What’s the risk of diabetes progression among older adults with prediabetes?

Despite the number of older adults who have prediabetes and diabetes, the risk of prediabetes progressing to diabetes in this population is not well understood. But new study findings published in JAMA Internal Medicine could help characterize prediabetes in older age.

Mary Rooney, PhD, MPH, and colleagues analyzed data after 3,400 community-dwelling older adults aged 71 to 90 years were followed to examine their prediabetes status.

“In this community-based cohort study of older adults, prediabetes was common, but its prevalence differed substantially based on the definition used,” the authors wrote in the study report.

During the 6.5-year follow-up period, fewer than 12% of older adults progressed from prediabetes to diabetes, regardless of the definition of prediabetes, researchers found. The study authors stated that there is currently no consensus on the best definition for prediabetes for use in clinical practice. Depending on the definition, the prevalence of prediabetes in the study ranged from 29% to 73%, they said.

In addition, a substantial proportion of individuals in the study with prediabetes at baseline regressed to normoglycemia at the follow-up visit: 13% among those with A1C levels of 5.7% to 6.4%, and 44% among those with fasting glucose levels of 100 mg/dL to 125 mg/dL.

“Indeed, in older adults with prediabetes, regression to normoglycemia or death was more common than progression to diabetes during the study period,” the study authors wrote.

The study authors concluded that prediabetes status may not be a useful prognostic marker for diabetes risk in older adults.