Prediabetes in a nursing facility patient with renal insufficiency.
OBJECTIVE
Prediabetes encompasses a variety of abnormalities, including impaired fasting glucose, impaired glucose tolerance, and metabolic syndrome. Prediabetes also increases the risk of developing type 2 diabetes mellitus (T2DM) by 3- to 10-fold, but the complications associated with hyperglycemia begin early in the patient's progression from normal glucose levels to diabetes. Early identification and treatment of prediabetes has the potential to reduce or delay progression to overt diabetes, to preempt related cardiovascular and microvascular disease, and to significantly improve morbidity and mortality. This clinical review provides a vehicle to examine management of prediabetes in patients 65 years of age and older, including diagnostic criteria and recommendations for management.


METHODS
Live symposium presentation based on clinical practice and research, medical literature, and studies published between May 1999 and March 2010 on managing diabetes in older adults, government statistics, and medical society guidelines.


CONCLUSIONS
Effective prediabetes management is important to reducing the risk of progression to T2DM. Recommended first-line therapy is lifestyle modification that may include exercise, nutritional therapy, and weight loss. Pharmacological therapies, when indicated, can aid in improving glucose, blood pressure, and lipid parameters in this patient subgroup.
Shane-McWhorter
Laura
L
Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, Utah 84112, USA. lmcwhorter@pharm.utah.edu
D000368:Aged; D001786:Blood Glucose / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000517:prevention & control*; D018450:Disease Progression; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008403:Mass Screening / Q000379:methods; D009735:Nursing Homes; D011236:Prediabetic State / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D051437:Renal Insufficiency / Q000150:complications*; D012307:Risk Factors
D001786:Blood Glucose; D008055:Lipids