[Diagnostic criteria for diabetes in older subjects]

Abstract

The remarkable feature of glucose metabolisms in older subjects is that 2h plasma glucose concentration (2h-PG) increases linearly with age, but fasting plasma glucose concentration (FPG) does not. 2h-PG is a better predictor of the risk of mortality from cardiovascular disease (CVD) than FPG in older age as well as in young and middle age. Even subjects with isolated impaired glucose tolerance have a two times higher risk of CVD than those with normal glucose tolerance. Thus, the use of fasting glucose alone for diabetes diagnosis may fail to identify older adults at high risk for CVD and they should be evaluated by oral glucose tolerance test.