DIABETES-MELLITUS, IMPAIRED GLUCOSE-TOLERANCE, AND HYPERINSULINEMIA IN AN ELDERLY POPULATION - THE ROTTERDAM STUDY

To estimate the prevalence of glucose intolerance in the elderly, oral glucose tolerance tests were performed as part of the Rotterdam Study , a population-based study in subjects aged 55 years and over, The stu dy population consisted of 2,668 men and 3,950 women, Diabetes mellitu s was defined as the use of antidiabetes medication, or a random or po st-load serum glucose level of greater than or equal to 11.1 mmol/lite r, Impaired glucose tolerance was defined as a post-load serum glucose between 7.8 and 11.1 mmol/liter. In men, the frequency of diabetes me llitus ranged from 5.9% in ages <60 years to 19.8% in ages >85 years, and in women from 3.846 in ages <60 years to 18.9% in ages >85 years; more than half of the subjects with diabetes were newly diagnosed. The prevalence of impaired glucose tolerance ranged from 8.8% and 11.0% i n men and women aged <60 years to 24.3% and 34.7% in men and women age d >85 years, The prevalence of diabetes mellitus in the total Rotterda m Study population of 7,439 elderly men and women was estimated to be 11.3% (95% confidence interval (Ci) 10.5-12.0), Waist/hip ratio, systo lic blood pressure, hypertension, and number of cigarettes smoked incr eased with a worsening of the glucose tolerance from normal, hyperinsu linemia, impaired glucose tolerance to diabetes in both men and women (p < 0.01, adjusted for age). Body mass index was higher in subjects w ith glucose intolerance, but the frequency of obesity showed a relativ e decrease with worsening of glucose tolerance, These results show tha t glucose intolerance, especially impaired glucose tolerance and undet ected diabetes mellitus, is common in the elderly. Moreover, not only subjects with diabetes mellitus but also subjects with hyperinsulinemi a and impaired glucose tolerance have an increase of cardiovascular ri sk factors.