Undetected type 2 diabetes in older adults

Abstract

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 ≥130 mmHg, triglycerides ≥1.7 mmo/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. © The Author 2008. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.