Effects of age on complications in adult onset diabetes

The prevalence of diabetes is greatest among older persons, yet few studies have specifically addressed the impact of age on diabetic complications. The present study examines the prevalence of four diabetic complications: retinopathy, peripheral neuropathy, autonomic neuropathy, and hypertension, as well as depression, in older male patients with noninsulin-dependent diabetes. Participants ranged in age from 53 to 80 years. Multiple risk factors, including age, duration of illness, type of treatment, metabolic control, and obesity were evaluated as predictors of these complications using logistic regression. Results suggest a significant increase in the prevalence of retinopathy with aging, independent of the effects of metabolic control, duration of illness, and other risk variables. Age was also related to prevalence of peripheral neuropathy symptoms, hypertension, and impotence. Current metabolic control was significantly associated with retinopathy, peripheral neuropathy, and hypertension prevalence. Time since diagnosis was only independently related to impotence and hypertension. These findings suggest that the increase in many diabetic complications in older persons cannot be wholly accounted for by simple disease status variables, and may result from an interaction of diabetes variables and general age-related changes.