Decision levels of diabetes mellitus and hyperlipidemia in elderly Japanese subjects]

Decision levels of diabetes mellitus and hyperlipidemia in elderly subjects as well as younger subjects should be determined to prevent complications of these diseases such as microvascular and macrovascular diseases. Therefore, prospective follow-up study is necessary to decide the decision levels. In the case of diabetes mellitus, there are some useful studies such as KUMAMOTO STUDY show that strict glycemic control can prevent microvascular diseases, but there are few studies in elderly subjects. However, hypoglycemia causes macrovascular events, and chronic hypoglycemia leads to dementia and apathy. It is generally accepted that the glycemic control level can be milder than that in younger subjects. We suggest that the following decision levels are reasonable for elderly diabetic subjects, 1. FPG > 140-160 mg/dl, 2. PG(2 h) > 200-250 mg/dl, 3. HbA1c > 7-8%. Decision level of hyperlipidemia in elderly subjects should also be determined to prevent cardiovascular disease. It is demonstrated that anti-hyperlipidemic treatment can prevent CHD even in elderly subjects by many prospective studies. Japan Atherosclerosis Society recommend that the decision levels of hyperlipidemia in elderly subjects can be the same as younger subjects. The decision levels indicating diet therapy and medication for risk factor free subjects(category A) are LDL-C > or = 140 and 160 mg/dl, respectively. Those for subjects without CHD but have some risk factors(category B) are LDL-C > or = 120 and 140 mg/dl, respectively. Those for subjects with CHD(category C) are LDL-C > or = 100 and 120 mg/dl, respectively.