What question did this study set out to answer?

To assess the impact of age on diabetes prevalence estimates based on ADA criteria versus WHO criteria.

February 1, 2000Diabetes CareOpen Access

American Diabetes Association diabetes diagnostic criteria, advancing age, and cardiovascular disease risk profiles: results from the Third National Health and Nutrition Examination Survey.

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Why the study?

How do ADA diagnostic criteria compare to WHO criteria in identifying diabetes and associated cardiovascular risk profiles across different age groups?

Population

2,844 subjects aged 40-74 years without reported diabetes who had both fasting glucose and oral glucose…

Comparison

American Diabetes Association diagnostic criteria vs World Health Organization diagnostic criteria

Design

Cross-sectional

Authors

HRHelaine E. ResnickGeneral / Preventive / Lipids MHMaureen I HarrisGeorgetown University DBDavid BrockSeoul National University

Discussion

Member takes

Implication

ADA criteria may flag higher-CVD-risk cases despite missing isolated postchallenge hyperglycemia in older adults; leaves open age-specific diagnostic trials.

Key Points

To assess the impact of age on diabetes prevalence estimates based on ADA criteria versus WHO criteria.
Analyzed data from 2,844 adults aged 40-74 without reported diabetes who underwent fasting glucose and OGTT testing.
Calculated age-specific ratios of undiagnosed diabetes to isolated postchallenge hyperglycemia (IPH).
Contrasted mean HbA1c and cardiovascular disease risk factors between undiagnosed diabetes, IPH, and nondiabetic groups.
Ratios of undiagnosed diabetes to IPH declined significantly from 5.49 in ages 40-44 to 0.77 in ages 70-74 (P=0.006).
Mean HbA1c levels were 7.1% in undiagnosed diabetes, significantly higher than 5.6% in IPH and 5.3% in nondiabetic individuals.
Individuals with undiagnosed diabetes exhibited poorer cardiovascular risk profiles compared to those with IPH.

Structured PICO

How do ADA diagnostic criteria compare to WHO criteria in identifying diabetes and associated cardiovascular risk profiles across different age groups?

Population

2,844 subjects aged 40-74 years without reported diabetes who had both fasting glucose and oral glucose tolerance test (OGTT) from the Third National Health and Nutrition Examination Survey.

Intervention

American Diabetes Association (ADA) diagnostic criteria (undiagnosed diabetes: fasting glucose >= 126 mg/dl)

Comparator

World Health Organization (WHO) diagnostic criteria (isolated postchallenge hyperglycemia [IPH]: fasting glucose < 126 mg/dl and OGTT >= 200 mg/dl)

Outcome

Age-specific ratios of undiagnosed diabetes to isolated postchallenge hyperglycemia (IPH)surrogate

Although ADA criteria underestimate postchallenge hyperglycemia in older adults compared to WHO criteria, they effectively identify individuals with worse cardiovascular risk profiles and higher long-term hyperglycemia exposure.

Cite This Study

Resnick et al. (2000) studied this question.

synapsesocial.com/papers/6a2090ffa5754bb7efc63e55 https://doi.org/10.2337/diacare.23.2.176

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Implication

ADA criteria may flag higher-CVD-risk cases despite missing isolated postchallenge hyperglycemia in older adults; leaves open age-specific diagnostic trials.

American Diabetes Association diabetes diagnostic criteria, advancing age, and cardiovascular disease risk profiles: results from the Third National Health and Nutrition Examination Survey.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

American Diabetes Association diabetes diagnostic criteria, advancing age, and cardiovascular disease risk profiles: results from the Third National Health and Nutrition Examination Survey.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider