This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (7)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Aging/ Geriatrics  • Cardiovascular System  • Prognosis/ Outcomes  • Cardiovascular Disease/ Myocardial Infarction  • Diabetes Mellitus  • Congestive Heart Failure/ Cardiomyopathy  • Alert me on articles by topic  Social Bookmarking   What's this?

M. Angelyn Bethel, MD; Frank A. Sloan, PhD; Daniel Belsky, BA; Mark N. Feinglos, MD, CM

Arch Intern Med. 2007;167(9):921-927.

Background  The natural history of type 2 diabetes mellitus (DM) in the elderly has not been previously described in a national longitudinal sample.

Methods  This national longitudinal analysis (January 1, 1991, to December 31, 2004) examines mortality and morbidity rates in a representative sample of elderly patients newly diagnosed as having DM. Medicare beneficiaries diagnosed as having DM in 1994 (n = 33 772) were compared with a control group (n = 25 563) regarding death, lower extremity complications, nephropathy, retinopathy, cardiovascular complications, and cerebrovascular complications.

Results  The DM group had excess mortality of 9.2% by year 11 compared with the control group. By 2004, 91.8% of the DM group experienced an adverse complication compared with 72.0% of the control group. The DM group had a higher prevalence and incidence of microvascular and macrovascular complications at all time points compared with controls. Patients with DM were at increased risk for all lower extremity complications, particularly those requiring surgical intervention (gangrene, debridement, and amputation). Cardiovascular complications were a leading cause of morbidity, with 57.6% of the DM group diagnosed as having heart failure compared with 34.1% of the controls.

Conclusion  Elderly persons newly diagnosed as having DM experienced high rates of complications during 10-year follow-up, far in excess of elderly persons without this diagnosis, implying a substantial burden on the individual and on the health care system.

Author Affiliations: Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Duke University Medical Center (Drs Bethel and Feinglos), and Duke University Center for Health Policy (Dr Sloan and Mr Belsky), Durham, NC.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Thiazolidinediones and cardiovascular outcomes in type 2 diabetes
Singh and Furberg
Heart 2009;95:1-3.
FULL TEXT  

Economic Costs of Diabetes in the U.S. in 2007
American Diabetes Association
Diabetes Care 2008;31:596-615.
ABSTRACT | FULL TEXT  

Preventing and managing diabetic complications in elderly patients
HORNICK and ARON
Cleveland Clinic Journal of Medicine 2008;75:153-158.
ABSTRACT | FULL TEXT  

The Growing Burden of Diabetes Mellitus in the US Elderly Population
Sloan et al.
Arch Intern Med 2008;168:192-199.
ABSTRACT | FULL TEXT  

The Growing Burden of Diabetes Mellitus in the US Elderly Population--Invited Commentary
Vinicor
Arch Intern Med 2008;168:199-199.
FULL TEXT