Clinical Implications of Using Post-Challenge Plasma Glucose Levels for Early Diagnosis of Type 2 Diabetes Mellitus in Older Individuals.
10.4093/dmj.2018.42.2.147
- Author:
Kyong Hye JOUNG
1
;
Sang Hyun JU
;
Ji Min KIM
;
Sorim CHOUNG
;
Jae Min LEE
;
Kang Seo PARK
;
Hyun Jin KIM
;
Bon Jeong KU
Author Information
1. Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea. bonjeong@cnu.ac.kr
- Publication Type:Original Article
- Keywords:
Age;
Diabetes mellitus;
Postprandial glucose
- MeSH:
Blood Glucose*;
Diabetes Mellitus;
Diabetes Mellitus, Type 2*;
Early Diagnosis*;
Fasting;
Glucose;
Glucose Tolerance Test;
Hemoglobin A, Glycosylated;
Humans;
Hyperglycemia;
Mass Screening;
Plasma*
- From:Diabetes & Metabolism Journal
2018;42(2):147-154
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The aim of this study was to explore the differences in the clinical characteristics and diagnostic rates of diabetes mellitus (DM) according to various criteria in different age groups and to evaluate the efficacy of each criterion for screening older patients. METHODS: We studied 515 patients and measured the fasting plasma glucose level (FPG), 2-hour plasma glucose level after the 75 g oral glucose tolerance test (2-hour postload glucose [2-h PG]), and glycosylated hemoglobin (HbA1c) for re-evaluation of hyperglycemia without a history of diabetes. Patients with newly diagnosed DM were grouped by age as younger ( < 65 years) or older (≥65 years). RESULTS: Older patients had significantly lower HbA1c, FPG, and 2-h PG levels and a higher homeostatic level of pancreatic β-cell function compared with younger patients (P < 0.001). The older group had the lowest diagnostic rate when using the FPG level (45.5%) and the highest diagnostic rate when using the 2-h PG level (84.6%). These results were mostly due to the higher frequency of isolated post-challenge hyperglycemia in the older patients than in the younger group (28.8% vs. 9.2%). The use of both the FPG and HbA1c levels significantly enhanced the low diagnostic power when employing only the FPG levels in the older group (71.2% vs. 45.5%). CONCLUSION: In the older patients, the 2-h PG level was the most accurate diagnostic criterion. When we consider the costs and convenience, a combination of the FPG and HbA1c criteria may be recommended as a screening test for DM in older people.
