Elderly persons who were diagnosed with diabetes
during middle age (40 to 64 years) and those diagnosed
later in life (over 65 years) comprise two distinct groups,
according to new research from the
Johns Hopkins Bloomberg
School of Public Health.
The study, published in the November issue of
Diabetes Care, found that these two age groups have
different disease burdens and may require different
"The number of individuals aged 65 or older in the
U.S. is increasing markedly, and diabetes is a growing
problem in this population. In addition, people are living
to much older ages with high quality of life, which speaks
to the need for more aggressive treatment among elderly
persons with diabetes," said Elizabeth Selvin, lead author
of the study and a postdoctoral fellow in the Bloomberg
Department of Epidemiology.
The study authors analyzed 1999-2002 data for 2,809
elderly persons in order to present a nationally
representative estimate of the prevalence of diabetes among
elderly persons in the general U.S. population. The data
were taken from the National Health and Nutrition
Examination Survey, an ongoing cross-sectional survey of
the civilian noninstitutionalized U.S. population.
The authors report that 15 percent of the U.S.
population aged 65 years or older had been diagnosed with
diabetes, a figure that represents approximately 5.4
million individuals. In addition, 6.9 percent of the U.S.
population aged 65 years or older, about 2.4 million
individuals, have undiagnosed diabetes and are unaware of
Elderly persons with middle age-onset diabetes were
more likely to have retinopathy, reflecting the cumulative
damage of high glucose levels over the course of many
years. They also had much worse glycemic control. In
contrast, elderly persons with newly diagnosed diabetes had
a comparable burden of cardiovascular disease but required
less aggressive treatment to reach blood pressure and
cholesterol treatment goals.
"The two types of elderly persons with diabetes have
distinct characteristics, including different burdens of
disease," Selvin said. "Elderly people with diabetes are a
heterogeneous group, and doctors may need to consider
different treatment goals for these two groups in clinical
The study was co-authored by Selvin, Josef Coresh and
Frederick L. Brancati. Selvin was supported by a grant from
the National Heart, Lung and Blood Institute.