Department of Family Medicine, University of Michigan, 300 N. Ingalls, Room 919, Ann Arbor, MI 48109-2007, USA.
J Gerontol A Biol Sci Med Sci. 2012 Dec;67(12):1313-20. doi: 10.1093/gerona/gls095. Epub 2012 Apr 6.
Middle-aged and older adults with diabetes are heterogeneous and may be characterized as belonging to one of three clinical groups: a relatively healthy group, a group having characteristics likely to make diabetes self-management difficult, and a group with poor health status for whom current management targets have uncertain benefit.
We analyzed waves 2004-2008 of the Health and Retirement Study and the supplemental Health and Retirement Study 2003 Diabetes Study. The sample included adults with diabetes 51 years and older (n = 3,507, representing 13.6 million in 2004). We investigated the mortality outcomes for the three clinical groups, using survival analysis and Cox proportional hazard models.
The 5-year survival probabilities were Relatively Healthy Group, 90.8%; Self-Management Difficulty Group, 79.4%; and Uncertain Benefit Group, 52.5%. For all age groups and clinical groups, except those 76 years and older in the Uncertain Benefit Group, survival exceeded 50%.
This study reveals the substantial survival of middle-aged and older adults with diabetes, regardless of health status. These findings have implications for the clinical management of and future research about diabetes patients with multiple comorbidities.
患有糖尿病的中老年患者存在异质性，可分为以下三种临床类型：相对健康组、可能使糖尿病自我管理变得困难的组，以及健康状况不佳、目前的管理目标获益不确定的组。
我们分析了 2004-2008 年的健康与退休研究（Health and Retirement Study）和补充健康与退休研究 2003 年糖尿病研究（Health and Retirement Study 2003 Diabetes Study）的数据。样本包括年龄在 51 岁及以上的糖尿病患者（n=3507，代表 2004 年的 1360 万人）。我们采用生存分析和 Cox 比例风险模型，调查了这三组临床患者的死亡结局。
相对健康组、自我管理困难组和获益不确定组的 5 年生存率分别为 90.8%、79.4%和 52.5%。除获益不确定组中 76 岁及以上人群外，所有年龄组和临床组的生存率均超过 50%。
本研究揭示了无论健康状况如何，中老年糖尿病患者都有相当高的生存率。这些发现对患有多种合并症的糖尿病患者的临床管理和未来研究具有重要意义。
