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Two-thirds of people with type 2 diabetes are experiencing high blood sugar after eating, but not after fasting. Thus, a fasting glucose test fails to identify this type of diabetes, known as IPH, or Isolated Postchallenge Hyperglycemia. Because IPH diabetes prevalence increases with age, a fasting glucose test will miss a diabetes diagnosis among the elderly population, particularly elderly women.
The August 1998 issue of Diabetes Care reported on a study led by Elizabeth Barrett-Connor, MD, of the University of California, San Diego. Dr. Barrett-Connor's study tested any link between IPH diabetes and the risk of cardiovascular disease in elderly people.
None of the 769 elderly people studied had a history of diabetes nor did they have hyperglycemia detected from a fasting glucose test. During the three-year study period, 133 men and 125 women were newly diagnosed with type 2 diabetes. Of the type 2 diabetics, 48 percent of men and 72 percent of women had IPH diabetes.
The connection between IPH and death by heart disease was significant among the women with IPH but there was no connection among the men. Dr. Barrett-Connor calls this consistent with other studies, which have also shown that women face a higher risk of heart disease caused by diabetes.
The results provoke questions of the reliability of fasting glucose screenings for diabetes in elderly people, particularly in women. Dr. Barrett-Connor says that the study "suggests the public health impact [of fasting glycemia] may be different in elderly people-particularly in elderly women."
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