S610 Prediabetes as a Risk Factor for the Development of Adenomatous Polyps

Introduction: Diabetes mellitus (DM) is a well-established risk factor for colorectal cancer (CRC). DM is also associated with an increased risk of development of adenomatous polyps, the precursor lesions of CRC. Prediabetes, a condition characterized by elevated blood glucose that has not yet progressed to DM, has also been linked to an increased risk of CRC. However, there is a paucity of data within the literature regarding the role prediabetes may have in the development of colorectal polyps. The objective of this study is to evaluate the potential association between prediabetes and the development of adenomatous polyps, and how this association compares to the increased risk of adenomatous polyps in DM. Methods: This is a retrospective study performed at the Brooklyn VA Hospital, including patients above age 18 who underwent colonoscopy between January 2020 and June 2021. Patients were excluded if the procedure was incomplete, if bowel preparation was inadequate, and if there was a history of inflammatory bowel diseases. Patients were stratified into 3 groups; those with diabetes, prediabetes, and non-diabetics. Demographic, endoscopic, and histological data was collected and analyzed. Results: 681 patients were included in our study; 171 non-diabetics, 246 prediabetics, and 264 diabetics. Prediabetics were more likely to have 5 or more adenomatous polyps than non-diabetics (4.9% vs 1.2%, P = 0.039) and diabetics were found to have a greater likelihood of having one or more adenomatous polyps than their prediabetic counterparts (50.8% vs 41.9%, P = 0.044). No statistically significant differences were found among the 3 groups in the likelihood of having polyps with villous or tubulovillous histology. Conclusion: CRC screening guidelines dictate follow up interval length based on patient risk for polyps and CRC. The guidelines consider family history as well as polyp history, but do not include other factors that may play a role among patients at higher risk of polyps, such as DM. Our results suggest prediabetes to be associated with an increased risk of 5 or more adenomatous polyps as compared to non-diabetics, and DM to be associated with an increased risk of one or more adenomatous polyps as compared to prediabetes. This suggests that prediabetes, in addition to DM, may be a risk factor for development of polyps. Further prospective studies are warranted to evaluate whether a history of prediabetes or DM should be incorporated into the CRC screening guidelines.