Diabetes Care: Not only diabetes, prediabetes can also lead to functional decline and disability in older adults

Diabetes is associated with functional decline, but the effects of prediabetes on body function are not clear.
cross-sectional studies that assess the relationship between diabetes and physical function have shown a high incidence of physical dysfunction in people with diabetes.
few studies have explored the relationship between diabetes and sudden physical injury.
because prediabetes is associated with a variety of diseases, such as vascular and kidney diseases, this group of patients may experience functional decline and disability before the full onset of diabetes.
, however, most studies on the relationship between function and diabetes divide prediabetes into normal groups of blood sugar.
addition, in studies involving prediabetes and physical function, most of which have been cross-sectional studies to date, no population-based queue studies have specifically investigated the relationship between prediabetes and decreased physical function and disability development.
recently, a new study published in Diabetes Care compared the effects of prediabetes and diabetes on body function and disability progression, and explored whether cardiovascular disease (CVDs) mediated these associations.
study, a population-based longitudinal study of 2013 participants at the Swedish National Institute of Research monitored participants over a 12-year period.
body functions are measured by chair stand (s) and walking speed (m/s) tests, and disability is measured by the total number of basic and instrumental activities impaired in daily life.
diabetes is determined by medical examination or clinical records, medication or glycation of hemoglobin (HbA1c) 6.5%.
prediabetes in patients with no diabetes were defined as HbA1c 5.7% and 6.4%.
cardiovascular diseases are determined through clinical examinations and national patient registrations.
use mixed effect model and mediation model to analyze the data.
of the study showed that 650 people (32.3%) had prediabetes and 151 had diabetes (7.5%) at the time of baseline testing.
in the multi-adjustment mixed effect model, even with control over the future development of diabetes, prediabetes patients had increased sitting time (beta 0.33, 95% CI 0.05 0.61) and reduced walking speed (0 Beta 0.006,95% CI 0.010 to 0.002), accelerated progress in disability (beta 0.05, 95% CI 0.01 0.08).
diabetes leads to a faster decline in function than prediabetes.
12 years of follow-up, the trajectory of the chair standing, walking speed, and disability score (ADL-IADL) was predicted based on blood sugar status.
the intermediary analysis, cardiovascular disease was mediated between 7.1%, 7.8% and 20.9% of prediabetes and sitting, walking speed, and disability progression, respectively.
of cardiovascular diseases associated with chair standing, walking speed and disability were 13.3%, 22.9% and 14.4%, respectively.
A brokered analysis of the correlation between changes in cardiovascular disease and chair, walking speed and disability scores during baseline prediabetes and diabetes follow-up in this population-based longitudinal study of older adults in Sweden found that: 1) In addition to diabetes, prediabetes were associated with faster physical decline and disability progression in older adults, independent of the future development of diabetes; 2) This link is stronger in diabetic patients than in prediabetes patients; 3) The rapid development of cardiovascular disease can be explained by the development of diabetes complications, which to some extent regulates the link between prediabetes and functional decline/disability.
study is the first independent risk factor to demonstrate that prediabetes is a sharp decline in physical function and faster progression in disability.
the importance of preventing cardiovascular disease in people with high blood sugar and the need to monitor the function of older people, even in the prediabetic stage.
: Ying Shang, Laura Fratiglioni, Davide Liborio Vetrano, Abigail Dov, Anna-Karin Welme and Weili Xu. Diabetes Care 2021 Mar; 44 (3): 690-698.MedSci Original Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Mets Medicine" or "Source: MedSci Originals" are owned by Mets Medicine and are not authorized to reproduce, and any media, website or individual authorized to reproduce them must indicate "Source: Met Medical".
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