Abstract: ObjectiveTo investigate the relationship between the status of knowledge about diabetes prevention and the incidence of hyperglycemia in an urban adult population in Nanjing city.MethodsMulti-stage randomized sampling and a 3 year follow-up were conducted in 3 urban communities in Nanjing city.The participants were 2 616 local residents at the age of 35 years or older and without diagnosed hyperglycemia,diabetes and cancer.The participants were divided into three sub-groups according to their scores for answering a questionnaire on knowledge about diabetes prevention(high,medium,and low score group).The outcome variable was newly diagnosed hyperglycemia during the followup.ResultsTotally 2 178 participants were followed-up(follow-up rate=83.3%)and there were 160 new diabetes cases diagnosed with a cumulative incidence of 7.35%.The average score of knowledge about diabetes was 5.31±1.61 for all participants and the ratio of participants with low,medium,and high score was 14.6%,34.3%,and 51.1%.Among the participants with hyperglycemia,the ratio of low,medium,and high score was 21.9%,32.5%,and 45.6%, while among participants without hyperglycemia,the corresponding ratio was 14.0%,34.5%,and 51.5%,respectively.There were significant differences between the participants with and without hyperglycemia in the distributions of age, body weight,education level,and family history of hyperglycemia(P<0.05 for all).There were significant differences in the scores of knowledge about diabetes prevention among the participants of different occupation(χ²=17.26,P<0.05).The incidence of hyperglycemia for the parteiciants with low,medium,and high score of knowledge was 11.0%,7.0%, and 6.6%.The incidence of hyperglycemia decreased with the increase of the score among the participants(χ²=7.54, P<0.05).Multivariate logistic regression analyses revealed that participants with high and medium score of knowledge of diabetes prevention were significantly less likely to develop hyperglycemia compared to those with the low score(relative riskRR=0.62,95% confidence intervalCI:0.40-0.98 and RR=0.60,95%CI:0.39-0.93).ConclusionThe knowledge about diabetes prevention is inversely associated with the risk of developing hyperglycemia in urban adult residents of Nanjing.