Classification of glucose intolerance in the aged based on hemoglobin A1.

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  • NAKAO JUNKO
    Department of Internal Medicine, Tokyo Metropolitan Geriatric Hospital
  • ORIMO HAJIME
    Department of Internal Medicine, Tokyo Metropolitan Geriatric Hospital
  • ITO HIDEKI
    Department of Internal Medicine, Tokyo Metropolitan Geriatric Hospital

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説明

While the incidence of glucose intolerance increases with age, the diagnostic criteria of diabetes mellitus in the aged have been controversial. In this study, glucose intolerance in the aged was classified according to the changes in Hb A1 concentrations and plasma glucose levels at the time of 50g oral glucose tolerance test. Ninety-six aged Japanese (60-90 years old, mean 72 years) were studied. Hb A1 was measured by Fast Hb Test System. The results suggested the existence of critical plasma glucose levels for the increment in Hb A1 in the aged, and the critical values were around 120mg/100ml at fasting, and around 240mg/100ml at 60 or 120 min after glucose load. Using these critical plasma glucose levels, glucose intolerance in the aged was classified into two groups, i. e., Group I with fasting plasma glucose below 120mg/100ml and both plasma glucose levels at 60 and 120 min below 240mg/100ml, and Group 2 with fasting plasma glucose above 120mg/100ml and both plasma glucose levels at 60 and 120 min above 240mg/100ml. The incidence of elevated Hb A1 in Group 1, 4.3%, was significantly lower than 94. 1% in Group 2, and insulinogenie index at 30 min in Group 1, 0.74, was significantly higher than 0.07 in Group 2. In conclusion, it was proposed that subjects in Group 2 represent diabetes mellitus, while subjects in Group 1 might not be of pathological glucose intolerance in the aged.

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