In the Light of the Metabolic Memory Theory, Should Not All Aged People with Dysglycemia Be Treated?

Dysglycemia has been coined to define the prediabetic state. It defines high glucose levels below the diabetes ‘‘cut-offs.’’ The negative effects of dysglycemia, leading to cardiovascular complications, are amplified during aging. Despite this knowledge, treatment of dysglycemia in old subjects is usually overlooked by clinical practice. This article deals with a new theory regarding an intensive therapeutic approach targeting aged people. This hypothesis arises from the recent theory of metabolic memory, which defines early imprinting due to hyperglycemia in cells of the vasculature and of target organs, favoring the development of vascular complications. In addition, metabolic memory determines a durable effect of hypoglycemic treatment that is much longer than the period of therapy. This new evidence could allow us to hypothesize that a treatment of dysglycemia in aged people could remodel their glucose ‘‘trajectory’’ during aging toward a more optimal one, leading to successful aging.