Lee Bong Ki, Kim Sang Wook, Choi Daehee, Cho Eun Hee
Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
Endocrinol Metab (Seoul). 2016 Sep;31(3):416-423. doi: 10.3803/EnM.2016.31.3.416. Epub 2016 Aug 26.
The prevalence of type 2 diabetes in elderly people has increased dramatically in the last few decades. This study was designed to clarify the clinical characteristics of type 2 diabetes in patients aged ≥80 years according to age of onset.
We reviewed the medical records of 289 patients aged ≥80 years with type 2 diabetes at the outpatient diabetes clinics of Kangwon National University Hospital from September 2010 to June 2014. We divided the patients into middle-age-onset diabetes (onset before 65 years of age) and elderly-onset diabetes (onset at 65+ years of age).
There were 141 male and 148 female patients. The patients had a mean age of 83.2±2.9 years and the mean duration of diabetes was 14.3±10.4 years. One hundred and ninety-nine patients had elderly-onset diabetes. The patients with elderly-onset diabetes had a significantly lower frequency of diabetic retinopathy and nephropathy, lower serum creatinine levels, lower glycated hemoglobin (HbA1c) levels, and similar coronary revascularization and cerebral infarction rates compared to those with middle-age-onset diabetes. There was no frequency difference in coronary revascularization and cerebral infarction and HbA1c levels between three subgroups (<5, 5 to 15, and ≥15 years) of diabetes duration in elderly onset diabetes. However, both in the elderly onset diabetes and middle-age-onset diabetes, the cumulative incidence of retinopathy was increasing rapidly according to the duration of diabetes.
We report that individuals with elderly-onset diabetes have a lower frequency of diabetic retinopathy and nephropathy and similar cardiovascular complications compared to those with middle-age-onset diabetes.
在过去几十年中，老年人2型糖尿病的患病率急剧上升。本研究旨在根据发病年龄阐明80岁及以上2型糖尿病患者的临床特征。
我们回顾了2010年9月至2014年6月在江原国立大学医院门诊糖尿病诊所就诊的289例80岁及以上2型糖尿病患者的病历。我们将患者分为中年发病糖尿病（65岁之前发病）和老年发病糖尿病（65岁及以后发病）。
有141例男性和148例女性患者。患者的平均年龄为83.2±2.9岁，糖尿病平均病程为14.3±10.4年。199例患者为老年发病糖尿病。与中年发病糖尿病患者相比，老年发病糖尿病患者的糖尿病视网膜病变和肾病发生率显著更低，血清肌酐水平更低，糖化血红蛋白（HbA1c）水平更低，冠状动脉血运重建和脑梗死发生率相似。在老年发病糖尿病患者中，糖尿病病程的三个亚组（<5年、5至15年和≥15年）之间的冠状动脉血运重建、脑梗死和HbA1c水平没有频率差异。然而，在老年发病糖尿病和中年发病糖尿病中，视网膜病变的累积发生率均随糖尿病病程迅速增加。
我们报告，与中年发病糖尿病患者相比，老年发病糖尿病患者的糖尿病视网膜病变和肾病发生率更低，心血管并发症相似。
