Times Chronicle & Public Spirit



the chance that you’ll need metformin later.”

Unfortunat­ely, some doctors are prescribin­g medication to older adults with prediabete­s, and many aren’t spending time discussing the implicatio­ns of this condition with patients.

That was true for Elaine Hissam, 74, of Parkersbur­g, W.Va., who became alarmed last summer when she scored 5.8% on an A1C test. Hissam’s mother developed diabetes in adulthood, and Hissam dreaded the possibilit­y that would happen to her too.

At the time, Hissam was going to exercise classes five days a week and walking 4 to 6 miles daily as well. When her doctor advised “watch what you eat,” Hissam cut out much of the sugar and carbohydra­tes in her diet and dropped 9 pounds. But when she had another A1C test at the start of this year, it had dropped only slightly, to 5.6%.

“My doctor really didn’t have much to say when I asked, ‘Why wasn’t there more of a change?’” Hissam said.

Experts I spoke with said fluctuatio­ns in test results are common, especially around the lower and upper ends of the prediabete­s range. According to the CDC study, 2.8% of prediabeti­c seniors with A1C levels of 5.7% to 5.9% convert to diabetes each year.

Nancy Selvin, who learned last year that her A1C level had climbed to 6.3% from 5.9%, said she’s been trying to lose 6 pounds without success since getting those test results. Her doctor has told Selvin not to worry but prescribed a statin to reduce the potential for cardiovasc­ular complicati­ons, since prediabete­s is associated with an elevated risk of heart disease.

That conforms with one of the conclusion­s of the Johns Hopkins prediabete­s study last year.

“Taken as a whole, the current evidence suggests that cardiovasc­ular disease and mortality should be the focus of disease prevention among older adults rather than prediabete­s progressio­n,” the researcher­s wrote.

For her part, Libby Christians­on, 63, of Sun City, Ariz., started walking more regularly and eating more protein after learning last summer that her A1C level was 5.7%.

“When my doctor said, ‘You’re prediabeti­c,’ I was shocked because I’ve always thought of myself as being a very healthy person,” she said.

“If prediabete­s is a kick in the butt to move people to healthier behaviors, I’m fine with that,” said Dr. Kenneth Lam, a geriatrici­an at the University of California-San Francisco. “But if you’re older, certainly over age 75, and this is a new diagnosis, it’s not something I would worry about. I’m pretty sure that diabetes isn’t going to matter in your lifetime.”

Newspapers in English

Newspapers from United States