Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 145 No. 4748 (2015)

Impaired glucose metabolism and type 2 diabetes in apparently healthy senior citizens

  • Pedro Medina Escobar
  • Michael Moser
  • Lorenz Risch
  • Martin Risch
  • Urs Ernst Nydegger
  • Zeno Stanga
DOI
https://doi.org/10.4414/smw.2015.14209
Cite this as:
Swiss Med Wkly. 2015;145:w14209
Published
15.11.2015

Summary

STUDY PRINCIPLE: To estimate the prevalence of unknown impaired glucose metabolism, also referred to as prediabetes (PreD), and unknown type 2 diabetes mellitus (T2DM) among subjectively healthy Swiss senior citizens. The fasting plasma glucose (FPG) and glycated haemoglobin A1c (HbA1c) levels were used for screening. A total of 1 362 subjects were included (613 men and 749 women; age range 60–99 years). Subjects with known T2DM were excluded.

METHODS: The FPG was processed immediately for analysis under standardised preanalytical conditions in a cross-sectional cohort study; plasma glucose levels were measured by means of the hexokinase procedure, and HbA1c was measured chromatographically and classified using the current American Diabetes Association (ADA) criteria.

RESULTS: The crude prevalence of individuals unaware of having prediabetic FPG or HbA1c levels, was 64.5% (n = 878). Analogously, unknown T2DM was found in 8.4% (n = 114) On the basis of HbA1c criteria alone, significantly more subjects with unknown fasting glucose impairment and laboratory T2DM could be identified than with the FPG. The prevalence of PreD as well as of T2DM increased with age. The mean HOMA indices (homeostasis model assessment) for the different age groups, between 2.12 and 2.59, are consistent with clinically hidden disease and are in agreement with the largely orderly Body Mass Indices found in the normal range.

CONCLUSIONS: Laboratory evidence of impaired glucose metabolism and, to a lesser extent, unknown T2DM, has a high prevalence among subjectively healthy older Swiss individuals. Laboratory identification of people with unknown out-of-range glucose values and overt diabetic hyperglycaemia might improve the prognosis by delaying the emergence of overt disease.

