Primary Care Research

Blood-sugar levels rise with age, even among people without diabetes

It is well-known that aging increases the likelihood of developing diabetes and associated cardiovascular disease (CVD). However, a new study reveals that blood-sugar levels rise with age even among people without diabetes who have normal glucose tolerance (NGT). Age-related impairment of glucose handling might increase the risk of CVD, even when patients do not meet standard criteria for the diagnosis of diabetes or prediabetes, suggest researchers at Emory University. They found that among older adults with NGT, older age was associated with an increase in glucose concentrations 1 hour (1-h OGTT) after an oral glucose challenge, the standard test for diagnosing diabetes by fasting and 2-h OGTT glucose concentrations. This was after controlling for body mass index and physical activity, which can also affect glucose levels.

Each 10-year increase in age conferred an additional 0.20 mmol/l increase in the 1-h OGTT glucose. Moreover, the researchers uncovered an interaction between age and gender, with 1-h OGTT glucose concentrations rising more rapidly with increasing age in men than in women. Smoking, having a family history of diabetes, and having more features of the metabolic syndrome were also associated with higher 1-h OGTT concentrations.

These findings suggest that higher 1-h OGTT glucose concentrations may play a role in the age-related risk in CVD incidence and mortality, as well as the higher incidence of CVD among men than women. The results were based on analysis of the relationship between age and documented 1-h OGTT glucose concentrations among 2,591 adults with NGT who participated in the 1976-1980 National Health and Nutrition Examination Survey. The study was supported in part by the Agency for Healthcare Research and Quality (AHRQ HS09722).

See "Postchallenge glucose rises with increasing age even when glucose tolerance is normal," by Mary K. Rhee, M.D., David C. Ziemer, M.D., Paul Kolm, Ph.D., and Lawrence Phillips, M.D., in the November 2006 Diabetic Medicine 23, pp. 1174-1179.

Editor's Note: Another AHRQ-supported study on diabetes found that administrative staff were more likely to rate their clinics higher on each structural dimension in the Assessment of Chronic Illness Care (ACIC) survey than caregivers or an external observer. For more details, see Kaissi, A.A., and Parchman, M. (2006, June). "Assessing chronic illness care for diabetes in primary care clinics." (AHRQ grant HS13008). Journal on Quality and Patient Safety 32(6), pp. 318-323.

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