TY - JOUR
T1 - One-hour postload plasma glucose in middle age and medicare expenditures in older age among nondiabetic men and women
T2 - The Chicago Heart Association Detection Project in Industry
AU - Liu, Kiang
AU - Dyer, Alan R.
AU - Vu, Thanh Huyen
AU - Pirzada, Amber
AU - Manheim, Larry M.
AU - Manning, Willard G.
AU - Ashraf, Muhammad S.
AU - Garside, Daniel B.
AU - Daviglus, Martha L.
PY - 2005/5
Y1 - 2005/5
N2 - OBJECTIVE - To examine associations in nondiabetic individuals of 1-h postload plasma glucose measured in young adulthood and middle age with subsequent Medicare expenditures for cardiovascular disease (CVD), diabetes, cancer, and all health care at age 65 years or older using data from the Chicago Heart Association Detection Project in Industry (CHA). RESEARCH DESIGN AND METHODS - Medicare data (1984-2000) were linked with CHA baseline records (1967-1973) for 8,580 men and 6,723 women ages 33-64 years who were free of coronary heart disease, diabetes, and major electrocardiogram (ECG) abnormalities and who were Medicare eligible (65+ years) for at least 2 years. Participants were classified based on 1-h postload plasma glucose levels <120, 120-199, or ≤200 mg/dl. RESULTS - With adjustment for baseline age, cigarette smoking, serum cholesterol, systolic blood pressure, BMI, ethnicity, education, and minor ECG abnormalities, the average annual and cumulative Medicare, total, and diabetes- and CVD-related charges were significantly higher with higher baseline plasma glucose in women, while only diabetes-related charges were significantly higher in men. For example, in women, multivariate-adjusted CVD-related cumulative charges were, respectively, $14,260, $18,909, and $21,183 for the three postload plasma glucose categories (P value for trend = 0.035). CONCLUSIONS - These findings suggest that maintaining low glucose levels early in life has the potential to reduce health care costs in older age.
AB - OBJECTIVE - To examine associations in nondiabetic individuals of 1-h postload plasma glucose measured in young adulthood and middle age with subsequent Medicare expenditures for cardiovascular disease (CVD), diabetes, cancer, and all health care at age 65 years or older using data from the Chicago Heart Association Detection Project in Industry (CHA). RESEARCH DESIGN AND METHODS - Medicare data (1984-2000) were linked with CHA baseline records (1967-1973) for 8,580 men and 6,723 women ages 33-64 years who were free of coronary heart disease, diabetes, and major electrocardiogram (ECG) abnormalities and who were Medicare eligible (65+ years) for at least 2 years. Participants were classified based on 1-h postload plasma glucose levels <120, 120-199, or ≤200 mg/dl. RESULTS - With adjustment for baseline age, cigarette smoking, serum cholesterol, systolic blood pressure, BMI, ethnicity, education, and minor ECG abnormalities, the average annual and cumulative Medicare, total, and diabetes- and CVD-related charges were significantly higher with higher baseline plasma glucose in women, while only diabetes-related charges were significantly higher in men. For example, in women, multivariate-adjusted CVD-related cumulative charges were, respectively, $14,260, $18,909, and $21,183 for the three postload plasma glucose categories (P value for trend = 0.035). CONCLUSIONS - These findings suggest that maintaining low glucose levels early in life has the potential to reduce health care costs in older age.
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U2 - 10.2337/diacare.28.5.1057
DO - 10.2337/diacare.28.5.1057
M3 - Article
C2 - 15855567
AN - SCOPUS:18144418523
SN - 0149-5992
VL - 28
SP - 1057
EP - 1062
JO - Diabetes care
JF - Diabetes care
IS - 5
ER -