The prevalence of diabetes mellitus and an assessment of methods of detection among a community of elderly Chinese in Hong Kong

Abstract

Summary This study provides information on the prevalence of diabetes mellitus in a group of elderly Chinese subjects aged 60 and above living in the community in Hong Kong, and investigates the sensitivity of the urine sugar, random blood glucose, glycosylated haemoglobin, and fructosamine measurements compared to a glucose tolerance test in screening for diabetes mellitus in this population. Four hundred twenty-seven subjects aged 60 and above were studied. The National Diabetes Data Group Criteria were used for the diagnosis of diabetes. Those with a random blood glucose exceeding 12.5 mmol/l were considered diabetic, and all of these patients had glycosuria together with elevated total glycosylated haemoglobin and fractosamine concentrations. A diagnostic 75 g oral glucose tolerance test was performed on patients with one or more of the following abnormalities: glycosuria, random plasma blood glucose 7.8 mmol/l to 12.5 mmol/l, glycosylated haemoglobin 8.5%, and fructosamine 2.20 mmol/l. By these criteria, the prevalence of diabetes in this community was found to be 9.8%. An elevated random glucose greater than 11.1 mmol/l proved to be the only specific method of screening and glycosuria was found to be at least as good as fractosamine and HbA₁. However, HbA₁ is more sensitive than random glucose, glycosuria or fructosamine in detecting impaired glucose tolerance. On the basis of this study, a higher reference range for glycosylated haemoglobin for the elderly alone is also suggested (5.74–9.34%).