The dilemma of defining diabetes mellitus in the aging population

Abstract

A total of 1,009 persons were given a 100-gram glucose solution orally after a three-day regimen of a diet preparation and an overnight fast. Fasting and two-hour plasma glucose levels were determined for each subject and the results tabulated. Most of the persons tested were in the sixth, seventh or eighth decade of life with 43 persons between 80 and 89 years of age. The frequency of fasting plasma glucose determinations above 140 mg per dl varied from 3 percent to 7 percent between the sixth and ninth decades. Those persons with two-hour plasma glucose values above 200 mg per dl represented 8 percent of the 50 to 59 year old group and the percentages rose respectively to 12 percent, 16 percent and 21 percent in the 60 to 69, 70 to 79 and 80 to 89 year old groups. Finally, those who had fasting plasma glucose levels below 140 mg per dl and two-hour glucose values between 140 and 200 mg per dl were tabulated according to decade of life. This group varied from 9 percent to 15 percent between ages 20 and 59 and represented 20 percent to 22 percent of those in the seventh, eighth and ninth decades. In light of the known deterioration of glucose tolerance with aging, some stratification of blood glucose concentrations should be applied with age, but to what degree and what diagnostic criteria should be applied are still unclear.