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Diagnostic criteria of diabetes mellitus in elderly people are still controversial. The major questions are whether (1) effects of hyperglycemia in generating diabetic complications are the same as in younger diabetics, (2) too many diabetics might be diagnosed in the elderly by the criteria proposed by WHO and Japan Diabetes Society. To answer these questions, we carried out two studies. Blood glucose data were collected from population-based studies and from voluntary health check-up studies. Fasting blood glucose values were classified by sex and the age (-49, 50-64, 65-years old). Population-based studies showed no age-dependent change in blood glucose. However, data from health check-up studies showed an increase in median values from the group aged 50-64 and the 65 and older group. Two-hour values after glucose tolerance tests were classified by age and the fasting blood glucose (-99, 100-119, 120-139, and 140- mg/dl). The eldest and 140- mg/dl group showed the highest 2-hour values. Effects of hyperglycemia on the appearance of diabetic complications were studied in patients being follow-up in three diabetes clinics. Patients who has a history of one year or less and without any retinopathy on the first visit to the clinic were registered. Data were analyzed by the Kaplan-Meier method and the appearance of retinopathy was used as the end point. There were no difference in the rate of appearance of retinopathy between the age groups (-49, 50-64 and 65-years old). No age effect on the hyperglycemia-dependent appearance of retinopathy could be observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Problems in Elderly Diabetics. Do Blood Glucose Levels in the Elderly Have Different Metabolic Significance than in Non-Elderly Subjects?