OBJECTIVE Prediabetes, which is a condition characterized by higher-than-normal blood glucose levels that are under the threshold for diabetes, impacts over one-third of U.S. adults. Excise taxes on sugar-sweetened beverages (SSBs) are a proposed policy intervention to lower population consumption of SSBs and generate revenue to support health-related programs, thus potentially delaying or preventing the development of diabetes in individuals with prediabetes. We leveraged data from Kaiser Permanente in California to examine the impact of SSB taxes in California on individual-level mean HbA1c levels and rates of incident diabetes. RESEARCH DESIGN AND METHODS We compared two outcomes, mean HbA1c levels and rates of incident diabetes, among a matched cohort of adults with prediabetes who lived and did not live in SSB excise tax cities, using outcomes collected in the 6 years prior and 4 years following SSB tax implementation. We used multivariable linear mixed effects models to analyze longitudinal mean HbA1c and discrete-time survival models for incident diabetes. RESULTS We included 68,658 adults in the analysis. In adjusted models, longitudinal mean HbA1c (percent) was 0.007 (95% CI 0.002, 0.011) units higher in the tax cities compared with controls; while the estimated difference was statistically significant, it was not clinically significant (HbA1c < 0.5%). There was no significant difference in the risk of incident diabetes between individuals living in tax and control cities. CONCLUSIONS We found no clinically significant association between SSB taxes and either longitudinal mean HbA1c or incident diabetes among adults with prediabetes in the 4 years following SSB tax implementation.

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城市级含糖饮料税对成人糖尿病前期纵向 HbA1c 和糖尿病发病率的影响


目的 糖尿病前期是一种以高于正常血糖水平且低于糖尿病阈值为特征的疾病，影响着超过三分之一的美国成年人。对含糖饮料（SSB）征收消费税是一项拟议的政策干预措施，旨在降低人口对含糖饮料的消费，并产生收入来支持健康相关计划，从而有可能延缓或预防糖尿病前期患者患糖尿病。我们利用加利福尼亚州 Kaiser Permanente 的数据来研究加利福尼亚州的 SSB 税对个人平均 HbA1c 水平和糖尿病发病率的影响。研究设计和方法 我们使用前 6 年和后 4 年收集的结果，比较了居住和不居住在 SSB 消费税城市的一组匹配的糖尿病前期成人的两个结果，即平均 HbA1c 水平和糖尿病发病率。 SSB 税收实施。我们使用多变量线性混合效应模型来分析糖尿病发病的纵向平均 HbA1c 和离散时间生存模型。结果 我们在分析中纳入了 68,658 名成年人。在调整后的模型中，与对照组相比，税收城市的纵向平均 HbA1c（百分比）高出 0.007 个单位（95% CI 0.002，0.011）；虽然估计的差异具有统计学显着性，但临床上并不显着（HbA1c < 0.5%）。居住在税收城市和管制城市的个体之间，发生糖尿病的风险没有显着差异。结论 我们发现，SSB 税实施后 4 年内，SSB 税与糖尿病前期成人的纵向平均 HbA1c 或糖尿病发病率之间没有临床显着关联。