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Diabetic Complications and the Aging Population

At what age will people require more diabetic care?…

In this cohort study which looked at patients from 2004-2010 the main objective was to identify if there was an increased incidence of diabetic complications depending on how long participants have had diabetes as well as how old they are. Given the increasing age of the population, it’s important to know which populations may require more care.

A short duration of diabetes was considered to be 0-9 years and a long duration of diabetes was ≥ 10 years. The age categories were divided into 60-69 years, 70-79 years, and ≥ 80 years of age. The diabetic complications which were measured included hyperglycemic events, hypoglycemic events, microvascular complications, cardiovascular complications, and all-cause mortality.

Looking at the duration of diabetes, in patients with a shorter or longer duration the main events were hypoglycemia and cardiovascular complications, with the longer duration patients having a higher incidence of both of these events. When comparing the differences in the age groups, an increasing age correlated with increasing rates of hypoglycemia, cardiovascular problems, and increased mortality. Interestingly, microvascular complications remained the same or even decreased with the increasing age of the groups. In conclusion, the populations with the most risk of these complications appear to be the oldest patients who have had the disease for the longest amount of time, with the most common complication being hypoglycemia.

Practice Pearls:
  • A longer duration of diabetes (≥10 years) increases the risks of diabetic complications.
  • Diabetic complications become more likely with increasing age, when comparing patients of the ages 60-69 years, 70-79 years, and ≥ 80 years.
  • Hypoglycemia was the most common diabetic complication across all age ranges involved in this study.

JAMA Internal Med., December 2013