HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Selvin, E. Articles by Brancati, F. L. Search for Related Content PubMed PubMed Citation Articles by Selvin, E. Articles by Brancati, F. L. Social Bookmarking                What's this?

The Burden and Treatment of Diabetes in Elderly Individuals in the U.S.

¹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
² Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland
³ Johns Hopkins School of Medicine, Baltimore, Maryland

Address correspondence and reprint requests to Elizabeth Selvin, PhD, MPH, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, 2024 E. Monument St., Suite 2-600, Baltimore, MD 21287. E-mail: lselvin{at}jhsph.edu

OBJECTIVE—To assess the prevalence of diabetes, distinguishing between elderly individuals with diabetes diagnosed in middle age ("middle age–onset diabetes") from elderly individuals with recently diagnosed diabetes ("elderly onset diabetes") and to assess the burden of complications and control of cardiovascular risk factors in these groups.

RESEARCH DESIGN AND METHODS—We analyzed data from 2,809 elderly individuals from the 1999–2002 National Health and Nutrition Examination Survey, a cross-sectional nationally representative survey of the civilian noninstitutionalized population of the U.S.

RESULTS—Among adults aged 65 years, the prevalence of diagnosed diabetes was 15.3%, representing 5.4 million individuals in the U.S. The prevalence of undiagnosed diabetes was 6.9% or 2.4 million individuals. Elderly individuals with middle age–onset diabetes had a much greater burden of microvascular disease but have a similar burden of macrovascular disease compared with individuals with elderly onset diabetes. Elderly individuals with middle age–onset diabetes had substantially worse glycemic control (proportion of individuals with HbA_1c >7% = 59.9%) compared with either elderly onset (41.6%) or nonelderly individuals with diabetes (55.3%). Individuals with elderly onset diabetes were also less likely to be taking glucose-lowering medications.

CONCLUSIONS—In this study, we documented a high prevalence of diabetes among elderly individuals and high rate of poor glycemic control in this population. Individuals with middle age–and elderly onset diabetes appear to represent distinct groups with differing burdens of disease and possibly differing treatment goals. Future studies of diabetes in elderly individuals may need to consider stratification based on age of diagnosis.

Abbreviations: ABI, ankle-brachial index • MEC, mobile examination center • NHANES, National Health and Nutrition Examination Survey

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?