Selvin Elizabeth, Coresh Josef, Brancati Frederick L
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, USA.
Diabetes Care. 2006 Nov;29(11):2415-9. doi: 10.2337/dc06-1058.
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.
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.
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.
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.
评估糖尿病的患病率，区分中年时被诊断出糖尿病的老年人（“中年发病型糖尿病”）与近期被诊断出糖尿病的老年人（“老年发病型糖尿病”），并评估这些人群的并发症负担和心血管危险因素的控制情况。
我们分析了来自1999 - 2002年美国国家健康与营养检查调查的2809名老年人的数据，该调查是一项针对美国非机构化平民人口的全国性代表性横断面调查。
在年龄≥65岁的成年人中，已诊断糖尿病的患病率为15.3%，在美国相当于540万人。未诊断糖尿病的患病率为6.9%，即240万人。与老年发病型糖尿病患者相比，中年发病型糖尿病的老年人微血管疾病负担要大得多，但大血管疾病负担相似。中年发病型糖尿病的老年人血糖控制明显更差（糖化血红蛋白A1c>7%的个体比例 = 59.9%），相比之下，老年发病型患者为41.6%，非老年糖尿病患者为55.3%。老年发病型糖尿病患者服用降糖药物的可能性也较小。
在本研究中，我们记录了老年人中糖尿病的高患病率以及该人群中血糖控制不佳的高比例。中年和老年发病型糖尿病患者似乎代表了不同的群体，疾病负担不同，治疗目标可能也不同。未来针对老年人糖尿病的研究可能需要考虑根据诊断年龄进行分层。
