Diabetes duration impacts outcomes at any age

Optimizing technology for diabetes care
Optimizing technology for diabetes care

HealthDay News -- Type 2 diabetes morbidity and mortality are associated with disease duration and advancing age, study findings indicate. 

Longer disease duration was associated with considerable increases in incident acute hyperglycemic events, hypoglycemia, microvascular complications, cardiovascular complications and all-cause mortality, Elbert S. Huang, MD, MPH, from the University of Chicago, and colleagues reported in JAMA Internal Medicine.

They compared rates of diabetes complications and mortality across patients in several age categories (60 to 69 years, 70 to 79 years, ≥80 years) and diabetes duration categories (zero to nine years and ≥10 years) using data from 72,310 patients with type 2 diabetes aged older than 60 years.

Among older adults with shorter diabetes duration the most common nonfatal complications were cardiovascular complications and hypoglycemia.

For example, among 70- to 79-year-olds with short duration of diabetes, coronary artery disease and hypoglycemia rates were higher (11.47 and 5.03 per 1,000 person-years, respectively) than end-stage renal disease, lower limb amputation and acute hyperglycemic events (2.60, 1.28, and 0.82 per 1,000 person-years, respectively). Patients in the same age group with a long duration of diabetes had a similar pattern (rates of 18.98 and 15.88, compared with 7.64, 4.26, and 1.76, respectively).

For a given age group, longer disease duration was associated with a considerable increase in the rates of each outcome, especially hypoglycemia and microvascular complications.

The rates of hypoglycemia, cardiovascular complications, and mortality increased with advancing age for a given duration of diabetes, while the rates of microvascular complications remained stable or decreased.

"The data from this study may inform the design and scope of public policy interventions that meet the unique needs of elderly patients with the disease," the researchers wrote.

References

  1. Huang ES et al. JAMA Intern Med. 2013; doi:10.1001/jamainternmed.2013.12956.
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