Prevalence of cardiovascular and renal complications in older adults with normal or impaired glucose tolerance or NIDDM. A population-based study

Abstract

Objective: To determine the prevalence of CVD and renal disease by glucose tolerance status in a population-based study.

Research design and methods: The study consisted of 991 men and 1243 women, aged 50-89 yr, living in the upper-middle class community of Rancho Bernardo, CA. All participants received a standard OGTT between 1984 and 1987.

Results: A total of 159 men and 158 women had NIDDM, whereas 237 men and 348 women had IGT. Age-adjusted prevalence of complications generally was highest in those who were previously diagnosed with NIDDM. A significant correlation was observed between increases in the prevalence of complications and increases in glucose intolerance for microproteinuria, macroproteinuria, and myocardial infarction (borderline), as well as for stroke and claudication in men and myocardial infarction and stroke in women. In men with IGT or NIDDM, the age-adjusted prevalence of proteinuria and CVD was highest when other complications were present whereas in women such a prevalence was highest when other complications were absent. In men with diabetes, microproteinuria was associated with duration of disease.

Conclusions: Prevalent CVD and renal disease were increased in adults with NIDDM and elevated in adults with IGT compared to those with normal glucose tolerance. The prevalence of complications in NIDDM subjects in this population-based study was substantially lower than that reported for clinic-based diabetic populations.