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Undetected type 2 diabetes in older adults
Rachel Dankner1, Galit Geulayov, Liraz Olmer
1The Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer, Israel. racheld@gertner.health.gov.il
Background:
early detection and prompt treatment of type 2 diabetes mellitus (T2D) may reduce the complications and burden associated with the disease.
Objective:
to evaluate the rate of undetected T2D (UT2D) among older adults who were screened 25 years ago, identify the characteristics of UT2D patients and suggest a high-risk profile most suitable for screening.
Methods:
a cross-sectional study of a group of 623 older adult survivors of 25-year cohort, 53.5% males, aged 58- 93 years in a personal interview on lifestyle habits, morbidity and medication use. Self-administered measurement of subjective health perception. Anthropometric measurements, laboratory examinations of 12-h fasting venous blood and 2-h oral glucose tolerance tests were carried out.
Results:
the prevalence of previously diagnosed diabetes was 18.9% and of UT2D 13.2%. The likelihood of having UT2D was higher for males, those with systolic blood pressure >or=130 mmHg, triglycerides >or=1.7 mmol/l (150 mg/dl) and large waist circumference; all are components of the metabolic syndrome. Compared to known diabetic patients, the undetected were predominantly males, slightly younger, rated their health status more favourably and had less comorbidities.
Conclusion:
a large proportion of older adults with T2D were undiagnosed. Screening efforts for T2D should address those exhibiting characteristics of the metabolic syndrome in a seemingly healthy population of older adults.
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