The burden and treatment of diabetes in elderly individuals in the U.S
Open accessAbstract
OBJECTIVE—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. RESEARCH DESIGN AND METHODS—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. RESULTS—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 HbA1c >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. CONCLUSIONS—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.
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Some older individuals may have developed diabetes years earlier and have significant complications, others are newly diagnosed and may have had years of undiagnosed diabetes with resultant complications, and still other older adults may have truly recent-onset disease with few or no complications.
“Some older individuals may have developed diabetes years earlier and have significant complications, others are newly diagnosed and may have had years of undiagnosed diabetes with resultant complications, and still, other older adults may have truly recent-onset disease with few or no complications (57).”
From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [57]
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- Authors
- Selvin, E., Coresh, J., & Brancati, F. L.
- Affiliations
- Johns Hopkins University (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2006-11-01
- Volume
- 29
- Issue
- 11
- Pages
- 2415-2419
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2039443663
- Cited by
- 261
- References
- 3
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 5 · 2023: 5 · 2022: 10 · 2021: 10 · 2020: 14 · 2019: 13 · 2018: 10 · 2017: 18 · 2016: 19 · 2015: 24 · 2014: 19 · 2013: 18 · 2012: 11
- FWCI
- 9.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32 HL 07024, T32HL007024)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- diabetes prevalence, older adults, undiagnosed diabetes, glycemic control, HbA1c, microvascular complications, macrovascular complications, cardiovascular risk factors, glucose-lowering medications
- MeSH terms
- Adult, Aged, Aged, 80 and over, Blood Glucose, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Health Surveys, Glycated Hemoglobin, Humans, Male, Microcirculation, Middle Aged, Risk Factors, United States, Prevalence, Cost of Illness, Age of Onset
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