Pre-diabetes diagnosis less useful in older adults

More than two million Australians have pre-diabetes – a condition in which blood glucose levels are higher than normal.

While people with pre-diabetes don’t present with diabetes symptoms and it is believed that without proper attention this condition can lead to type 2 diabetes, a new study suggests that this might not be true for older adults.

The study from John Hopkins Bloomberg School of Public Health found that older adults who are classified as having pre-diabetes due to moderately elevated measures of blood sugar usually don’t go on to develop full-blown diabetes.

The study followed nearly 3500 older adults with a median age of 76 for more than six years and found that pre-diabetes was not a useful indicator of diabetes risk in people of more advanced age.

“Our results suggest that for older adults with blood sugar levels in the pre-diabetes range, few will actually develop diabetes,” says senior study author Professor Elizabeth Selvin.

“The category of pre-diabetes doesn’t seem to be helping us identify high-risk people.

“Doctors instead 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 a chronically excess blood level of glucose, which stresses organs including the kidneys, weakens the immune system and damages blood vessels, promoting heart disease and stroke among other conditions.

“It’s very common for older adults to have at least mildly elevated blood glucose levels, but how likely they are to progress to diabetes has been an unresolved question,” Prof. Selvin explained.

The research studied participants who were aged between 71 and 90 and attended an initial screening between 2011-13 and had a follow-up visit in 2016-17.

It found that only small numbers of the participants who presented with pre-diabetes in 2011-13 had developed diabetes by their 2016-17 visit.

The results showed that older adults with pre-diabetes, over intervals such as the one in the study, were more likely to have lower blood sugar levels – or to die for other reasons – than to progress to diabetes.

“It appears that in older adults, pre-diabetes is just not a robust diagnosis,” Prof. Selvin explained.

“Our findings support a focus on lifestyle improvements, including exercise and diet when feasible and safe, for older adults with pre-diabetes,” explained Dr Mary Rooney, another of the study’s authors. “This approach has broad benefits for patients.”

Prof. Selvin recommends that for older adults, GPs should focus their screening efforts on risk factors, such as hypertension, that are more useful in predicting illness and mortality in this population.

The risk factors of pre-diabetes are similar to those of diabetes, including:

  • being overweight
  • living a sedentary lifestyle
  • having high blood pressure
  • having a family history of type 2 diabetes and/or heart disease
  • having high triglycerides and low HDL-C (good cholesterol).

Some of the ways you can help beat pre-diabetes include exercising regular, drinking more water, eating wholegrain foods, getting more sleep and eating foods that are high in fibre.

Have you ever been diagnosed with pre-diabetes? Did it develop into type 2 diabetes? Are you worried about developing diabetes?

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Written by Ben

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