Fasting glucose and HbA1c levels were measured by the Cork University Hospital Biochemistry Laboratory. Glucose concentrations were determined using a glucose hexokinase assay (Olympus Life and Material Science Europa Ltd., Lismeehan, Co. Clare, Ireland) and HbA1c levels were measured in the haematology laboratory on an automated high-pressure liquid chromatography instrument Tosoh G7 [Tosoh HLC-723 (G7), Tosoh Europe N.V, Tessenderlo, Belgium]. Pre-diabetes was defined using HbA1c ADA cut-offs between 5.7%─6.4% (39–46 mmol/mol), HbA1c WHO-IEC cut-offs between 6.0%–6.4% (42–46 mmol/mol) [19] and FPG ADA cut-offs between 5.6─6.9 mmol/l [16]. In this study, participants were classified as having type 2 diabetes if they had a HbA1c level ≥6.5% (≥48 mmol/mol) or a FPG level ≥7.0 mmol/l [16]. Results for HbA1c and FPG were available for 1,361 (98.8%) and 1,364 (99.0%) subjects, respectively. Participants with a self-reported diagnosis of type 2 diabetes, but who did not have positive test results for diabetes by either HbA1c or FPG, were excluded from analyses (n = 25).

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