Study Finds That Older Adults with Prediabetes Are Unlikely to Progress to Diabetes

The Centers for Disease Control and Prevention say there are 88 million Americans with prediabetes. The diagnosis can ultimately lead to diabetes. However, a new study finds that this doesn’t typically happen in older adults.

Researchers from John Hopkins University Bloomberg School of Public Health looked into the risk that older adult with prediabetes have of progressing into diabetes. Their findings were recently published in JAMA Internal Medicine.

Elizabeth Selvin, senior author and professor in the Department of Epidemiology at the Bloomberg School, says, “Our results suggest that for older adults with blood sugar levels in the prediabetes range, few will actually develop diabetes. The category of prediabetes doesn’t seem to be helping us identify high-risk people. Doctors instead should focus on healthy lifestyle changes and important disease risk factors such as smoking, high blood pressure, and high cholesterol.”


The study included 3,412 older adults with a median age of 76. Researchers contacted participants semiannually for six-and-a-half years, ending in December 2017. They found the participants through the Atherosclerosis Risk in Communities Study, which has been ongoing at four medical centers since 1987. Each participant had attended a follow-up visit between 2011 and 2013 and did not have a history of diabetes. At the next follow-up visit, between 2016 and 2017, researchers looked at the differences that had occurred in participants’ blood glucose levels during that time.

At the initial visit, 59% had prediabetes as defined by moderately high blood levels of glucose after overnight fasting, while 44% were prediabetic as determined by a blood test for glycated hemoglobin, or HbA1c.

When they went to their follow-up appointments in 2016 and 2017, only 8% of those in the overnight fasting prediabetic group had progressed to full-on diabetes, while just 9% of the HbA1c group had. Meanwhile, 44% of the first group and 13% of the second actually had better numbers and were considered back in the normal range. Before the follow-up, 16% and 19%, respectively, had died of other causes.


Study authors say this indicates that older adults with prediabetes are more apt to lower their blood sugar levels or die of other reasons than to actually develop diabetes.

So what should older adults with prediabetes do to stay healthy?

Mary Rooney, lead author and postdoctoral fellow at the Bloomberg School, says, “Our findings support a focus on lifestyle improvements, including exercise and diet when feasible and safe, for older adults with prediabetes. This approach has broad benefits for patients.”


In younger and middle-aged adults, however, prediabetes is still considered a good indicator of ultimately developing diabetes. Lifestyle improvements are also recommended to those in these age groups. The CDC recommends losing just 5-7% of body weight, doing brisk walking or a similar activity for at least 150 minutes a week, and finding some favorite healthy foods to incorporate into your diet.

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