News – Older adults diagnosed with “prediabetes” as a result of moderately high blood sugar levels don’t usually go on to develop full-blown diabetes, according to a study led by researchers at the Johns Hopkins Bloomberg School of Public Health.
Doctors still consider prediabetes as a useful indicator of the risk of future diabetes in young and middle-aged adults. However, the study, which followed nearly 3,500 older adults, at the median age of 76, for about six and a half years, reveals that prediabetes is not a useful indicator of diabetes risk in older people advanced.
The results were announced February 8 in JAMA Internal Medicine.
“Our findings suggest that, for older adults with blood sugar levels in the prediabetes range, few develop diabetes,” says study lead author Elizabeth Selvin, PhD, senior professor in the Department of Epidemiology at the Bloomberg School. “The prediabetes category does not seem to help us identify people at high risk. Instead doctors should focus on healthy lifestyle changes and important disease risk factors such as smoking, high blood pressure, and high cholesterol. “
Type 2 diabetes leads to excessive glucose blood levels, which stress organs including the kidneys, weaken the immune system, and damage blood vessels , promotes heart disease and stroke among other conditions. The incidence of type 2 diabetes diagnosed in the United States has gone from less than one percent in the 1950s to more than 7 percent today – and researchers believe that the real numbers now, including undiagnosed diabetes, more than 12 percent. This sharp increase is due to an aging U.S. population and higher levels of obesity and obesity.
Doctors have used the concept of prediabetes – involving higher-than-normal blood glucose levels but not yet in the diabetic field – as an indication of the increased risk of diabetes in younger and middle-aged people. However, the usefulness of the idea in older adults – especially those 70 and older – was less clear.
“It’s very common for older adults to have at least high blood glucose levels, but it’s so difficult for them to progress to diabetes,” says Selvin.
To get a better picture of how older adults are with prediabetes, Selvin and colleagues turned to the Atherosclerosis in Communities Risk Study. This major epidemiological cohort project, funded by the U.S. National Heart, Lung, and Blood Institute and involving both black and white participants, has been run at four medical centers. USA, including Johns Hopkins, since 1987. For their prediabetes analysis, the researchers selected 3,412 ARIC study participants who had a follow-up visit in 2011-13 – a time when participants were between 71 and 90 years old – and had no history of diabetes. The researchers then looked at how measures of participants’ blood glucose levels had changed at the next follow-up visit in 2016-17.
As expected, the researchers found that “prediabetes,” defined by two blood test steps, was very common among participants on the 2011-13 trip. Those with prediabetes, defined by moderately high blood levels of glucose after overnight employment (the deficient glucose test, or IFG), represented 59 percent of the original sample, and those with prediabetes defined by a different blood test for glycated hemoglobin (HbA)1c), representing 44 percent of the original sample.
However, the results showed that only small numbers of participants with prediabetes in 2011-13 had developed diabetes by the 2016-17 cycle – 8 percent of the prediabetics described by IFG, and 9 percent of the HbA1c-de prediabetics.
Conversely, 44 percent of the IFG group and 13 percent of the HbA1c the group had developed enough by the 2016-17 trip that their test results were back in the normal range. In addition, 16 and 19 percent of these two groups had died of other causes prior to the 2016-17 visit.
The findings show that older adults with prediabetes, over time like the one in the study, are more likely to have lower blood sugar levels – or die for other reasons – than to progress to diabetes. -sugar.
“It seems that in older adults, ‘prediabetes’ is not just a strong diagnosis,” says Selvin.
“Our findings support a focus on lifestyle improvements, including exercise and diet where possible and safe, for older adults with prediabetes,” says Mary Rooney, PhD, a graduate of the Bloomberg School and the first author of the paper. “This approach has far-reaching benefits for patients. ”
Selvin and her colleagues suggest that, for older adults, physicians should focus their screening efforts on risk factors, such as hypertension, which are more useful in predicting illness and mortality. in this population.
“Risk of progression to diabetes in older adults with Prediabetes” was written by Mary Rooney, Andreea Rawlings, James Pankow, Justin Echouffo Tcheugui, Josef Coresh, Richey Sharrett, and Elizabeth Selvin.
Funding was provided by the NHLBI (T32HL007024, K24HL152440) and the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK089174).
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