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Journal Article Ppublish 5 citations

PubMed: 39705138 DOI: 10.2337/dc24-1990

Glucose Abnormalities Detected by Continuous Glucose Monitoring in Very Old Adults With and Without Diabetes.

Diabetes Care 48(3):416-421

Authors: Natalie R Daya, Michael Fang, Dan Wang, Arielle Valint, B Gwen Windham, Josef Coresh, Justin B Echouffo-Tcheugui, Elizabeth Selvin

Affiliations

  • The Welch Center for Prevention, Epidemiology and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
  • Collaborative Studies Coordinating Center, University of North Carolina Gillings School of Public Health, Chapel Hill, NC.
  • Memory Impairment and Neurodegenerative Dementia (MIND) Center, Department of Medicine, University of Mississippi Medical Center, Jackson, MS.
  • The Welch Center for Prevention, Epidemiology and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Optimal Aging Institute, Department of Population Health and Medicine, New York University Grossman School of Medicine, New York, NY.
  • Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

Abstract

OBJECTIVE

To characterize the prevalence of continuous glucose monitoring (CGM)-defined glucose abnormalities in a large, community-based population of very old adults (>75 years).

RESEARCH DESIGN AND METHODS

A cross-sectional analysis of 1,150 older adults with and without diabetes who attended the Atherosclerosis Risk in Communities Study (2021-2022). Diabetes was based on a self-reported diagnosis of diabetes by a health care provider, use of diabetes medication, or a hemoglobin A1c (HbA1c) ≥6.5%. Prediabetes was defined as an HbA1c of 5.7% to <6.5% and normoglycemia as an HbA1c of <5.7%. We analyzed CGM metrics, including mean glucose, measures of hyperglycemia, and the coefficient of variation, by diabetes status.

RESULTS

Of the 1,150 participants (mean age 83 years, 59% women, 26% who are Black), 35.1% had normoglycemia, 34.5% had prediabetes, and 30.4% had diabetes. The summary 24-h ambulatory glucose profile for participants with prediabetes was very similar to those with normoglycemia. No participants with normoglycemia or prediabetes had a CGM mean glucose >140 mg/dL, while 32.7% of participants with diabetes had a CGM mean glucose >140 mg/dL.

CONCLUSIONS

In very old adults with normal or prediabetes HbA1c, hyperglycemia detected by CGM was rare. This suggests that HbA1c adequately captures the burden of hyperglycemia for most people in this population.

MeSH

Diabetes Mellitus, Hyperglycemia, Prediabetic State, Continuous Glucose Monitoring

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