Department of Internal Medicine I, University of Lübeck, Lübeck, Germany.
Diabet Med. 2012 Aug;29(8):e176-9. doi: 10.1111/j.1464-5491.2012.03681.x.
Elderly and old patients with Type 1 diabetes represent a growing population that requires thorough diabetes care. The increasing relevance of this subgroup, however, plays only a minor role in the literature. Here, we describe elderly patients with Type 1 diabetes on the basis of a large multi-centre database in order to point out special features of this population.
Data of 64609 patients with Type 1 diabetes treated by 350 qualified diabetes treatment centres were assessed and analysed by age group.
Compared with the age group ≤ 60 years, patients aged >60 years (n=3610 61-80 years and n=377 >80 years old) were characterized by a longer diabetes duration (27.7 vs. 7.7 years), an almost double risk for severe hypoglycaemia (40.1 vs. 24.3/100 patient-years), a lower level of HbA(1c) [60 vs. 67 mmol/mol (7.6 vs. 8.3%)] and higher percentages of microalbuminuria (34.5 vs. 15.6%), diabetic retinopathy (45.2 vs. 8.3%), myocardial infarction (9.0 vs. 0.4%) or stroke (6.8 vs. 0.3%). Elderly patients used insulin pumps less frequently (12.2 vs. 23.8%), but more often used conventional premixed insulin treatment (10.8 vs. 3.8%). Differences between elderly and younger patient groups were significant, respectively.
Diabetes care of elderly patients with Type 1 diabetes involves individualized treatment concepts. Increased hypoglycaemia risk and functional impairment attributable to diabetes-associated and/or age-related disorders must be taken into account.
1 型糖尿病老年和高龄患者代表着一个不断增长的群体，他们需要全面的糖尿病护理。然而，这一亚组的重要性在文献中仅占很小的比例。在此，我们根据一个大型多中心数据库描述 1 型糖尿病老年患者，以指出该人群的特殊特征。
评估和分析了 350 个合格的糖尿病治疗中心治疗的 64609 例 1 型糖尿病患者的数据，并按年龄组进行分组。
与年龄≤60 岁的患者相比，年龄>60 岁的患者（61-80 岁 3610 例，>80 岁 377 例）具有更长的糖尿病病程（27.7 年 vs. 7.7 年）、严重低血糖的风险几乎增加一倍（40.1 例 vs. 24.3/100 患者年）、HbA1c 水平更低[60 例 vs. 67mmol/mol（7.6 例 vs. 8.3%）]、微量白蛋白尿发生率更高（34.5 例 vs. 15.6%）、糖尿病视网膜病变（45.2 例 vs. 8.3%）、心肌梗死（9.0 例 vs. 0.4%）或中风（6.8 例 vs. 0.3%）。老年患者使用胰岛素泵的频率较低（12.2% vs. 23.8%），但更常使用常规预混胰岛素治疗（10.8% vs. 3.8%）。老年患者组和年轻患者组之间的差异具有统计学意义。
1 型糖尿病老年患者的糖尿病治疗需要个体化的治疗方案。必须考虑到与糖尿病相关的和/或与年龄相关的疾病引起的低血糖风险增加和功能障碍。
