title: One-hour postload plasma glucose in middle age and Medicare expenditures in older age among nondiabetic men and women: the Chicago Heart Association Detection Project in Industry.
abstract: OBJECTIVE
  To examine associations in nondiabetic individuals of 1-h postload plasma glucose measured in young adulthood and middle age with subsequent Medicare expenditures for cardiovascular disease (CVD), diabetes, cancer, and all health care at age 65 years or older using data from the Chicago Heart Association Detection Project in Industry (CHA).
  
  
  METHODS
  Medicare data (1984-2000) were linked with CHA baseline records (1967-1973) for 8,580 men and 6,723 women ages 33-64 years who were free of coronary heart disease, diabetes, and major electrocardiogram (ECG) abnormalities and who were Medicare eligible (65+ years) for at least 2 years. Participants were classified based on 1-h postload plasma glucose levels <120, 120-199, or > or =200 mg/dl.
  
  
  RESULTS
  With adjustment for baseline age, cigarette smoking, serum cholesterol, systolic blood pressure, BMI, ethnicity, education, and minor ECG abnormalities, the average annual and cumulative Medicare, total, and diabetes- and CVD-related charges were significantly higher with higher baseline plasma glucose in women, while only diabetes-related charges were significantly higher in men. For example, in women, multivariate-adjusted CVD-related cumulative charges were, respectively, USD 14,260, 18,909, and 21,183 for the three postload plasma glucose categories (P value for trend = 0.035).
  
  
  CONCLUSIONS
  These findings suggest that maintaining low glucose levels early in life has the potential to reduce health care costs in older age.
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 North Lake Shore Drive, Suite 1102, Chicago, IL 60611, USA. kiangliu@northwestern.edu
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.forename: Alan R
authors.initials: AR
authors.lastname: Dyer
authors.forename: Thanh-Huyen
authors.initials: TH
authors.lastname: Vu
authors.forename: Amber
authors.initials: A
authors.lastname: Pirzada
authors.forename: Larry M
authors.initials: LM
authors.lastname: Manheim
authors.forename: Willard G
authors.initials: WG
authors.lastname: Manning
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Ashraf
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Garside
authors.forename: Martha L
authors.initials: ML
authors.lastname: Daviglus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D002561:Cerebrovascular Disorders / Q000191:economics / Q000453:epidemiology; D002641:Chicago / Q000453:epidemiology; D017046:Cost Savings; D016208:Databases, Factual; D003920:Diabetes Mellitus; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D006943:Hyperglycemia / Q000191:economics* / Q000453:epidemiology*; D008297:Male; D006278:Medicare / Q000191:economics*; D008875:Middle Aged; D019518:Postprandial Period
chemical_list: D001786:Blood Glucose