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[Glucose intolerance in elderly persons in The Netherlands; the Twello Study]
P V Cromme1, J T van Eijk, E A van der Veen
1Vakgroep Huisarts- en Verpleeghuisgeneeskunde, Vrije Universiteit, Amsterdam.
Objective:
To determine the prevalence of grades of glucose intolerance in subjects over 64 years of age.
Design:
Point prevalence study.
Setting:
Twello, a rural village in the Netherlands.
Methods:
Of a total of 696 persons aged over 64 years recruited from a general practice, 460 subjects had an oral glucose tolerance test (OGTT) in 1985, 56 were known with non-insulin-dependent diabetes mellitus. Glucose estimations were done in capillary whole blood with a Glucometer. OGTT results were classified according to WHO 1985 recommended cut-off points and combination rules.
Results:
The prevalence of normal glucose tolerance was 42%, of impaired glucose tolerance 27% and of diabetes mellitus 31%. The estimated prevalence in the source population were 45% (44.4-44.6), 28% (28.3-28.5) and 27% (95% CI: 27.1-27.2) respectively, adjusted for age and gender by standardization to the Dutch population of 1985. Re-evaluation of the earlier diagnoses of 'diabetes mellitus' according to the new WHO guidelines revealed that 55% of earlier diabetic with diet as the only therapy were no longer classified as diabetics. The prevalence of diabetes mellitus in persons over 64 was 10% before the investigation took place, and 30% afterwards.
Conclusions:
Te prevalence of diabetes mellitus as well as of impaired glucose tolerance from the Twello study rank among the higher rates reported in Caucasian populations. Case finding of glucose intolerance in those at risk over 64 years of age is recommended.