Prevalence of undiagnosed non-insulin-dependent diabetes mellitus and impaired glucose tolerance in a cohort of older persons with hypertension

Karen Johnson, Marshall J. Graney, William B. Applegate, Abbas E. Kitabchi, John W. Runyan, Ronald I. Shorr

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

OBJECTIVE: To determine the prevalence of undiagnosed non-insulin- dependent diabetes mellitus (NIDDM) and impaired glucose tolerance (IGT) in a cohort of older persons with hypertension. To examine the usefulness of screening for NIDDM in this study population. DESIGN: Cross-sectional study. SETTING: University of Tennessee, Memphis and the General Clinical Research Center (GCRC). PATIENTS: Ninety-five participants in the Trial of Nonpharmacologic Interventions in the Elderly (TONE) study who agreed to participate in an ancillary study. MEASUREMENTS: A standard oral glucose tolerance test (OGTT) with insulin and C-peptide levels was performed before the beginning of the TONE intervention. RESULTS: In this cohort, 43 participants (45.3%) had normal glucose tolerance (NGT), 41 (43.2%) had IGT, and 11 (11.6%) had undiagnosed NIDDM. The positive predictive value for NIDDM of a fasting glucose ≤ 115 mg/dL in our participants was 57%. Hyperinsulinemia occurred in truly one participant, a subject in the IGT group. CONCLUSIONS: Our data demonstrate that undiagnosed NIDDM is common in our cohort of older persons who are being treated for essential hypertension and that impaired glucose tolerance may be more common than in the general population of the same age. Further, our data show that the vast majority of this older, obese, hypertensive cohort did not have fasting hyperinsulinemia. We also infer that a fasting glucose alone has a low positive predictive value for screening of NIDDM in our older cohort. As the prevalence of NIDDM and impaired glucose tolerance in older hypertensive patients in the general population is unknown, we believe that further investigation is needed to characterize the relationship of hypertension, glycemic status, and hyperinsulinemia in the general population.

Original languageEnglish (US)
Pages (from-to)695-700
Number of pages6
JournalJournal of the American Geriatrics Society
Volume45
Issue number6
DOIs
StatePublished - Jan 1 1997

Fingerprint

Glucose Intolerance
Type 2 Diabetes Mellitus
Hypertension
Hyperinsulinism
Fasting
Glucose
Population
C-Peptide
Glucose Tolerance Test
Cross-Sectional Studies
Insulin
Research

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology

Cite this

Prevalence of undiagnosed non-insulin-dependent diabetes mellitus and impaired glucose tolerance in a cohort of older persons with hypertension. / Johnson, Karen; Graney, Marshall J.; Applegate, William B.; Kitabchi, Abbas E.; Runyan, John W.; Shorr, Ronald I.

In: Journal of the American Geriatrics Society, Vol. 45, No. 6, 01.01.1997, p. 695-700.

Research output: Contribution to journalArticle

Johnson, Karen ; Graney, Marshall J. ; Applegate, William B. ; Kitabchi, Abbas E. ; Runyan, John W. ; Shorr, Ronald I. / Prevalence of undiagnosed non-insulin-dependent diabetes mellitus and impaired glucose tolerance in a cohort of older persons with hypertension. In: Journal of the American Geriatrics Society. 1997 ; Vol. 45, No. 6. pp. 695-700.
@article{eb4b6c86012a4b108f1cb51d58285ed5,
title = "Prevalence of undiagnosed non-insulin-dependent diabetes mellitus and impaired glucose tolerance in a cohort of older persons with hypertension",
abstract = "OBJECTIVE: To determine the prevalence of undiagnosed non-insulin- dependent diabetes mellitus (NIDDM) and impaired glucose tolerance (IGT) in a cohort of older persons with hypertension. To examine the usefulness of screening for NIDDM in this study population. DESIGN: Cross-sectional study. SETTING: University of Tennessee, Memphis and the General Clinical Research Center (GCRC). PATIENTS: Ninety-five participants in the Trial of Nonpharmacologic Interventions in the Elderly (TONE) study who agreed to participate in an ancillary study. MEASUREMENTS: A standard oral glucose tolerance test (OGTT) with insulin and C-peptide levels was performed before the beginning of the TONE intervention. RESULTS: In this cohort, 43 participants (45.3{\%}) had normal glucose tolerance (NGT), 41 (43.2{\%}) had IGT, and 11 (11.6{\%}) had undiagnosed NIDDM. The positive predictive value for NIDDM of a fasting glucose ≤ 115 mg/dL in our participants was 57{\%}. Hyperinsulinemia occurred in truly one participant, a subject in the IGT group. CONCLUSIONS: Our data demonstrate that undiagnosed NIDDM is common in our cohort of older persons who are being treated for essential hypertension and that impaired glucose tolerance may be more common than in the general population of the same age. Further, our data show that the vast majority of this older, obese, hypertensive cohort did not have fasting hyperinsulinemia. We also infer that a fasting glucose alone has a low positive predictive value for screening of NIDDM in our older cohort. As the prevalence of NIDDM and impaired glucose tolerance in older hypertensive patients in the general population is unknown, we believe that further investigation is needed to characterize the relationship of hypertension, glycemic status, and hyperinsulinemia in the general population.",
author = "Karen Johnson and Graney, {Marshall J.} and Applegate, {William B.} and Kitabchi, {Abbas E.} and Runyan, {John W.} and Shorr, {Ronald I.}",
year = "1997",
month = "1",
day = "1",
doi = "10.1111/j.1532-5415.1997.tb01472.x",
language = "English (US)",
volume = "45",
pages = "695--700",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Prevalence of undiagnosed non-insulin-dependent diabetes mellitus and impaired glucose tolerance in a cohort of older persons with hypertension

AU - Johnson, Karen

AU - Graney, Marshall J.

AU - Applegate, William B.

AU - Kitabchi, Abbas E.

AU - Runyan, John W.

AU - Shorr, Ronald I.

PY - 1997/1/1

Y1 - 1997/1/1

N2 - OBJECTIVE: To determine the prevalence of undiagnosed non-insulin- dependent diabetes mellitus (NIDDM) and impaired glucose tolerance (IGT) in a cohort of older persons with hypertension. To examine the usefulness of screening for NIDDM in this study population. DESIGN: Cross-sectional study. SETTING: University of Tennessee, Memphis and the General Clinical Research Center (GCRC). PATIENTS: Ninety-five participants in the Trial of Nonpharmacologic Interventions in the Elderly (TONE) study who agreed to participate in an ancillary study. MEASUREMENTS: A standard oral glucose tolerance test (OGTT) with insulin and C-peptide levels was performed before the beginning of the TONE intervention. RESULTS: In this cohort, 43 participants (45.3%) had normal glucose tolerance (NGT), 41 (43.2%) had IGT, and 11 (11.6%) had undiagnosed NIDDM. The positive predictive value for NIDDM of a fasting glucose ≤ 115 mg/dL in our participants was 57%. Hyperinsulinemia occurred in truly one participant, a subject in the IGT group. CONCLUSIONS: Our data demonstrate that undiagnosed NIDDM is common in our cohort of older persons who are being treated for essential hypertension and that impaired glucose tolerance may be more common than in the general population of the same age. Further, our data show that the vast majority of this older, obese, hypertensive cohort did not have fasting hyperinsulinemia. We also infer that a fasting glucose alone has a low positive predictive value for screening of NIDDM in our older cohort. As the prevalence of NIDDM and impaired glucose tolerance in older hypertensive patients in the general population is unknown, we believe that further investigation is needed to characterize the relationship of hypertension, glycemic status, and hyperinsulinemia in the general population.

AB - OBJECTIVE: To determine the prevalence of undiagnosed non-insulin- dependent diabetes mellitus (NIDDM) and impaired glucose tolerance (IGT) in a cohort of older persons with hypertension. To examine the usefulness of screening for NIDDM in this study population. DESIGN: Cross-sectional study. SETTING: University of Tennessee, Memphis and the General Clinical Research Center (GCRC). PATIENTS: Ninety-five participants in the Trial of Nonpharmacologic Interventions in the Elderly (TONE) study who agreed to participate in an ancillary study. MEASUREMENTS: A standard oral glucose tolerance test (OGTT) with insulin and C-peptide levels was performed before the beginning of the TONE intervention. RESULTS: In this cohort, 43 participants (45.3%) had normal glucose tolerance (NGT), 41 (43.2%) had IGT, and 11 (11.6%) had undiagnosed NIDDM. The positive predictive value for NIDDM of a fasting glucose ≤ 115 mg/dL in our participants was 57%. Hyperinsulinemia occurred in truly one participant, a subject in the IGT group. CONCLUSIONS: Our data demonstrate that undiagnosed NIDDM is common in our cohort of older persons who are being treated for essential hypertension and that impaired glucose tolerance may be more common than in the general population of the same age. Further, our data show that the vast majority of this older, obese, hypertensive cohort did not have fasting hyperinsulinemia. We also infer that a fasting glucose alone has a low positive predictive value for screening of NIDDM in our older cohort. As the prevalence of NIDDM and impaired glucose tolerance in older hypertensive patients in the general population is unknown, we believe that further investigation is needed to characterize the relationship of hypertension, glycemic status, and hyperinsulinemia in the general population.

UR - http://www.scopus.com/inward/record.url?scp=0030995754&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030995754&partnerID=8YFLogxK

U2 - 10.1111/j.1532-5415.1997.tb01472.x

DO - 10.1111/j.1532-5415.1997.tb01472.x

M3 - Article

VL - 45

SP - 695

EP - 700

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 6

ER -