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Health Risk Factor Modification Predicts Incidence of Diabetes in an Employee Population: Results of an 8-Year Longitudinal Cohort Study

Rolando, Lori MD, MPH; Byrne, Daniel W. MS; McGown, Paula W. MSN, Macc, RN, FNP-BC, CPA; Goetzel, Ron Z. PhD; Elasy, Tom A. MD, MPH; Yarbrough, Mary I. MD, MPH, FACOEM, FACPM

Journal of Occupational and Environmental Medicine: April 2013 - Volume 55 - Issue 4 - p 410–415
doi: 10.1097/JOM.0b013e31827cbaec
Original Articles

Objective: To understand risk factor modification effect on Type 2 diabetes incidence in a workforce population.

Methods: Annual health risk assessment data (N = 3125) in years 1 through 4 were used to predict diabetes development in years 5 through 8.

Results: Employees who reduced their body mass index from 30 or more to less than 30 decreased their chances of developing diabetes (odds ratio = 0.22, 95% confidence interval: 0.05 to 0.93), while those who became obese increased their diabetes risk (odds ratio = 8.85, 95% confidence interval: 2.53 to 31.0).

Conclusions: Weight reduction observed over a long period can result in clinically important reductions in diabetes incidence. Workplace health promotion programs may prevent diabetes among workers by encouraging weight loss and adoption of healthy lifestyle habits.

Supplemental Digital Content is Available in the Text.

From Health & Wellness (Drs Rolando and Yarbrough and Mr Byrne and Ms McGown), Division of Administration, Human Resources, the Division of General Internal Medicine and Public Health (Drs Rolando, Elasy, and Yarbrough, and Mr Byrne), Department of Medicine, and the Department of Biostatistics (Dr Byrne), Vanderbilt University, Nashville, Tenn; and the Institute for Health and Productivity Studies (Dr Goetzel), Emory University and Truven Health Analytics, Bethesda, Md.

Address correspondence to: Mary I. Yarbrough, MD, MPH, FACOEM, FACPM, Faculty and Staff Health & Wellness, Vanderbilt University, 1211 21st Ave S, Ste 640 Medical Arts Building, Nashville, TN 37212 (

Funding for this study was provided in part by Vanderbilt University Clinical and Translational Science Award grant UL1 TR000445 from the National Center for Advancing Translational Sciences of the National Institute of Health and Vanderbilt's Center for Diabetes and Translational Research grant P30DK092986 from National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Disclosure: The authors declare no conflicts of interest.

©2013The American College of Occupational and Environmental Medicine