title: Impaired glucose metabolism and type 2 diabetes in apparently healthy senior citizens.
abstract: To estimate the prevalence of unknown impaired glucose metabolism, also referred to as prediabetes (PreD), and unknown type 2 diabetes mellitus (T2DM) among subjectively healthy Swiss senior citizens. The fasting plasma glucose (FPG) and glycated haemoglobin A(1c) (HbA(1c)) levels were used for screening. A total of 1 362 subjects were included (613 men and 749 women; age range 60-99 years). Subjects with known T2DM were excluded.
  
  
  METHODS
  The FPG was processed immediately for analysis under standardised preanalytical conditions in a cross-sectional cohort study; plasma glucose levels were measured by means of the hexokinase procedure, and HbA(1c) was measured chromatographically and classified using the current American Diabetes Association (ADA) criteria.
  
  
  RESULTS
  The crude prevalence of individuals unaware of having prediabetic FPG or HbA(1c) levels, was 64.5% (n = 878). Analogously, unknown T2DM was found in 8.4% (n = 114) On the basis of HbA(1c) criteria alone, significantly more subjects with unknown fasting glucose impairment and laboratory T2DM could be identified than with the FPG. The prevalence of PreD as well as of T2DM increased with age. The mean HOMA indices (homeostasis model assessment) for the different age groups, between 2.12 and 2.59, are consistent with clinically hidden disease and are in agreement with the largely orderly Body Mass Indices found in the normal range.
  
  
  CONCLUSIONS
  Laboratory evidence of impaired glucose metabolism and, to a lesser extent, unknown T2DM, has a high prevalence among subjectively healthy older Swiss individuals. Laboratory identification of people with unknown out-of-range glucose values and overt diabetic hyperglycaemia might improve the prognosis by delaying the emergence of overt disease.
authors.affiliation: Division of Clinical Chemistry, Labormedizinisches Zentrum Dr. Risch, Liebefeld b. Bern, Switzerland; University of Triesen, Triesen, Principality of Liechtenstein.
authors.forename: Pedro
authors.initials: P
authors.lastname: Medina Escobar
authors.affiliation: Department of Endocrinology, Diabetes and Clinical Nutrition, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Michel
authors.initials: M
authors.lastname: Moser
authors.affiliation: Division of Clinical Chemistry, Labormedizinisches Zentrum Dr. Risch, Liebefeld b. Bern, Switzerland; University of Triesen, Triesen, Principality of Liechtenstein; Division of Clinical Biochemistry, Medical University, Innsbruck, Austria.
authors.forename: Lorenz
authors.initials: L
authors.lastname: Risch
authors.affiliation: Central Laboratory, Kantonsspital Graubünden, Chur, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Risch
authors.affiliation: Division of Clinical Chemistry, Labormedizinisches Zentrum Dr. Risch, Liebefeld b. Bern, Switzerland.
authors.forename: Urs Ernst
authors.initials: UE
authors.lastname: Nydegger
authors.affiliation: Department of Endocrinology, Diabetes and Clinical Nutrition, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Zeno
authors.initials: Z
authors.lastname: Stanga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D015577:Geriatric Assessment; D006442:Glycated Hemoglobin; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin