Few Older Adults With Prediabetes Show Disease Progression

A study in JAMA Internal Medicine found fewer prediabetic older adults exhibit progression of their disease, according to Physician's Weekly . The researchers examined data from the Atherosclerosis Risk in Communities Study to detect 3,412 older adults average age, 75.6 without diabetes. Over a 6.5-year follow-up, there were 156 incident total diabetes cases and 434 deaths. Forty-four percent of subjects fulfilled prediabetes criteria using glycated hemoglobin (HbA1c) levels of 5.7 to 6.4 percent, while 59 percent met impaired fasting glucose (IFG) criteria; 73 percent met the HbA1c or IFG criteria, while 29 percent met both criteria. Nine percent of those with HbA1c-defined prediabetes at baseline progressed to diabetes, 13 percent regressed to normoglycemia, and 19 percent died. Eight percent of participants with IFG-defined prediabetes at baseline developed diabetes, 44 percent reverted to normoglycemia, and 16 percent died. Among those with HbA1c levels lower than 5.7 percent at baseline, 17 percent progressed to HbA1c-defined prediabetes and 3 percent developed diabetes. Eight percent of those with fasting glucose levels lower than 100 mg/dL at baseline progressed to IFG-defined prediabetes and 3 percent developed diabetes. "In this community-based cohort study of older adults, the prevalence of prediabetes was high; however, during the study period, regression to normoglycemia or death was more frequent than progression to diabetes," the authors concluded. "These findings suggest that prediabetes may not be a robust diagnostic entity in older age."