A better explanation of prediabetes could provide a better way to predict which patients may be at higher risk of developing diabetes.
A team, led by Mary R. Rooney, PhD, MPH, Welch Center for Prevention, Epidemiology, and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, compared different interpretations and identified the risks of prediabetes and diabetes in the elderly. adults in a community-based setting.
“Raising prediabetes is used to identify those at high risk for developing diabetes,” the authors wrote. “In this elderly population, very few people have met the explanations for prediabetes that have progressed to diabetes.”
The risk of diabetes
In the prospective cohort study, the researchers examined 3412 older adults without diabetes from the Atherosclerosis Risk Study in Communities. The average age of the patient population was 75.6 years old and 60% of the participants were female.
All were contacted every half year between baseline – 2011-2013 – and 2017. They also went on a follow-up visit between 2016-2017 (mid-term). [range] follow-up, 5.0 years).
2497 participants aged 45–64 years at baseline attended follow-up cycles or died. The study organizers excluded all patients with a history of diabetes and participants with HbA1c rates of 6.5% or higher.
Researchers sought key outcomes of total diabetes – physician diagnosis, use of glucose-lowering drug, HbA1c 6.5%, or FG level 126 mg / dL.
There were 156 total diabetes cases (118 confirmed) and 434 deaths in the 6.5-year follow-up period.
In addition, a total of 1490 participants (44%) had HbA1c levels of 5.7-6.4%, 1996 (59%) on IFG, 2482 (73%) met the HbA1c or IFG criteria, and 1004 (29%) both met the HbA1c and IFG criteria.
For patients with HbA1c levels of 5.7-6.4% at baseline, 97 (9%) progressed to diabetes, 148 (13%) reverted to normoglycemia (HbA1c, <5.7%), and 207 (19%) died.
For those with baseline IFG, 112 (8%) progressed to diabetes, 647 (44%) reverted to normoglycemia (FG, <100 mg / dL), and 236 (16%) died. ).
Of those with baseline HbA1c levels of less than 5.7%, 239 (17%) progressed to HbA1c levels of 5.7% to 6.4% and 41 (3%) developed diabetes, and of those with baseline IFG levels below 100 mg / dL, 80 (8%) progressed. to IFG (FG, 100–125 mg / dL) and 26 (3%) developed diabetes.
Prediabetes
“In this community cohort study of older adults, the incidence of prediabetes was high; however, during the study period, relapse to normoglycemia or death was more frequent than progression to diabetes, ”the authors wrote. “These findings show that prediabetes may not be a strong study group in old age. ”
Previous research has shown that the incidence of prediabetes and diabetes increases dramatically with age, with approximately 25% of adults 65 or older with diabetes in the U.S. and 50% of those with diabetes. these patients meet the criteria for prediabetes according to the definition used.
The Diabetes Association of America has reported that hyperglycemia may help predict these conditions in older adults.
The study, “Risk of progression to diabetes in older adults with Prediabetes,” was published online in JAMA inside Medicine.