Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
Aging Branch, Neuroscience Institute, National Research Council, Padua, Italy.
Age Ageing. 2022 Feb 2;51(2). doi: 10.1093/ageing/afab222.
Prediabetes is used to identify people at increased risk for diabetes. However, the importance of prediabetes in older populations is still poorly explored. Therefore, we aimed to investigate the prevalence of prediabetes, based on either glycated haemoglobin (HbA1c) levels or fasting glucose (FG) levels, or both and the progression of prediabetes to diabetes or to mortality in older participants of the English Longitudinal Study on Ageing.
Prediabetes was categorized based on HbA1c levels (5.7%-6.4%) and/or FG levels (5.6-7.0 mmol/L). Information regarding mortality and incident diabetes were recorded during follow-up period of 10 years.
In 2027 participants (mean age: 70.6 years, 55.2% females), the prevalence of prediabetes ranged between 5.9% and 31.1%. Over 8 years of follow-up, 189 participants (5.4% of the initial population) developed diabetes and 606 (17.4%) died. Among 1,403 people with HbA1c at the baseline <5.7%, 33 developed diabetes and 138 died; in contrast, among 479 participants with a diagnosis of prediabetes using a value of HbA1c between 5.7% and 6.4%, 62 developed diabetes and 56 died. Similarly, among 1,657 people with normal values of FG at baseline 60 had a diagnosis of diabetes during follow-up and 163 died, compared to 225 with FG between 5.6 mmol/L and 7.0 mmol/L in which 35 developed diabetes and 31 died.
The prevalence of prediabetes in older adults is high, but the progression from prediabetes to diabetes is uncommon, whereas the regression to normoglycemia or the progression to death was more frequent.
糖尿病前期用于识别糖尿病风险增加的人群。然而，糖尿病前期在老年人群中的重要性仍未得到充分探索。因此，我们旨在调查基于糖化血红蛋白（HbA1c）水平或空腹血糖（FG）水平或两者的糖尿病前期患病率，以及在英国老龄化纵向研究中年龄较大的参与者中糖尿病前期向糖尿病或死亡的进展情况。
糖尿病前期根据 HbA1c 水平（5.7%-6.4%）和/或 FG 水平（5.6-7.0mmol/L）进行分类。在 10 年的随访期间记录了死亡率和新发糖尿病的信息。
在 2027 名参与者（平均年龄：70.6 岁，55.2%为女性）中，糖尿病前期的患病率在 5.9%至 31.1%之间。在 8 年的随访中，有 189 名参与者（初始人群的 5.4%）发生了糖尿病，606 名（17.4%）死亡。在基线 HbA1c<5.7%的 1403 人中，有 33 人发生了糖尿病，138 人死亡；相比之下，在基线 HbA1c 在 5.7%至 6.4%之间诊断为糖尿病前期的 479 名参与者中，有 62 人发生了糖尿病，56 人死亡。同样，在基线 FG 正常的 1657 人中，有 60 人在随访期间被诊断患有糖尿病，163 人死亡，而在 FG 在 5.6mmol/L 和 7.0mmol/L 之间的 225 人中，有 35 人发生了糖尿病，有 31 人死亡。
老年人群中糖尿病前期的患病率较高，但从糖尿病前期向糖尿病的进展并不常见，而向正常血糖或向死亡的进展则更为常见。
