Diabetes Complications May Grow With Age

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Hypoglycemia and heart complications were common health issues for older diabetes patients

December 10, 2013 / Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

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(dailyRx News) As a patient ages and has diabetes longer, the health risks rise. A new study pinpointed what some of these risks may be for diabetes patients 60 and older.

Almost half of the diabetes patients in the US are over the age of 60, and over the next 20 years, that number is expected to double, according to the International Diabetes Federation. As patients age and have diabetes for longer time periods, health complications grow.

According to this new study, hypoglycemia (low blood sugar) and cardiovascular complications topped the list of possible diabetes-related health issues.

"Control your diabetes to lower the risk for complications."

Elbert S. Huang, MD, of the section of General Internal Medicine at the University of Chicago, and his fellow researchers examined rates of diabetes complications and death among 72,310 diabetes patients who were age 60 and older at the start of this study.

After following patients for up to seven years, these researchers discovered that cardiovascular complications (coronary artery disease, congestive heart failure and cerebrovascular disease, which is related to blood flow in the brain) and hypoglycemia were the most common nonfatal complications among older adults with diabetes of short duration (defined as 0 to 9 years).

For example, patients age 70 to 79 with the short-term diabetes had higher rates of coronary artery disease (11.47 per 1,000 person-years) and hypoglycemia (5.03 per 1,000 person-years). In comparison, the risk for other health complications was lower. The rate of end-stage renal disease was 2.6 per 1,000 person-years, of lower limb amputation was 1.28 per 1,000 person-years and of acute hyperglycemic (high blood sugar) events totaled 0.82 per 1,000 person-years.

The researchers observed a similar pattern among patients who had diabetes for a longer amount of time (defined as 10 years or greater).

This group had the highest rates of coronary artery disease (18.98 per 1,000 person-years) and hypoglycemia (15.88 per 1,000 person-years). Again, the risk rates for other complications in this group were lower — 7.64 per 1,000 person-years for end-stage renal disease, 4.26 per 1,000 person-years for lower limb amputation and 1.76 per 1,000 person-years for acute hyperglycemic events.

The rates of all outcomes — particularly hypoglycemia and microvascular complications (small vessel disease) — rose dramatically with longer duration of the disease, the authors of this study wrote.

Cardiovascular complications have long been among the most serious health risks that patients with diabetes face. This research showed that hypoglycemia rates were on par with coronary artery disease, especially among those who had diabetes for a long duration.

“As long-term survivorship with diabetes increases and as the population ages, more research and public health efforts to reduce hypoglycemia will be needed to complement ongoing efforts to reduce cardiovascular and microvascular complications,” the authors wrote.

This study was published online on December 9 in JAMA Internal Medicine. This research was funded by grants from the National Institute of Diabetes and Digestive and Kidney Diseases and a University of Chicago John A. Hartford Centers of Excellence Award.