Diagnosis of Type 2 Diabetes at an Older Age

Abstract

OBJECTIVE -To compare the mortality of people who were diagnosed with type 2 diabetes over 65 years of age with that of nondiabetic individuals. RESEARCH DESIGN AND METHODS-Using a population-based diabetes information system for an observational cohort study in Tayside, Scotland, people who were diagnosed with type 2 diabetes over the age of 65 years between 1993 and 2002 were identified. Nondiabetic comparators, matched for age and sex, were identified from the nondiabetic population. The two cohorts were followed up for mortality and cardiovascular mortality according to death certification records.RESULTS -There were 3,594 people with type 2 diabetes (48% male) and 7,188 matched comparators identified in the study. Over a mean follow-up period of 4.6 Ϯ 2.9 years for 3,594 people with type 2 diabetes and 7,188 comparators, 909 (25.3%) patients in the diabetic cohort and 1,651 (23.0%) in the nondiabetic cohort died. The adjusted relative risk for mortality in the diabetic cohort compared with the nondiabetic cohort was 1.06 (95% CI 0.94 -1.19) for men and 1.29 (1.15-1.45) for women. Cardiovascular deaths accounted for 49.4% of the deaths in people with and 45.2% in those without diabetes (adjusted relative risk 1.01 [0.93-1.10]).CONCLUSIONS -Men diagnosed with type 2 diabetes over the age of 65 years have no excess mortality compared with their nondiabetic counterparts, a finding that was not replicated for women. Diabetes Care 27:2797-2799, 2004D iabetes is known to reduce life expectancy in older people (1). However, older people with diabetes are a heterogeneous group, including newly diagnosed people and those whose diagnosis may have occurred up to 20 years previously (2-4). Some research suggests that the effect on mortality of a diagnosis of diabetes becomes progressively less as age at diagnosis increases (5). A group of older people whose diabetes was detected by screening had an increased risk of mortality (6), and even patients who were diagnosed with diabetes over the age of 80 years had a reduced life expectancy of ϳ1 year (7). However, two European studies found no difference in mortality between men diagnosed with diabetes over the age of 75 years and nondiabetic men (8,9). We compared all-cause and cardiovascular mortality in cohorts of people diagnosed with type 2 diabetes at an older age with that in nondiabetic individuals. RESEARCH DESIGN AND METHODS -The DARTS/MEMO (Diabetes Audit and Research in TaysideScotland/Medicines Monitoring Unit) Collaboration (9) works on the record linkage of health care data to facilitate epidemiological and health services research in the population of Tayside, Scotland (estimated population of 389,800 in 1998). Record linkage is enabled by the widespread use of a unique health care identifier (community health index number) that is allocated to people when they register with a general practitioner in Scotland. This study was conducted in a defined population of general practitioner-registered people who were known to be residents of Tayside during the entire ...

Screening for type 2 diabetes: literature review and economic modelling

“…However, although the prevalence of diabetes is greater in the older ages groups, the excess mortality may fall. Tan and colleagues 102 found that in men diagnosed with T2DM over the age of 65 years in Tayside, there was no excess mortality compared with the general population. This might represent a survival selection effect.…”

Predicting New Onset Diabetes Mellitus in Older Taiwanese: Metabolic Syndrome or Impaired Fasting Glucose?

“…A recent report indicated that MS did not predict NOD in a middle-aged Chinese population 18) ; however, the effectiveness of MS to predict NOD in older adults remains uncertain. The clinical significance of DM onset at later age has been challenged 19) ; therefore, using a diagnosis of MS to predict NOD in the elderly population may be logically problematic. In spite of the aforementioned challenges, MS is reported to be closely associated with coronary artery disease and cerebrovascular events in elderly Turks, which supported the benefits of diagnosing MS in older adults 20) .…”

Mimicking of pulse shape-dependent learning rules with a quantum dot memristor

“…39 Thus the memductance state can be controlled either by optical or electrical pulses or by combinations of both, which allows the integration with photodetectors as sensory neurons. The conductance control is further sensitive to the wavelength of incoming light 51 , which was also demonstrated with other memristors 52 and memcapacitors 53 and enables encoding information in the wavelength. For the present device, the light sensitivity leads to varying learning processes in the dark and under illumination, which is the key advantage compared to other memristor realization with large on/off ratios of up to 10 12 , 54 low switching times in the sub-nanosecond range 55 or high endurance (10 12 cycles).…”