02741nas a2200241   4500008004100000245017300041210006900214260001500283300000700298490000700305520201400312653001002326653001302336653001202349653001102361100001602372700001402388700001702402700001502419700001502434700001402449856003602463       2005                        eng d00aUtility of 2-Hour Postchallenge Glucose in Predicting Incident Diabetes in Older Adults with Normal Fastng Glucose: 9-Year Follow-up of the Cardiovascular Health Study.0 aUtility of 2Hour Postchallenge Glucose in Predicting Incident Di  c2005-02-01  a870 v123 a	

S.80 (PUBLISHED) Utility of 2-Hour Postchallenge Glucose in Predicting Incident Diabetes in Older Adults with Normal Fastng Glucose: 9-Year Follow-up of the Cardiovascular Health Study. Doug Shaffer
Writing Chair

CHS Collaborator
Proposal Status

PUB: (Diab.Med) 2-05; vol 12 no. 2 83-87
Writing Group

Doug Shaffer, Nicholas Smith, Joshua Barzilay,Peter Savage, Lewis Kuller, Gregory Burke
Keywords

Description

ABSTRACT

Objective

We calculated rates of diabetes mellitus (DM, defined as having a fasting glucose (FG) > 126 mg/dl or starting diabetic medication) in older adults > 65 years of age (mean 72.9 years, SD=5.6) with normal FG and evaluated the added value of baseline 2-hour glucose (2HG) level as a predictor of subsequent DM.

Methods

We evaluated 3563 participants in the Cardiovascular Health Study with normal FG

(< 110 mg/dl) and calculated DM incidence rates overall and stratified by baseline 2HG using 3 World Health Organization categories (< 140 [normal], 140-199 [impaired glucose tolerance], and > 200 mg/dl [DM]).

Results

Ninety-five participants (2.7%) developed DM during a mean follow-up of 8.5 years (median follow-up 9.9 years) corresponding to an overall incidence rate of 3.1 cases per 1000 person-years. The DM incidence rates given baseline 2HG category were 1.7 (< 140 mg/dl), 4.4 (140-199 mg/dl), and 13.1 (> 200 mg/dl) per 1000 person-years, respectively. Individuals with baseline 2HG concentrations of 140-199 mg/dl and > 200 mg/dl were 2.7 times (HR=2.7, 95% CI 1.7, 4.2) and 7.8 times (HR=7.8, 95% CI 4.2, 13.3) more likely to develop DM compared to those with baseline 2HG measure < 140 mg/dl, respectively. These risks changed little after adjusting for baseline FG, age, sex, race, and BMI: HR=2.3 (1.4, 3.8) and HR=7.5 (4.3, 13.1), respectively.

Conclusions

While 2HG is predictive of DM, the overall DM rate in older adults with normal FG is low. FG without 2HG may be adequate for DM screening in this population.10aAdult10aDiabetes10aGlucose10aHealth1 aShaffer, DN1 aSmith, NL1 aBarzilay, JI1 aSavage, PJ1 aKuller, LK1 aBurke, GL  uhttps://chs-nhlbi.org/node/1530