and early intervention. The study does not change practice on its own, but it does suggest that sex-specific risk assessment could improve how clinicians think about the period before diabetes develops.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
