Prevalence and clinical implications of American Diabetes Association-defined diabetes and other categories of glucose dysregulation in older adults:The Health, Aging and Body Composition Study

Using data on history of diabetes, fasting glucose (FG) and the oral glucos e tolerance test (OGTT), the authors contrasted cardiovascular disease (CVD ) risk factors (body mass index, blood pressure. lipids and glycated hemogl obin) in 3052 African-American and White adults aged 70-79 in mutually excl usive categories of diagnosed diabetes, undiagnosed diabetes defined by the American Diabetes Association (ADA), isolated post-challenge hyperglycemia (IPH:, FG < 126 mg/dL and 2 h post-OGTT <greater than or equal to> 200 mg/ dL), impaired fasting glucose (IFG; FG greater than or equal to 110 but < 1 26 mg/dL), and individuals who were non-diabetic by both ADA and World Heal th Organization (WHO) criteria (FG < 126 mg/dL and 2 h post-challenge gluco se < 200 mg/dL). The prevalence of diagnosed diabetes, undiagnosed ADA diab etes and IPH were 15.2, 3.8 and 4.7%, respectively, with more diagnosed and undiagnosed ADA diabetes in African-Americans than Whites. Compared to mea n glycated hemoglobin (HbA(1c)) among ADA/WHO non-diabetic individuals (6.0 %), HbA(1c) was substantially higher in the diagnosed diabetes and undiagno sed ADA diabetes groups (8.0% and 7.7%), but not in the IPH group (6.3%). T he diagnosed and undiagnosed ADA diabetic groups had worse CVD risk factor profiles than the ADA/WHO non-diabetic group. IPH subjects had elevated lev els of some CVD risk factors, but differences were more modest than those f or the diabetic groups. Among people with IPH, those who also had IFG had w orse CVD profiles than those with IPH alone. Although the OGTT may identify additional adults with more CVD risk factors than normals, these differenc es appear to be clustered among those who also have IFG. (C) 2001 Elsevier Science Inc. All rights reserved.