Prediabetes refers to a condition in which individuals are at a high risk of diabetes. The natural history of prediabetes in older adults is not well characterized. This study aims to evaluate the risk of prediabetes and diabetes among older adults in a community-based setting.

 This prospective cohort analysis included a total of 3,412 older adults without diabetes. The presence of prediabetes was defined by a glycated hemoglobin (HbA1c) level of 5.7-6.4% or impaired fasting glucose (IFG) level of 100-125 mg/dL, or both. The primary objective of the study was incident total diabetes measured with a physician diagnosis, HbA1c level, and glucose-lowering medication use.

 Of 3,412 participants included in the study, the follow-up data for 2,497 participants were available. During the follow-up of 6.5 years, a total of 156 incidents of diabetes and 434 deaths were reported. A total of 1,490 participants had HbA1c levels of 5.7-6.4%, 1,996 had IFG, and 1,004 met both HbA1c and IFG criteria. Among participants with IFG at baseline, 112 progressed to diabetes and 207 died.

 The research concluded that the prevalence of prediabetes was high in older adults and the regression to normoglycemia or death was more common than the progression to diabetes.