Lifestyle Intervention for Prediabetes Treatment in the Elderly

Using prediabetes definitions, the Diabetes Prevention Program (DPP) trial showed that lifestyle intervention could delay or prevent diabetes for those persons experiencing prediabetes. While the primary outcome of the trial was diabetes and not a reduction of cardiovascular risk, cardiovascular risk factors such as high blood pressure and high cholesterol were monitored.  However, a recent study did shed light on the effect of lifestyle intervention on cardiovascular risk for older persons.

Indeed, one of the primary goals of the study was to determine if reversion to normal glucose from prediabetes could reduce cardiovascular risk in older people. The study was done by investigators in Germany. The investigators used results from the KORA S4 study which was a population-based health survey. The age range of the participants in the study was 55 to 74 years of age.

To determine prediabetes, the investigators used the following definitions of prediabetes: For HbA1c, they used a range of 5.7 to 6.4 percent. For oral glucose tolerance tests, the investigators used a range of 140 to 199 mg/dl. The investigators found that by lowering the weight and waist circumference, an older person could increase his or her “probabilities of returning to” normal blood glucose and maintaining normal blood glucose.

The investigators concluded that “in older adults, even moderate weight reduction contributes to reversion from prediabetes to normoglycaemia and to maintaining normoglycaemia." This conclusion supports the results from the original DPP trial. In fact, the results from the trial indicated that lifestyle intervention is, in general, more effective in prediabetes treatment for persons over 60 years of age than for younger persons.

Healthcare providers should consider these results and use the results in consultations with older patients who are diagnosed with prediabetes. The efforts could be beneficial to the patients, and the effort might even improve an organization’s financial position by giving the healthcare organization a strong platform for negotiating contracts with insurers.

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