Risk of progression to diabetes among older adults with prediabetes

Researchers explored prediabetes among older adults in a community-based setting, tracking the risk for an eventual diagnosis of full-blown diabetes. The prospective cohort analysis included 2,497 older adults who did not have diabetes at enrollment and who were followed for 6.5 years. In all, 1,490 participants were prediabetic, based on either glycated hemoglobin level of 5.7%–6.4%, impaired fasting glucose (IFG) level, or both. Among those with elevated glucose levels at baseline, 9% progressed to diabetes, 13% returned to normal blood glucose levels, and 19% died. For patients with IFG at baseline, 8% developed full-scale diabetes, 44% achieved normoglycemia, and 16% passed away. By comparison, 17% of enrollees with normal blood glucose levels at baseline progressed to prediabetes and 3% developed diabetes. Participants with normal FG levels when the study launched progressed to IFG at a rate of 8% and to diabetes at a rate of 3%. Collectively, the data indicate that while prediabetes was common in the study cohort, older adults were more like to regress to normoglycemia or to die over time than to advance to full-blown diabetes. “These findings suggest,” the investigators report, “that prediabetes may not be a robust diagnostic entity in older age.”