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

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Abstract
While the incidence of glucose intolerance increases with age, the diagnostic criteria of diabetes mellitus in the aged are controversial. Glucose intolerance in the aged was classified according to the changes in HbA1 concentrations and plasma glucose levels at the time of 50 g oral glucose tolerance test. Ninety-six aged Japanese (60-90 yr old, mean 72 yr) were studied. HbA1 was measured by Fast Hb Test System. Critical plasma glucose levels apparently exist for the increment in HbA1 in the aged, and the critical values were .apprx. 120 mg/100 ml at fasting, and .apprx. 240 mg/100 ml at 60 or 120 min after glucose load. Using these critical plasma glucose levels, glucose intolerance in the aged was classified into 2 groups, i.e., group I with fasting plasma glucose below 120 mg/100 ml and both plasma glucose levels at 60 and 120 min below 240 mg/100 ml, and group 2 with fasting plasma glucose above 120 mg/100 ml and both plasma glucose levels at 60 and 120 min above 240 mg/100 ml. The incidence of elevated HbA1 in group 1, 4.3%, was significantly lower than 94.1% in group 2, and the insulinogenic index at 30 min in group 1, 0.74, was significantly higher than 0.07 in group 2. Subjects in group 2 apparently represent diabetes mellitus, while subjects in group 1 might not have pathological glucose intolerance of the aged.

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