References

  1. Kaiser A, Vollenweider P, Waeber G, Marques-Vidal P. Prevalence, awareness and treatment of type 2 diabetes mellitus in Switzerland: the CoLaus study. Diabet Med. 2012;29(2):190–7.
  2. Blum J, Aeschbacher S, Schoen T, Bossard M, Pumpol K, Brasier N, et al. Prevalence of prediabetes according to hemoglobin A1c versus fasting plasma glucose criteria in healthy adults. Acta Diabetol. 2015;52(3):631–2.
  3. Salinero-Fort MA, de Burgos-Lunar C, Mostaza Prieto J, Lahoz Rallo C, Abanades-Herranz JC, Gomez-Campelo P, et al. Validating prediction scales of type 2 diabetes mellitus in Spain: the SPREDIA-2 population-based prospective cohort study protocol. BMJ Open. 2015;5(7):e007195.
  4. Jornayvaz FR, Philippe J. Le diabète en 2015: en augmentation constante, mais avec une offre thérapeutique qui s’élargit. Rev Med Suisse. 2015;11(477):1219–20.
  5. Selvin E, Parrinello CM, Sacks DB, Coresh J. Trends in prevalence and control of diabetes in the United States, 1988-1994 and 1999–2010. Ann Internal Med. 2014;160(8):517–25.
  6. Mota M, Popa SG, Mota E, Mitrea A, Catrinoiu D, Cheta DM, et al. Prevalence of diabetes mellitus and prediabetes in the adult Romanian population: PREDATORR study. J Diabetes. 2015 Apr 7. doi: 10.1111/1753-0407.12297. [Epub ahead of print]
  7. Centers for Disease Control and Prevention (CDC). Awareness of prediabets – United Status, 2005-2010. MMWR Morb and Mortal Wkly Rep. 2013;62(11):209–12.
  8. Diabetes Prevention Program Outcomes Study Research Group, Orchard TJ, Temprosa M, Barrett-Connor E, Fowler SE, Goldberg RB, et al. Long-term effects of the Diabetes Prevention Program interventions on cardiovascular risk factors: a report from the DPP Outcomes Study. Diabet Med. 2013;30(1):46–55.
  9. Gillies CL, Abrams KR, Lambert PC, Cooper NJ, Sutton AJ, Hsu RT, et al. Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. BMJ. 2007;334(7588):299.
  10. Heianza Y, Hara S, Arase Y, Saito K, Fujiwara K, Tsuji H, et al. HbA1c 5.7–6.4% and impaired fasting plasma glucose for diagnosis of prediabetes and risk of progression to diabetes in Japan (TOPICS 3): a longitudinal cohort study. Lancet. 2011;378(9786):147–55.
  11. Jaisson S, Leroy N, Guillard E, Desmons A, Gillery P. Analytical performances of the D-100TM hemoglobin testing system (Bio-Rad) for HbA1c assay. Clin Chem Lab Med. 2015 May 23. pii: /j/cclm.ahead-of-print/cclm-2015-0288/cclm-2015-0288.xml. doi: 10.1515/cclm-2015-0288. [Epub ahead of print]
  12. Little RR, La’ulu SL, Hanson SE, Rohlfing CL, Schmidt RL. Effects of 49 Different Rare Hb Variants on HbA1c Measurement in Eight Methods. J Diabetes Scie Technol. 2015;9(4):849–56.
  13. Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ, et al. Translating the A1C assay into estimated average glucose values. Diabetes Care. 2008;31(8):1473–8.
  14. Federal Office of Public Health (FOPH). The 6th Swiss Nutrition Report. 2012.
  15. American Diabetes Association (ADA). Standards of medical care in diabetes – 2014. Diabetes Care. 2014;37(Suppl1):S14–S80.
  16. WHO. Physical status: the use and interpretation of anthropometry. Geneva. World Health Organ Tech Rep ser. 2006.
  17. Heianza Y, Arase V, Hsieh SD, Saito K, Tsuji H, Kodoma S, et al. Development of a new scoring system for predicting the 5 year incidence of type 2 diabetes in Japan: the Toranomon hospital health management center study 6 (TOPICS 6). Diabetologia. 2012;55:3213–23.
  18. McMurdo ME, Roberts H, Parker S, Wyatt N, May H, Goodman C, et al. Improving recruitment of older people to research through good practice. Age Ageing. 2011;40(6):659–65.
  19. Zimmet PZ, Magliano DJ, Herman WH, Shaw JE. Diabetes: a 21st century challenge. The Lancet Diabetes Endocrinol. 2014;2(1):56–64.
  20. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32:1327–34.
  21. Karve A, Hayward RA. Prevalence, diagnosis, and treatment of impaired fasting glucose and impaired glucose tolerance in nondiabetic U.S. adults. Diabetes Care. 2010;33(11):2355–9.
  22. Geiss LS, James C, Gregg EW, Albright A, Williamson DF, Cowie CC. Diabetes risk reduction behaviors among U.S. adults with prediabetes. Am J Prev Med. 2010;38(4):403–9.
  23. Tabak AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for developing diabetes. Lancet. 2012;379(9733):2279–90.
  24. Swiss Federal Statistical Office (SFSO). Diabetes. Neuchâtel 2014.
  25. Aeschbacher S, Schoen T, Clair C, Schillinger P, Schonenberger S, Risch M, et al. Association of smoking and nicotine dependence with pre-diabetes in young and healthy adults. Swiss Med Wkly. 2014;144:w14019.
  26. Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes Care. 1998;21(4):518–24.
  27. Mann DM, Carson AP, Shimbo D, Fonseca V, Fox CS, Muntner P. Impact of A1C screening criterion on the diagnosis of pre-diabetes among U.S. adults. Diabetes Care. 2010;33(10):2190–5.
  28. Heianza Y, Arase Y, Fujihara K, Tsui H, Saito K, Hsieh SD, et al. Screening for pre-diabetes to predict future diabetes using various cut-off points for HbA1c and impaired fasting glucose: the Toranomon Hospital Health Management Center Study 4 (TOPICS 4). Diabet Med. 2012;29:c279–c85.
  29. Replication DIG, Meta-analysis C, Asian Genetic Epidemiology Network Type 2 Diabetes C, South Asian Type 2 Diabetes C, Mexican American Type 2 Diabetes C, Type 2 Diabetes Genetic Exploration by Next-generation sequencing in muylti-Ethnic Samples C, et al. Genome-wide trans-ancestry meta-analysis provides insight into the genetic architecture of type 2 diabetes susceptibility. Nat Geneti. 2014;46(3):234–44.
  30. Chang AM, Halter JB. Aging and insulin secretion. Am J Physiol Endocrinol Metab. 2003;284(1):E7–12.
  31. Reers C, Erbel S, Esposito I, Schmied B, Buchler MW, Nawroth PP, et al. Impaired islet turnover in human donor pancreata with aging. Eur J Endocrinol. 2009;160(2):185–91.
  32. Maedler K, Schumann DM, Schulthess F, Oberholzer J, Bosco D, Berney T, et al. Aging correlates with decreased beta-cell proliferative capacity and enhanced sensitivity to apoptosis: a potential role for Fas and pancreatic duodenal homeobox-1. Diabetes. 2006;55(9):2455–62.
  33. Dube JJ, Allison KF, Rousson V, Goodpaster BH, Amati F. Exercise dose and insulin sensitivity: relevance for diabetes prevention. Med Science Sports Exerc. 2012;44(5):793–9.
  34. Yoon U, Kwok LL, Magkidis A. Efficacy of lifestyle interventions in reducing diabetes incidence in patients with impaired glucose tolerance: a systematic review of randomized controlled trials. Metabolism. 2013;62(2):303–14.
  35. Crandall JP, Knowler WC, Kahn SE, Marrero D, Florez JC, Bray GA, et al. The prevention of type 2 diabetes. Nat Clin Pract Endocrinol Metab. 2008;4(7):382–93.
  36. Hopper I, Billah B, Skiba M, Krum H. Prevention of diabetes and reduction in major cardiovascular events in studies of subjects with prediabetes: meta-analysis of randomised controlled clinical trials. Eur J Cardiovasc Prev Rehabil. 2011;18(6):813–23.
  37. Li Y, Burrows NR, Gregg EW, Albright A, Geiss LS. Declining rates of hospitalization for nontraumatic lower-extremity amputation in the diabetic population aged 40 years or older: U.S., 1988-2008. Diabetes Care. 2012;35(2):273–7.
  38. McGregor RA, Poppitt SD, Cameron-Smith D. Role of microRNAs in the age-related changes in skeletal muscle and diet or exercise interventions to promote healthy aging in humans. Ageing Res Rev. 2014;17:25–33.
  39. Zhu Y, Armstrong JL, Tchkonia T, Kirkland JL. Cellular senescence and the senescent secretory phenotype in age-related chronic diseases. Curr Opin Clin Nutr Metab Care. 2014;17(4):324–8.

Most read articles by the same author(s)

1 2 > >>