Diagnosis of Diabetes in Older Adults
| Autor: | Derek LeRoith, Jeffrey B. Halter |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty endocrine system diseases Endocrinology Diabetes and Metabolism MEDLINE 030209 endocrinology & metabolism Disease 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Internal Medicine medicine Humans 030212 general & internal medicine Prediabetes Epidemiology/Health Services Research Aged Advanced and Specialized Nursing American diabetes association business.industry nutritional and metabolic diseases Guideline medicine.disease Increased risk Diabetes Mellitus Type 2 Public Health business Older people |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 |
| Popis: | OBJECTIVE: Screening for diabetes is typically done using hemoglobin A(1c) (HbA(1c)) or fasting plasma glucose (FPG). The 2019 Endocrine Society guidelines recommend further testing using an oral glucose tolerance test (OGTT) in older adults with prediabetic HbA(1c) or FPG. We evaluated the impact of this recommendation on diabetes prevalence, eligibility for glucose-lowering treatment, and estimated cost of implementation in a nationally representative sample. RESEARCH DESIGN AND METHODS: We included 2,236 adults aged ≥65 years without known diabetes from the 2005–2016 National Health and Nutrition Examination Survey. Diabetes was defined using: 1) the Endocrine Society approach (HbA(1c) ≥6.5%, FPG ≥126 mg/dL, or 2-h plasma glucose ≥200 mg/dL among those with HbA(1c) 5.7–6.4% or FPG 100–125 mg/dL); and 2) a standard approach (HbA(1c) ≥6.5% or FPG ≥126 mg/dL). Treatment eligibility was defined using HbA(1c) cut points (≥7% to ≥9%). OGTT screening costs were estimated using Medicare fee schedules. RESULTS: Diabetes prevalence was 15.7% (∼5.0 million) using the Endocrine Society’s approach and 7.3% (∼2.3 million) using the standard approach. Treatment eligibility ranged from 5.4% to 0.06% and 11.8% to 1.3% for diabetes cases identified through the Endocrine Society or standard approach, respectively. By definition, diabetes identified exclusively through the Endocrine Society approach had HbA1(1c) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|