Newly diagnosed, insulin-dependent diabetes mellitus in elderly patients

Over a two-year period 398 out of 1776 new referrals to a diabetic clinic were newly diagnosed diabetic patients aged 65 years and over. Initial treatment of this group was diet--122 (31%), diet plus oral hypoglycaemic agents--232 (58%) and diet plus insulin--41 (10%). Sixteen (39%) of the group treated initially with insulin died within 3.5 years of diagnosis compared with 21% of the 345 patients treated with diet +/- oral hypoglycaemic agents who were followed for this time. Twenty-five patients treated initially with insulin survive but 8 have stopped insulin and are treated with diet +/- oral hypoglycaemic agents, and a further 5 had a period of 6-24 months on oral therapy. Twelve patients have been treated with insulin continuously but of these only 3 are clearly insulin-dependent. These data suggest that true dependence on insulin is uncommon in patients aged 65 years or over at diagnosis.