Ajou University School of Medicine, Suwon, Republic of Korea.
Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
Age Ageing. 2022 Jun 1;51(6). doi: 10.1093/ageing/afac116.
active screening can improve health outcomes for people with prediabetes. However, its efficacy in older adults remains uncertain.
the study aimed to analyse the progression from prediabetes to diabetes in older adults, including associated complications and mortality rates, to determine the benefits of active screening.
retrospective cohort study.
Korean National Health Insurance Service claims database.
a total of 36,946 adults aged ≥65 years who underwent national health examinations from 2006 to 2008.
follow-up was until 31 December 2015. Cox's proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for death and diabetic complications.
over a median follow-up of 8.2 years, 19.3% of older adults with prediabetes progressed to diabetes. Compared with normoglycaemic adults, the multivariable-adjusted HRs (95% CI) for major adverse cardiovascular events were 1.01 (0.95-1.07), 1.08 (0.95-1.23), 1.14 (1.05-1.23) and 1.50 (1.35-1.68) in adults with prediabetes, newly diagnosed diabetes, diabetes not on insulin and diabetes on insulin, respectively. The corresponding HRs (95% CI) for diabetic retinopathy risk were 1.28 (1.15-1.43), 3.16 (2.71-3.69), 6.58 (6.02-7.19) and 9.17 (8.21-10.24). Diabetic nephropathy risk also significantly increased.
progression from prediabetes to diabetes is an important concern among older adults. Prediabetes is associated with the risk of microvascular complications, but not cardiovascular complications and mortality. Therefore, active regular screening for prediabetes is necessary to prevent microvascular complications.
积极筛查可以改善糖尿病前期患者的健康结果。然而，其在老年人中的疗效尚不确定。
本研究旨在分析老年人从糖尿病前期进展为糖尿病的情况，包括相关并发症和死亡率，以确定积极筛查的益处。
回顾性队列研究。
韩国国民健康保险服务索赔数据库。
共有 36946 名年龄≥65 岁的成年人，他们在 2006 年至 2008 年期间接受了国家健康检查。
随访至 2015 年 12 月 31 日。Cox 比例风险模型估计了死亡和糖尿病并发症的风险比（HR）和 95%置信区间（CI）。
在中位数为 8.2 年的随访期间，19.3%的糖尿病前期患者进展为糖尿病。与血糖正常的成年人相比，多变量调整后的 HR（95%CI）为主要不良心血管事件的风险分别为 1.01（0.95-1.07）、1.08（0.95-1.23）、1.14（1.05-1.23）和 1.50（1.35-1.68），分别为糖尿病前期、新诊断的糖尿病、未使用胰岛素的糖尿病和使用胰岛素的糖尿病患者。糖尿病视网膜病变风险的相应 HR（95%CI）分别为 1.28（1.15-1.43）、3.16（2.71-3.69）、6.58（6.02-7.19）和 9.17（8.21-10.24）。糖尿病肾病的风险也显著增加。
从糖尿病前期进展到糖尿病是老年人的一个重要关注点。糖尿病前期与微血管并发症的风险相关，但与心血管并发症和死亡率无关。因此，积极定期筛查糖尿病前期对于预防微血管并发症是必要的。
